After Extractions & Wisdom Teeth Removal

Printable Instructions

Instrucciones de cuidado en el hogar para la extracción

Please follow these instructions after surgery to help promote healing, prevent complications and make yourself comfortable. You should be feeling better in about 2-5 days.

Important Information

  • A blood clot should will form in the extraction site which is normal. Be careful to protect it
  • If you were given an irrigating syringe and instructions, start using it 5 days after surgery
  • Healing is slower and more swelling is expected for the removal of impacted teeth
  • Don’t smoke after surgery. It slows healing and lead to a dry socket

Bleeding

A gauze pack was placed on the extraction site(s) to limit bleeding and help a blood clot form. Gauze is only needed if there is active bleeding, which typically lasts about 2-3 hours. Change the gauze every 30 minutes by folding it into a square, moistening with clean water, placing it over the site and biting down with firm pressure. Keep doing this until active bleeding stops; about 2-3 hours. Don’t chew on the pack. The gauze will always have some blood on it, but is no longer needed if active bleeding has stopped.  If heavy bleeding continues after 4-5 hours, please call the office for assistance.

Medications

If you were given prescription medications, start taking them the day of your procedure, unless otherwise instructed. Use ibuprofen or another NSAID as your primary pain controller for the first 3 days every six hours. This will help with pain and swelling. Don’t take it if you are allergic or your primary care doctor says otherwise. Narcotic pain medications are optional and only needed for severe pain. It is okay to take NSAID’s and narcotics at the same time. If you were prescribed antibiotics, start them right away and finish all of them to prevent infection and promote healing. When taking antibiotics, please use probiotics to avoid stomach and intestine problems.

Anesthesia

The length of time you experience numbness varies, depending on the type of local anesthetic you received. While your mouth is numb, be careful not to bite your cheek, lip or tongue. The numbness should wear off in about 24 hours. If you’ve had IV sedation, walk with some assistance for the first 12 -18 hours to avoid falls and no driving for 24 hours.

Swelling

Swelling is expected after surgery and peaks in about 3 days, then slowly resolves for 7-10 days. Sometimes it’s hard to open your mouth fully during this time. This is all normal and should get better. To help reduce swelling and pain, apply an ice pack immediately after surgery to your face/jaw —30 minutes on and 30 minutes off—for 24-48 hours. When using an ice pack, cover it with a cloth to avoid skin irritation. Also sleep with your head elevated about 30 degrees (2-3 pillows) for the first two nights after surgery. After 72 hours, ice isn’t helpful anymore.

Oral Hygiene/Wound Care

Starting the night of surgery, rinse your mouth with warm salt water six times a day, especially after meals. Do this for 7 days or longer.  To make, mix 8oz. of warm water with ½ teaspoon of salt or use a disposable water bottle and add the salt to it. Brushing and flossing is okay, but avoid the surgical areas. Refrain from smoking as this will delay healing and lead to complications. The sutures are dissolvable and will come out on their own about 2-6 days after surgery. Take is easy after surgery and avoid exercise and strenuous activities for about 3 days.

Diet

After surgery, begin drinking clear liquids first, to make sure your stomach is settled, then progress to softer foods as tolerated. It usually takes about 4-5 days to return to a normal diet, but really varies depending on surgery. Avoid hot liquids until the numbness wears off, chewing over your surgical site and straws for the first 72 hours. Also avoid alcoholic beverages for the first 3 days. If you are troubled by nausea and vomiting, call our office for advice.

Food suggestions:

Food
Soups – cooled
Eggs
Cottage Cheese
Yogurt or Ice Cream
Pasta
Potato – mashed or baked
Macaroni and Cheese
Applesauce

Drinks (No Straws!)
Fruit Juice: apple or grape
Sodas
Milk shakes
Iced tea
Gatorade
Water
Protein Drinks

Complications

If any of the following occur, please call the office:

  • Uncontrolled pain or if pain persists after 3 days which isn’t getting better
  • Severe bleeding
  • Fever over 101.5 F
  • New swelling and pain that starts after 4 days
  • Persistent nausea or vomiting

Questions or Concerns

We can be reached 24 hours a day and seven days a week at (503) 581-0223

Frequently Asked Questions

What Will I Feel Like after Wisdom Teeth Removal Surgery?

On the first day after surgery, you may experience some minor bleeding and pain. You should cover your pillowcase with something so that you don’t get any blood on it. Each individual’s reaction to surgery varies, and the sensation of pain can range from mild discomfort to severe pain.

A variable amount of swelling can be expected following the surgery. This swelling usually peaks on the second day and should begin resolving on the third day. You can limit the amount of swelling you will have by using ice for the entire first day.

The more ice you use the first day, the less swelling you are likely to have on the second day. Please remember to put ice on the first day even if it is somewhat uncomfortable to have a cold next to your skin.

On the third day, you will notice that your jaw muscles are stiff, and it is difficult to open your mouth normally. You can apply moist heat to your face on the second and third day allowing your muscles to relax more and open wider. Most of the time you will want to limit your activities for a few days.

We ask that you follow your post-operative instructions closely. Doing so will make you as comfortable as possible during the first few days following your procedure. Please allow time for your body to begin healing before resuming an active social, academic, or athletic schedule. Most patients feel like they are over the hump and on their way to recovery in 3 to 5 days.

Are There Any Problems after the Extraction of Wisdom Teeth?

As with any medical procedure, there can be complications or an unanticipated result. Some complications that patients undergoing Wisdom Tooth Extraction may experience include: Damage to the sensory nerve that supplies sensation to the lips and tongue, sinus communication, infections, and dry sockets.

After the procedure, our assistants will review your post-operative instructions with your escort. We ask that you follow these instructions closely, as they will make you most comfortable following your procedure. If you were sedated, you will be comfortable and drowsy when you leave the office.

Most patients prefer to go home and rest with no other physical or scholastic activities planned for a few days. With any medical procedure, there can be unexpected results. These can include delayed healing, infection, and post-operative numbness or tingling in your lip, chin, or tongue. The oral surgeon will review relevant post-operative events with you and answer any questions during your office visit.

Do You Want Your Wisdom Teeth Removed?

If your wisdom teeth are causing you pain or you want to avoid future problems, contact our office to schedule an appointment.

Call us: 503-581-0223
A representation of numbness caused by damage to a sensory nerve

Damage to Sensory Nerve:

A primary concern is a nerve within the lower jaw bone that supplies feeling to the lower lip, chin, and tongue. This nerve is frequently very close to the roots of the lower wisdom teeth. Having these teeth out between the ages of 12 and 18 usually provides shorter roots so that the nerve is not so close to the roots of these teeth. Occasionally, when the teeth are removed, and especially in older patients, the nerve can become injured. When local anesthesia wears off, you may experience a tingling or numbing sensation in the lower lip, chin, or tongue. Should this occur, it is usually temporary and will resolve gradually over a period of weeks or months. On rare occasions it can result in a permanent alteration of sensation similar to having local anesthesia. We feel that you should be aware of this possibility before consenting to surgery.

A diagram showing the opening that can occur between your mouth and sinuses

Sinus Communication:

The upper wisdom teeth are situated close to your sinuses, and their removal can result in an opening between your mouth and the sinus. Once again, if the teeth are removed at an early age, the root formation is minimal, and this complication is very unlikely. However, if it does occur, it will usually close spontaneously, but we may give you special instructions to follow, such as avoid blowing your nose for two or three days following the surgery. You can wipe your nose, but don’t blow your nose. If you have to sneeze, you should sneeze with an open mouth into a tissue. Pressure should not be created in the sinus area, which may dislodge the healing blood clot. If you sense this condition occurring after the surgery, please contact the office. An additional procedure may RARELY be necessary to close the opening.

A visual of dry socket that developed after the removal of wisdom teeth

Dry Sockets:

Dry sockets continue to be the most common problem people experience following dental surgery. They arise due to premature loss of a blood clot in the empty tooth socket. This seems to occur with greater frequency in people who smoke or are taking birth control pills. While both jaws can be affected, they usually occur in the lower jaw on the third to fifth day. They cause a deep, dull, continuous aching on the affected side(s). Patients may first notice the pain starting in the ear radiating down towards the chin.

The symptoms frequently begin in the middle of the night, and your pain medication regimen may not help. Treatment can involve changing your prescription. Occasionally it is helpful to place a medicated dressing in the empty tooth socket. This will help decrease the pain and protect the socket from food particles. The effectiveness in alleviating the pain lasts for 24-48 hours and may require dressing changes every day or two, for five to seven days. Dressings usually are removed when you have been pain-free for 2 to 3 days.

The dressing doesn’t aid in healing. The only reason to place a dressing is for pain control. If medication is controlling the pain, the socket will heal without a dressing. Following removal of the dressing, an irrigation device may be provided to help you to keep food particles from lodging in the extraction site.

A diagram depicting an infection that occurs after wisdom teeth removal

Infection:

Occasionally, post-operative infections occur. This usually requires an office visit and clinical examination. Many times, just placing you on an antibiotic for one week will take care of the infection. If it persists, the area will have to be drained and cleaned. Other temporary problems you may experience in the post-operative period include stiffness of the jaws, chafing around the corners of your lips, facial bruising, and blood oozing from the extraction sites. The post-operative instruction sheet we will provide should answer many of the questions related to these more common concerns. If not, don’t hesitate to call the office at Oral Surgery Office in Salem Phone Number 503-581-0223.