Surgical Instructions

After Dental Extractions / Removal of Wisdom Teeth

Post-operative Instructions following:
Dental Extractions, Removal of Impacted Wisdom Teeth, General Anesthesia, or Intravenous Sedation

Please take a moment to read these instructions.
Please ask for clarification if you have any questions.

Immediately After Surgery – “PROTECT THE BLOOD CLOT”

Bite on gauze for at least 45 minutes
No talking
No spitting
Carefully drink a room-temperature or colder beverage (carbonated or soda preferred)
Do not drink with a straw
Avoid hot liquids
Avoid alcoholic beverages
No smoking
Elevate your head
Apply ice packs to the side of your face 30 minutes on and 30 minutes off – Do not apply ice directly on your skin

During the First 24 to 48 Hours After Surgery:

Bleeding
Continue to follow the instructions listed above to “Protect the Blood Clot”. Change the gauze if it becomes saturated or every hour. If the bleeding persists, bite of a tea bag for 30 minutes. You may remove the gauze when the bleeding stops.
A small amount of bloody saliva is normal for the first 48 hours after surgery. (Hint: cover your pillow with a towel to prevent blood stains)

Swelling
Keep your head elevated (you can use some extra pillows)
Use ice packs for 24 to 48 hours (30 minutes on, 30 minutes off). Stop using ice after 48 hours. Swelling usually peaks between on the second or third post-operative day.

Discomfort / Pain
Take the prescribed medication as directed for pain relief. Do not take any medication on an empty stomach, especially pain medications.
The post-operative pain is typically most severe after the local anesthesia wears off and gradually lessens within the first 8 hours.
Even if you have no post-operative pain, we recommend you take ibuprofen 400 mg by mouth every 4 hours for the first 48 hours after surgery (only if you are not allergic or hypersensitive to the medication).

Oral Hygiene
You may gently brush your teeth during the first 24 hours. After the first day you can follow your usual oral hygiene routine. You can gently rinse your mouth with salt water after bleeding has ceases.

Nausea and Vomiting
Nausea and vomiting usually occurs after swallowing blood and due to medications. Small sips of a carbonated beverage (Coke or Pepsi) will help to ease an upset stomach. Even if you are nauseated, continue drinking clear liquids to prevent dehydration.
If nausea persists, only take ibuprofen or Tylenol for pain relief. Once nausea ceases you should resume your medications as directed. If nausea and/or vomiting persists, please call the doctor for further directions.

The Post-Operative Period 48 Hours and Beyond

Swelling
After the swelling peaks (the third day after surgery) stop using ice and begin applying warm moist heat.

There are a number of ways to apply heat to the face and extraction sockets:

Let warm water wash over your face in the shower
Use a soaked warm-to-hot washcloth over the swollen area
Use warm salt water rinses. Hold the water inside your mouth over the surgical sites for five minutes five times a day

Pain / Irritation
Avoid clenching or grinding your teeth. Do not “Play” with the surgical areas as this can create pain in the surgical sites.
If the pain initially improves but then suddenly becomes severe, you may have a “dry socket”. You should call the office for instructions and possibly schedule an appointment to have a dressing placed in the socket.

The corners of you mouth may become irritated. Apply lip balm and the inflammation should resolve in a few days.

The may be some prolong pain and difficulty opening your jaw and difficulty chewing. Your jaw joints (TMJ) located in front of your ears may be sore or stiff. This is expected and should readily improve. Modify your diet by eating soft foods. The jaw joints and muscles need the exercise associated with chewing to work out the soreness.

The teeth adjacent to the surgical sites may be sensitive to hot and/or cold. This usually rapidly improves but can last longer.

Bruising
Bruising may occur in the cheeks and underneath the jaw line. As the bruising resolves it will change color to green or yellow, will migrate down the neck, and will occasionally be seen on the upper chest. This is normal so do not become alarmed.

Fever
If a fever (oral temperature greater than 101 degrees) occurs after the initial 48 hours following surgery, please call the office immediately for further instructions.

Dizziness
If you feel dizzy or faint, lie down immediately with your legs and feet elevated. Once the dizziness resolves you should get up very slowly.

Intravenous Site
The intravenous site in the hand or arm may develop a painful bump that can persist up to a month following surgery. Also a cord-like lump running up the arm with associated red streaking may occur. These are normal reactions to IV medications. Please contact the office if you have and concerns.

Persistent Numbness
With lower teeth removal there is a chance of persistent numbness to the lower lip, chin, teeth, or tongue. If this occurs please call the office to speak to the doctor.

Stitches
The stitches placed at the surgical site are dissolvable (unless otherwise specified by the surgeon), may fall out on their own, or occasionally may be present up to two weeks following surgery. The surgeon may decide to remove the stitches if they become a source of irritation.