Wisdom Teeth Post-Op Instructions

AFTER SURGERY: Hold light pressure on the gauze by biting down for 30-45 min. The purpose of the gauze is to create pressure on the socket so that a blood clot will form. Talking and jaw movement should be kept to a minimum, so that pressure on the surgical area is continuous. Do not probe the area with any objects or your fingers. After 30-45 min, remove the gauze and look at the surgical site, if you do not see blood continuously pouring from the socket (active bleeding), you do not need to use any more gauze. Oozing and blood in the saliva is normal, you do not need to use gauze for that. Please DO NOT SMOKE for at least 48 hours, since it is very detrimental to healing.

BLEEDING: Intermittent bleeding, oozing, and blood in your saliva is normal for a few days after the procedure. Active bleeding can be controlled by placing fresh *MOISTENED* gauze over the surgical areas and biting down firmly for an additional 30-60 minutes. Bleeding should never be severe. If it is, that usually means that the packs are being clenched between your teeth rather than exerting pressure on the surgical areas. Try repositioning fresh moist gauze packs over the surgical areas. If active bleeding persists or becomes heavy, you may substitute a moist tea bag (soaked in warm water, squeezed damp-dry and wrapped in moist gauze) and biting down for 20 or 30 minutes. If bleeding remains uncontrolled, please call our office.

SWELLING: Often there is swelling associated with oral surgery. You can minimize this by using a cold pack or ice bag wrapped in a towel and applied firmly to your cheek adjacent to the surgical area. This should be applied twenty minutes on and twenty minutes off during the first 12 to 48 hours after surgery. Your swelling may peak 2-3 days after the surgery and will begin to subside 3-4 days after the surgery. In some cases, discoloration, or bruising of the skin follows swelling. This is a normal post-operative occurrence, which may occur 2-3 days post-operatively. Moist heat applied to the area 48 hours after surgery may speed up the removal of the discoloration.

PAIN & MEDICATION: Unfortunately most oral surgery is accompanied by some degree of discomfort. The best way to manage pain is to start the first dose of ibuprofen(preferred) or tylenol before the anesthetic has worn off. You may alternate ibuprofen and tylenol every 3 hours to maximize pain control. To do so, you would take a dose of medication every 3 hours. For example- If your first dose of ibuprofen is at 12:00, you would take tylenol at 3:00, ibuprofen at 6:00, and tylenol at 9:00, and so on. We recommend that you follow this schedule for at least 3 days after surgery or until you feel it is no longer needed. Do not take more than 4,000mg of tylenol or 3,200mg of ibuprofen in a 24hr period! If you have pain that is not controlled with over the counter pain medication you may have what we call “breakthrough pain”. You will receive a prescription for a small amount of opioid pain medication (Norco, Percocet, Tramadol) Use the opioid pills if you are experiencing breakthrough pain. Continue taking ibuprofen while taking the opioid pain medication. Discontinue taking tylenol, as the opioid contains tylenol. It is extremely important that if you take the opioid pain medication, you eat something beforehand to avoid nausea. Any antibiotics (penicillin, erythromycin, etc.) should be taken until gone. Pain medication should only be taken as prescribed to relieve discomfort. Remember, narcotic based pain relievers can cause drowsiness and decreased coordination. You should refrain from driving or using alcohol and other sedative-type drugs while using them. You will start the PERIDEX RINSE the day after your surgery. Remember, no vigorous swishing or spitting. Use rinse for 2 weeks after surgery and discontinue.

NAUSEA: Nausea is not an uncommon event after surgery, and it is sometimes caused by stronger pain medicines. Nausea may be reduced by preceding each pill with a small amount of soft food, then taking the pill with a large volume of water. Try to keep taking clear fluids and minimize the pain medication, but call us if you do not feel better or if repeated vomiting is a problem.
DIET: For the first few days we recommend soft foods such as: scrambled eggs, mashed potatoes, cooked pastas like macaroni and cheese, etc. Avoid foods like crispy/crunchy items for about 2 weeks and things like nuts, seeds, popcorn, etc., that may get lodged in the socket areas, until they are completely healed over. Over the next several days you can progress to solid foods at your own pace.

DRY SOCKET: Dry socket can occur if the blood clot in an extraction site is dislodged or doesn’t form. The best ways to avoid dry socket are: No vigorous swishing, spitting, sucking through a straw, or smoking. Avoid any kind of suction in the mouth to prevent the blood clot from being dislodged for 7 to 10 days.

SHARP EDGES: If you feel sharp edges in the surgical areas with your tongue it is probably the bony walls which originally supported the teeth. Occasionally small slivers of bone may work themselves out during the first week or two after the surgery. They are not pieces of tooth. If necessary, we will remove them. Please call our office if you are concerned.

BRUSHING: Begin your normal oral hygiene routine as soon as possible after surgery. Soreness and swelling may not permit vigorous brushing of all areas, but please make every effort to clean your teeth within the bounds of comfort.

BITE: It is not uncommon for the bite to feel “different”, or that the lower teeth have “shifted” following surgery. This is usually due to stiffness in the muscles resulting in a slight repositioning of the lower jaw or release of pressure on the adjacent teeth and thus a change in the way the teeth meet. This situation generally returns to normal in 1-2 weeks.

ACTIVITY: Take it easy the first few days after surgery. It is important to get plenty of rest and avoid strenuous activity especially during the first 48 – 72 hours. You may gradually return back to your normal activities after 3-4 days. If you do not see steady improvement 4-5 days after surgery, don’t suffer needlessly. Some indicators that you may have post-operative problems which should be looked at are: persistent pain and swelling after the first 3-4 days, persistent jaw stiffness, and repeated active bleeding or discharge from the surgical site. Call the office and report symptoms so you can be seen as soon as possible.

HAVING PROBLEMS? Contact Dr. Lee during office hours at 740-432-8768. After hours Dr. Lee may be reached on his cell phone at 740-607-3370.