Most problems that patients face after surgery are related to pain and swelling, bleeding or oozing, dietary difficulties, or medication-related side effects. We have attempted to provide some helpful hints that you may use to minimize any post-surgical difficulties and make your experience as pleasant as possible. If you have any questions, please call our office.
Bleeding
Bleeding is common to some degree in the first 24 hours. Your bleeding should stop within 4 hours after surgery. Oozing and episodes of occasional bleeding may occur for up to 1–2 weeks, and you should not be alarmed. Usually, simple pressure with a wet, rolled gauze pad over the extraction site will stop the bleeding when applied for about 45 minutes to 1 hour. Remove the gauze after about 1 hour and replace it if the bleeding persists. A tea bag is often more effective in stopping the bleeding. If bleeding persists, the tea bag may be used like a gauze pad. Take the staple out of the tea bag, dampen it, roll it up, and place it over the extraction site. Bite on the bag for 45 minutes to 1 hour.
Swelling and Bruising
It is common to swell and bruise. Swelling is usually at its worst 48–72 hours after the surgery, and then it begins to improve. Bruising may occur over a few days and resolve within 2 weeks. Ice helps. Apply ice to your face over the surgical areas for about 20 minutes on and 20 minutes off over the first 24 hours.
Pain
Each person experiences pain in a different way, and what may seem like a minor procedure to one person may be very objectionable to another. Although pain may persist for a few days to some degree, it always seems to get better. If your pain does not improve, you may be developing a dry socket. A dry socket is a condition that may develop when the clot in an extraction site breaks down and leaves behind a painful socket that may need to be treated with medicated gauze in the office. Please call us if you are concerned that you may be experiencing unusual discomfort.
Warm saltwater rinses help muscle stiffness and pain. Mix a ½ teaspoon of salt in an 8-ounce glass of warm water (as warm as possible without burning yourself). Swish over the extraction site(s) and spit 3–4 times per day for 1 week starting the morning after your surgery. Avoid smoking! Do not use straws, and do not use a Waterpik®.
Take over-the-counter ibuprofen (200 mg) every 6 hours for 3–4 days or the prescribed anti-inflammatory medication. Call us if you develop any nausea, stomach cramps, upset stomach, or notice blood in your stool.
You have been prescribed narcotic pain medication. Take this medication as prescribed on that bottle if necessary.
Infection
Continue to take any antibiotics as prescribed. Unusual swelling or discharge may mean that you have an infection. Please note that your healing wound will appear whitish-grey. A slight elevation in temperature after surgery is common in the first 24 hours and does not necessarily signify an infection.
Brush your teeth. Your teeth need to be clean to help prevent an infection. Use a toothbrush, softened under warm water, and brush gently around the teeth next to your extraction sites. A little bleeding with brushing is common.
Diet
After your surgery, it will be difficult to eat. Hot, spicy foods and sharp particulate foods are especially difficult to chew and may irritate a wound or tooth socket. Softer, bland foods are the best to eat. Jell-O®, cottage cheese, ice cream, scrambled eggs, mashed potatoes, soft fish, apple sauce, macaroni and cheese, ground beef in small pieces, yogurt, and well-cooked vegetables are some examples.
You may try more substantial foods as the wounds begin to heal a few days after surgery. Be sure to use care when eating while your mouth is numb. You may expect to be numb from 2 to 12 hours depending on the anesthetic used.
Stitches
We may use dissolving or non-dissolving sutures. The sutures may untie, fall out, or dissolve in a few hours, a few days, or a week. Do not be alarmed by this. We usually remove them at your follow-up visit. They usually do not need to be present for more than a few hours.
Medications
Medications and general anesthetic agents may cause nausea and have undesirable effects. Take your medications with food if they upset your stomach, and please call us if you have any questions.
If you were provided an irrigation syringe because you had your lower wisdom teeth removed, please start using it 5–7 days after surgery.
Please review these tips for the safe use and proper disposal of prescription medications.
If you have any questions or concerns, please feel free to call our office at (360) 293-2808. Our after-hours emergency number is (360) 647-4027.
Post-Operative Instructions:
Wisdom Teeth Removal
The following will cover important information regarding proper post-surgical care for a dental extraction. If you have had a tooth extracted, it will be important to follow these instructions exactly as we present them.
Discomfort is normal after the extraction of teeth. If you are not allergic or intolerant to nonsteroidal anti-inflammatory drugs, start taking ibuprofen (also known as Advil® or Motrin®) as instructed by your doctor at the time of your surgery. If you are asthmatic, do not take ibuprofen unless you have tolerated it in the past.
Gauze pad(s) should be placed directly over the extraction site(s) and held in place with firm biting pressure; the pressure from biting is what helps to stop the bleeding. Replace the gauze pad(s) about every 25 minutes. When the gauze pads have little or no blood on them, they are no longer necessary. The amount of bleeding will vary from person to person. Most of your bleeding will slow within 3–4 hours, but a small amount of bleeding is common for up to 24 hours. Please do not spit after surgery as it can prolong bleeding.
Do not rinse on the day of surgery; it may prolong your bleeding. Begin saltwater rinses the day after surgery and continue for 1 week. Rinse with warm salt water 3–4 times each day. To make the saltwater solution, dissolve a ½ teaspoon of salt in a small glass of warm tap water. Swelling is normal after surgery and may be a cause of post-extraction discomfort.
Swelling typically peaks by the third or fourth day and then starts to resolve; it can be reduced by the use of an ice pack. Apply the ice pack to the side of your face for 10 minutes; transfer it to the opposite side for another 10 minutes. Continue icing the face for the first 24 hours. Do not freeze the skin. Ice packs are most useful for the first 24 hours. Also, keep your head elevated on 2 pillows for 3–4 days. These measures will not eliminate swelling, but they will help to reduce its severity.
To allow blood clots to form undisturbed, do not eat for 1 hour after surgery. Gradually ramp up your diet as tolerated. Always cool down any hot foods or liquids during the first 24 hours. You should eat soft foods for the first week: for example, soups, eggs, mashed potatoes, and meatloaf are fine. To help prevent dry socket, do not use a straw for the first 3 days after surgery.
Begin brushing your teeth the day after surgery. It is important to brush all of your teeth, even if the teeth and gums are sensitive. Bacterial plaque and food accumulation near the extraction site will delay healing. Do not smoke for at least a week. Smoking may increase your bleeding, impair healing, and cause a dry socket.
Unless told otherwise, do no vigorous physical activity for 5 days following your surgery. Physical activity increases your blood pressure, which will cause an increase in your swelling, pain, and bleeding. You may gradually increase your activity, such as jogging or tennis, 5–7 days after your surgery.