Wisdom Teeth: Instructions Following Oral Surgery

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Medications

You will have received a prescription for a pain medication and possibly an antibiotic. Take these medications as prescribed.

Pain

Post-operative discomfort is a normal response to any surgical procedure. The local anesthetic or freezing administered during your surgery will probably last from two to six hours and may last up to twelve hours. It is advisable to take the prescribed pain pills soon after your surgery. As long as discomfort continues, use your pain medications as prescribed. The discomfort usually peaks in the first 48 hours. If in fact the pain is increasing after this period of time, please contact this office for further instructions.

Please Note: Pain medications taken on an empty stomach often result in an unsettled feeling and /or nausea and vomiting. Please attempt to take food or fluids with your pain tablets or as soon after as possible.

Bleeding

It is normal to bleed or ooze for some time following oral surgery. It is not unusual to have blood on the pillow or see streaks of blood in the saliva for 3-4 days after surgery. To control bleeding using the supplied gauze, bite down with firm, constant pressure directly over the surgical site. Change the gauze every 30 minutes. Once the bleeding is minimal, the gauze may be removed. Ensure that the gauze is removed prior to going to bed for the night. It is not unusual to taste blood for a few days. Avoid spitting.

If the bleeding is excessive, (i.e. the gauze soaked with blood every 5 minutes): rinse mouth with warm water; wipe away old blood with clean gauze; bite down on a gauze-wrapped (one layer only) tea bag (non-herbal, containing caffeine) directly over the surgical site. Bite down with constant pressure for 45-60 minutes. Repeat if necessary. If heavy bleeding persists, call our office.

If the oozing or bleeding continues the following day, then simply re-apply firm gauze pressure as directed above. If gauze packs are not available, then a clean cloth folded as a pack or a tea bag may be used as a substitute. Again, while applying pressure, do not “chew” the gauze, but rest quietly with firm pressure and with your head elevated slightly.

Facial Swelling and Stiffness

This occurs following nearly all extractions and oral surgery. This is nature’s way of helping the healing process by splinting and resting the surgery area. The swelling is at its peak on the second day following surgery and begins to disappear on the fourth day.

Apply an ice pack to the jaw immediately upon your return home. Alternate 15 minutes on and 15 minutes off for the next 48 hours WHEN AWAKE. After 48 hours, moist heat to the jaw will likely increase comfort. Remember, swelling usually peaks 2 days following your surgery, and could last up to one week. It is not uncommon to experience moderate bruising of the facial tissues. This will resolve on its own over time. Return of normal jaw movement may take up to 2-3 weeks.

Infection

Post-operative infections are rare. Signs of infection may include: sudden increase of swelling, elevated temperature, and feeling ill. If this should occur, please contact our office.

A slight postoperative temperature elevation for 2-3 days is normal following surgery and anesthesia. Careful attention to oral hygiene will greatly reduce the possibility of infection.

Bruising

Moderate bruising of the facial tissues following oral surgery or extractions is not uncommon. The bruising may appear as a dark purple to a greenish yellow color. Normally the bruising will disappear in seven to ten days. Gentle massage with a hot face towel applied to the area for fifteen minutes each waking hour will aid in a gradual return to normal coloration.

Diet and Nutrition

Day of Surgery: cool soft foods are usually tolerated well, i.e. milkshakes (use a spoon: NO straw), ice cream, applesauce, pudding, jello, yogurt, mashed potatoes, scrambled eggs, porridge, pasta, etc. AVOID hot liquids (coffee, tea, soup, etc.) for 4-5 hours.

Days Following Surgery: following extractions or other surgery, your body requires adequate fluids and nourishment. Drink ample fluids (2-3 litres/day). Avoid alcohol as it delays healing. Gradually progress to more solid foods. Hard or crunchy foods are NOT a good idea for 3-4 weeks. *DO NOT use a straw for 6-7 days!

Smoking

DON’T!! Smoking is discouraged during the healing period (2 to 4 weeks). Smoke is a tissue irritant and it can lead to increased risk of infection, delayed healing and dry sockets.

Stitches

Dissolving Stitches are routinely used. These will release or dissolve in one to ten days. Loose stitches may be gently removed with tweezers or the long ends can be carefully trimmed.

Oral Hygiene

The day following your surgery, you can start gently brushing your teeth and rinsing with warm, salty water (1/2 – 1 tsp. salt in a large glass) after meals and at bedtime. DO NOT spit when brushing or rinsing, just let it drip into the sink.

Seven days after surgery, you can start to use the curved-tip syringe (if you have been given one). The purpose of this syringe is to clean food/debris out of the lower sockets. Fill the syringe with warm, salty water, pull the cheek out to one side and insert the tip of the syringe into the lower sockets and gently flush. This can be done after meals and at bedtime for ONE week only.

Numbness or Tingling in the Lip or Tongue

Due to the position of many impacted teeth, sensory nerves supplying the lip, chin or tongue may be affected. In the unlikely event that the nerve was affected at surgery, you may experience numbness, tingling or an altered sensation in the lower lip, chin and/or tongue. This indicates that the involved nerves are regaining normal function. It may, however, require several months for normal function to return. In extremely rare situations, normal sensation may not return.

Intravenous Sedation and General Anesthetic Pain

Patients who have a general anesthetic may experience muscle pain especially around the neck and shoulders, but this can occur anywhere, including the chest, back, legs, and arms. The pain is often like that which occurs after heavy exercise. Although it is inconvenient and uncomfortable, it is not unusual or dangerous to experience these symptoms. The stiffness and discomfort usually lasts for only two to three days, but has been known to linger for up to one week. It is best treated by rest, heat and your postoperative pain pills.

General Anesthetic and Intravenous Sedation

1. DO NOT leave the patient alone for the remainder of the surgical day. Accompany the patient home where he or she is to rest.

2. ABSOLUTELY NO driving or operating any machinery for the first 24 hours following your surgery.

After a general anesthetic, you may also experience an irritated nose and throat because of the breathing tube that was inserted while you were asleep. This will resolve over the next couple of days.

If you have any questions or concerns, do not hesitate to contact our office at Calgary Office Phone Number 403-271-1665 or 1-800-342-0382. If your call is not answered, hang up and call again in 5-10 minutes. There is an Oral and Maxillofacial Surgeon on call 24 hours/day.

For postoperative concerns, please call our office rather than your own dentist or family doctor. However, if this is a life-threatening emergency, do not delay: dial 911.

If you are admitted to hospital within 10 days after your surgery in our office, please notify us immediately.