Surgical Instructions


Locations

Northwest Office

Henderson Office

Southwest Office

702-360-8918

After Wisdom Tooth Removal

The removal of impacted teeth is a serious surgical procedure. Post-operative care is very important. Unnecessary pain and the complications of infection and swelling can be minimized if the instructions are followed carefully.

Immediately Following Surgery

  • The gauze pad placed over the surgical area should be kept in place for a half hour. After this time, the gauze pad should be removed and discarded.  If the area is still oozing replace the gauze placing it over the surgical area.  (Not just between the teeth.  Firm pressure must be placed to the surgical area).
  • Vigorous mouth rinsing or touching the wound area following surgery should be avoided. This may initiate bleeding by causing the blood clot that has formed to become dislodged.
  • Take the prescribed pain medications as soon as you begin to feel discomfort. This will usually coincide with the local anesthetic becoming diminished.  Make sure you eat before taking ANY pain medications or it will increase the likelihood of nausea/vomiting.
  • Restrict your activities the day of surgery and resume normal activity when you feel comfortable.
  • Place ice packs to the sides of your face where surgery was performed.  Place ice packs (wrapped in a towel) on for 15 minutes/off for 15 minutes, while awake for the first 36 hours following surgery. 
  • DO NOT rinse vigorously, suck on straws, smoke, drink alcohol or brush your teeth following your extraction. 

Bleeding

  • A certain amount of bleeding is to be expected following surgery. Slight bleeding, oozing, or redness in the saliva is not uncommon. Excessive bleeding may be controlled by first rinsing or wiping any old clots from your mouth, then placing a gauze pad over the area and biting firmly for thirty minutes. Repeat if necessary. If bleeding continues, bite on a moistened tea bag for thirty minutes. The tannic acid in the tea bag helps to form a clot by contracting bleeding vessels. If bleeding continues, rinse vigorously with hydrogen-peroxide for 30 seconds, SPIT and QUICKLY replace the gauze or tea bag.  Again, it is not abnormal to continue to ooze for the first 24 hours after surgery.  To minimize further bleedinding, do not disturb the area and avoid exercise.

Swelling

  • The swelling that is normally expected is usually proportional to the surgery involved. Swelling around the mouth, cheeks, eyes and sides of the face is not uncommon. This is the body's normal reaction to surgery and eventual repair. The swelling will not become apparent until the day following surgery and will not reach its maximum until 2-3 days post-operatively. However, the swelling may be minimized by the immediate use of ice packs. Two baggies filled with ice, or ice packs should be applied to the sides of the face where surgery was performed.
  • The ice packs should be left on continuously while you are awake (15 minutes on, 15 minutes off).  After 36 hours, ice has no beneficial effect. If swelling or jaw stiffness has persisted for several days, there is no cause for alarm. This is a normal reaction to surgery. Thirty-six (36) hours following surgery, the application of moist heat to the sides of the face is beneficial in reducing the size of the swelling.

Pain

  • For mild to moderate pain, one or two tablets of Tylenol may be taken every four hours OR Ibuprofen, (Motrin or Advil) two-four 200 mg tablets may be taken every 4 hours.
  • For moderate to severe pain, take the tablets prescribed as directed. The prescribed pain medicine will make you groggy and will slow down your reflexes. DO NOT drive an automobile or work around machinery. Avoid alcoholic beverages. Pain or discomfort following surgery should subside more and more every day after the 2nd to 3rd post-operative day. If pain persists, it may require attention and you should call the office at 702-360-8918.

Diet

  • After general anesthetic or I.V. sedation, liquids should be initially taken. Do not use straws for 2 weeks after surgery. Drink from a glass. The sucking motion can cause more bleeding by dislodging the blood clot. You may eat anything soft by chewing away form the surgical sites. It is very important to eat normally to keep up your strength and to promote healing. 
  • NO RINSING of any kind should be performed until the day following surgery.  You can brush your teeth the night of surgery but rinse gently.  The day after surgery you should begin rinsing 5-6 times a day especially after eating, with a cup of warm water mixed with a teaspoon of salt.

Discoloration/Bruising

  • In some cases, discoloration of the skin follows swelling. The development of black, blue, green, or yellow discoloration is due to blood spreading beneath the tissues. This is a normal post-operative occurrence, which may occur 2-3 days post-operatively. Moist heat applied to the area may speed up the removal of the discoloration.

Antibiotics

  • If you have been placed on antibiotics, take the tablets or liquid as directed until gone. Antibiotics may be given to help prevent infection. Discontinue antibiotic use in the event of a rash or other unfavorable reaction. Call the office at 702-360-8918 if you have any questions.

Nausea and Vomiting

  • In the event of nausea and/or vomiting following surgery, DO NOT take anything by mouth for at least an hour including the prescribed medicine. You should then sip on water, tea or ginger ale. You should sip slowly over a fifteen-minute period. When the nausea subsides you can begin taking solid foods and the prescribed medicine.

Other Complications

  • If numbness of the lip, chin, or tongue occurs there is no cause for alarm. As stated before surgery, this is usually temporary in nature. You should be aware that if your lip or tongue is numb, you could bite it and not feel the sensation. So be careful. Call the office if you have any questions.
  • Slight elevation of temperature immediately following surgery is not uncommon. If the temperature persists, notify the office. Tylenol or Ibuprofen should be taken to reduce the fever.
  • You should be careful going from the lying down position to standing. You were not able to eat or drink prior to surgery. It was also difficult to take fluids. Taking pain medications can make you dizzy. You could get light headed when you stand up suddenly. Before standing up, you should sit for one minute then get up.
  • Occasionally, patients may feel hard projections in the mouth with their tongue. They are not roots, they are the bony walls which supported the tooth. These projections usually smooth out spontaneously. If not, your surgeon can remove them.
  • If the corners of your mouth are stretched, they may dry out and crack. Your lips should be kept moist with an ointment such as Vaseline.
  • Sore throats and pain when swallowing are not uncommon. The muscles get swollen. The normal act of swallowing can then become painful. This will subside in 2-3 days.
  • Stiffness (Trimus) of the jaw muscles may cause difficulty in opening your mouth for a few days following surgery. This is a normal post-operative event which will resolve in time.

Finally

  • Sutures are placed the area of surgery to minimize post-operative bleeding and to help healing. Sometimes they become dislodged, this is no cause for alarm. Just remove the suture form your mouth and discard it. The sutures will be removed approximately one week after surgery. In some instances dissolvable sutures are used an will not need to be removed.  The removal of sutures requires no anesthesia or needles. It takes only a minute or so, and there is no discomfort associated with this procedure. 
  • There will be a cavity where the tooth was removed.  The cavity will gradually over the next month fill in with new tissue.  In the mean time, the area should be kept clean especially after mealswith salt-water rinses or a toothbrish. 
  • Your case is individual, no two mouths are alike. Do not accept well intended advice from friends. Discuss your problem with the persons best able to effectively help you: Drs. Johnson, Holtzen and Paul, or your family dentist.
  • Brushing your teeth is okay - just be gentle at the surgical sites.
  • A dry socket is when the blood clot gets dislodged prematurely from the tooth socket. Symptoms of pain at the surgical site and even pain to the ear may occur 2-3 days following surgery. Call the office if this occurs.
  • If you are involved in regular exercise, be aware that your normal nourishment intake is reduced. Exercise may weaken you. If you get light headed, stop exercising.