Wisdom Tooth

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. You may experience a slight oozing of blood for some time after the surgery, but should be controlled by reapplying the gauze. Should there be excessive or persistent bleeding, see the section on bleeding below, or contact the office.
• Apply ice packs to the face for 15-20 minute periods of time for the first 24 hours.
• 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.
• Depending on the nature of you surgery, you should restrict your activities for 2-3 days afterwards. Slowly resume normal activities when you feel comfortable.

Diet

After general anesthetic or I.V. sedation, liquids should be initially taken. Do not use straws. 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. High calorie, high protein intake is very important. Refer to the section on suggested diet instructions at the end of the brochure. Nourishment should be taken regularly. You should prevent dehydration by taking fluids regularly. Your food intake will be limited for the first few days. You should compensate for this by increasing your fluid intake. At least 6-8 cups of liquid should be taken daily. Try not to miss a single meal. You will feel better, have more strength, less discomfort and heal faster if you continue to eat. Caution: If you suddenly sit up or stand from a lying position you may become dizzy. If you are lying down following surgery, make sure you sit for one minute before standing.

Keep the mouth clean

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 at least 5-6 times a day especially after eating with a cup of warm water mixed with a half teaspoon of table salt.

Antibiotics

If you have been placed on antibiotics, take the tablets or liquid as directed and until the prescription is completed. Discontinue antibiotic use in the event of a rash or other unfavorable reaction. Call the office if you have any questions. Many antibiotics will interfere with birth control pills. If you are taking birth control pills, you should use alternative methods for the complete cycle.

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 coke, 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. Over the counter anti-nausea drugs such as Gravol can also be used if the nausea is persistent. Call Dr. McCann if you feel that it is worrisome.

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 Dr. McCann 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, they can be removed by Dr. McCann.
• 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. They will normally melt away in 3-4 days following surgery, but sometimes they become dislodged earlier. This is no cause for alarm as long as there is no bleeding. Just remove the suture form your mouth and discard it. If there is some bleeding, apply a gauze pad for 15-20 minutes.
• The pain and swelling should reach a peak around the third or fourth post operative day. It will then gradually subside after this period. If there is a sudden peak of severe pain that is not controlled with the use of your pain medications, please contact Dr. McCann.
• There will be a cavity where the tooth was removed. The cavity will gradually over the next month fill in with the new tissue. In the mean time, the area should be kept clean especially after meals with salt water rinses or a toothbrush. In most cases you be given an irrigation syringe that will help to cleanse the socket. Begin using this 3-4 days after surgery.
• Your case is individual, no two mouths are alike. Avoid accepting well intended advice from friends. Discuss your problem with the persons best able to effectively help you: Dr. McCann and his staff are always there to help!
• 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.