Wisdom Teeth and Extractions: Instructions Following Oral Surgery
- Take all medications as prescribed. If you were given an antibiotic, please take it to completion (unless directed otherwise).
- Medications on an empty stomach may cause nausea/vomiting. Take all medications with food and fluids.
- Local anesthetic (dental freezing) will last anywhere from 2 to 6 hours and at times up to 12 hours.
- Alternating an anti-inflammatory medication (eg. ibuprofen, naproxen) with a Tylenol-based medication (eg. Tylenol, Tylenol 3, Tramacet) is recommended (ie: start with ibuprofen → 3 hours later → Tylenol → 3 hours later → ibuprofen etc.).
- Pain will peak at 48 hours and improve slowly over the next few days.
- Bite down with firm, constant pressure and change the gauze every 30 minutes as bleeding persists throughout the day. Minor bleeding can continue for a few days following surgery. Gauze packs are not needed for this level of bleeding. If heavier bleeding does occur, bite down firmly on a dry, black teabag (wrapped in a piece of gauze). Apply constant bite pressure for 45-60 minutes before removing.
- Remove gauze when going to bed at night or if napping. Sleep with your head slightly elevated for 48 hours after surgery.
- Avoid aggressive spitting and hot fluids/foods for the next 48 hours.
Facial Swelling, Bruising and Stiffness
- Swelling is to be expected following surgery. The degree of swelling can vary widely among patients.
- As a rule, swelling peaks at 48 hours and persists for 1-2 weeks.
- Use ice 20 minutes ON and 20 minutes OFF for the first 48 hours after surgery. Switch to moist heat after 3-4 days for comfort.
- Mild to moderate bruising may occur (purple/blue in colour during the first 1-3 days and yellow/green in colour from days 3-7). It may travel down the neck and towards the chest area as time progresses.
- Jaw stiffness and limited mouth opening can occur and may require stretching exercises for 1-2 weeks.
- If new swelling occurs after the first 3 to 4 days, please call our office for guidance.
Oral Hygiene and Syringe Use
- Start gently brushing the day of surgery.
- Rinse several times daily with salt water (1 tsp salt in glass of water) after eating and at bedtime.
- Use the prescribed mouth rinse (Chlorhexidine) 3 times per day. Rinse for 1 minute then gently spit.
- A Monoject syringe may have been provided in your home care bag. Begin using the syringe 4-7 days after surgery by inserting the tip directly into the lower sockets. Gently flush (pulsatile) the socket after meals and at bedtime (4 times/day) using water, salt water or the prescribed mouth rinse.
- Do NOT smoke for 2 weeks after your surgery. This includes cigarettes, e-cigarettes and marijuana.
- Most stitches are dissolvable and will release in 4-10 days. An appointment will be made for you to remove any non-dissolving suture.
- If sutures become loose, you can remove them with tweezers or carefully trim any long ends.
Diet and Nutrition
- Cool, soft foods are ideal for the first 2 days following surgery. Continue with softer foods for 1 week as directed by your doctor. Avoid crunchy foods for at least 3-4 weeks and straws for 1 week.
- Drink plenty of fluids (an average-sized adult will need about 2-3 litres/day unless medical history dictates differently).
- Avoid alcohol for 1 week after surgery.
Numbness or Tingling of the Lip or Tongue
- Due to the positioning of some impacted teeth, numbness to the lip, chin, gums and tongue and/or loss of taste may occur. It may take days, weeks or even a year for the sensation to improve. In some situations, however, normal sensation may never fully return.
Denture and Retainer Use
- If new dentures have been made, they may or may not fit properly following surgery. Keep them inserted if you are not bleeding. If bleeding persists, take the dentures out and bite with firm pressure on the gauze provided. Post-operative swelling may temporarily affect a proper fit as well.
- Please book an appointment with your dentist or denturist within 1-3 days to start any adjustments.
- Retainers can be left out for 2-3 days after surgery.
Signs of Infection
- Signs of infection may include: new swelling, elevated temperature and feeling unwell four or more days after surgery. Please call the office to describe your concerns.
- Good oral hygiene can reduce the risk of infection.
General Anesthetic and Intravenous Sedation
- Muscle pain can occur after surgery and may involve the neck, shoulders, chest, back, legs and arms. This can last 2-3 days (sometimes up to a week) and feel like what occurs following heavy exercise.
- A sore throat, nose irritation or nose bleeds can occur after surgery and take a few days to resolve. This may be related to the use of a breathing tube.
- You should not be left alone for the remainder of the surgical day.
- Do not drive, operate heavy machinery or sign legal documents for 24 hours following surgery.
- Fever: A slight fever (38C) is not uncommon the first 48 hours after surgery. If a higher fever develops or the fever persists, try a pediatric antipyretic medication, such as Tylenol or Advil, and increase fluid intake. Monitor your child for excessive fluid lossdue to dehydration or from vomiting.
- Numbness: The mouth will be numb approximately two to four hours and sometimes longer. Advise your child does not bite, scratch, or injure the cheek, lips, or tongue during this time.
- Surgical site care: Today, do not disturb the surgical site. Do not stretch the lips or cheeks to look at the area. Do not rinse vigorously, use mouthwash, or probe the area with fingers or other objects. Beginning tomorrow, you may use the prescription mouth rinse or warm salt water.
- Pain: Because some discomfort is expected, you may give your child Advil or Tylenol before the numbness wears off. Do NOT give aspirin to your child. Follow the instructions on the bottle for dosing based upon your child’s age/weight.
Please call our office first with any questions or concerns at 403-271-1665 or 1-800-342-0382. A doctor is on-call 24 hours/day, 7 days/week. If you are calling after hours, please listen to the emergency message at the phone number(s) provided. You can then leave a message at the designated phone number and the Doctor will call you back. If you are admitted to the hospital within 10 days of surgery, please notify us immediately.
If you are having a life-threatening medical emergency, do not delay – dial 911.