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Post-operative instructions:
wisdom teeth

Home care instructions following wisdom teeth extractions with general anesthesia

BLEEDING

A certain amount of bleeding is to be expected following surgery. Slight bleeding, oozing, or redness in the saliva is not uncommon. Bite on the gauze pack in your mouth with firm, continuous pressure for at least 30 minutes after leaving the office. Repeat at least twice if bleeding continues. Sit upright. While biting on the gauze, avoid any spitting or expectorating. Remove the gauze when there is a residual component of one-quarter red and the rest pink, which is a normal small amount of seepage and will continue for 24–48 hours. Dissolvable sutures are placed in the surgical site to minimize post-operative bleeding and to help with healing. Sometimes they become loose or dislodged; this is no cause for alarm. Just remove the suture and discard it.

ACTIVITIES

Reduce your physical activities today to avoid exertion that could reinitiate the bleeding or induce swelling. Do not smoke cigarettes for the first 4 days following surgery to minimize the chance of secondary infection or dry socket. It is advisable for the first 24–48 hours following surgery to have someone assist you when going from lying to standing position. To help avoid becoming lightheaded or dizzy, rise slowly to a sitting position and sit for several minutes before standing. It is advised to refrain from sports or aerobic activities for 4–5 days.

SWELLING

To minimize swelling, apply ice packs over the affected areas as soon as possible for 20 minutes on and 20 minutes off the day of the surgery only (24 hours). Please note that ice is not effective after 24 hours. The swelling will not become apparent until the day following surgery and will not reach its maximum until 2–3 days postoperatively. However, the swelling may be dramatically reduced with immediate use of ice packs.

Anti-inflammatory medications, as well as elevation of the head while you sleep for the first 2–3 nights after surgery, will help minimize swelling. If swelling appears to be increasing on the fourth day, please notify the office. The application of heat can be done with the small ice packs dispensed by the office (warming them in hot water or the microwave) or blue gel hot/cold pack. Apply heat for 5–7 minutes on each side, starting 2 DAYS after surgery. When the heat is in place, it is helpful to open and close the mouth and shift the jaw from side to side. Repeat 3 times a day for 3–4 days.

PAIN

Some discomfort or pain is normal and should be relieved by the prescription medication. Take all medications with food to avoid stomach upset or nausea. For many routine procedures, an anti-inflammatory medication (such as Advil® or Motrin®) can be used the day of the procedure or over a period of 3–4 days taken at breakfast, lunch, and before turning in at night. Medication is to decrease the need for strong prescription medications. If you receive a prescription anti-inflammatory (e.g., Lodine®), please DO NOT utilize an over-the-counter anti-inflammatory until the prescription anti-inflammatory is finished.

FOR IV PATIENTS (Wisdom teeth procedures)

It is recommended for the first 3 nights to keep your pain medication at your beside and set an alarm for a DOSE IN THE MIDDLE OF THE NIGHT (4–6 hours from the last dose). This will help keep the medication uniform in your bloodstream to help with pain management.

NUMBNESS

For procedures on the lower jaw, our office uses a long-acting local anesthetic. Your chin and tongue may be numb for 12–36 hours following surgery. Prolonged lower jaw numbness can be perceived as having difficulty in swallowing; however, you still have the ability to swallow. Take small, slow sips of fluid while slightly tilting your head back. For upper jaw procedures, a shorter-acting anesthetic will be used, lasting 2–4 hours following surgery.

MEDICATIONS

Please have any prescriptions filled immediately. The antibiotics, if prescribed, need to be taken until completely gone. (Please note that antibiotics decrease the effectiveness of birth control pills.) Take all medications with a minimum of a glass of water and soft foods. If any side effects or nausea occur, discontinue the medications and call the office. Avoid combining medications at the same time. Allow at least 1–2 hours before taking your next medication. Medications should be taken with FOOD and FLUIDS. PLEASE DO NOT SPLIT OR CRUSH MEDICATIONS. If you experience difficulty swallowing pills, please contact our office.

NAUSEA

This may be caused by taking pain medication on an empty stomach or by swallowing blood. Avoid taking any further medications until the nausea is controlled. Antacids may be effective to relieve stomach upset, followed by bland food. If nausea persists, please contact the office.

ORAL HYGIENE

Do not rinse or brush the day of surgery. You can resume brushing teeth the day after surgery but avoid vigorous rinsing or spitting. Please leave out any retainer or bite guard for 3–4 days. After you have finished the oral Peridex™ rinse, you may begin using warm saltwater rinses. Please use a soft brush for 2 weeks.

DIET

Start with liquids such as juices, soups, Jell-O®, yogurt, or softer foods today. Resume your normal diet as soon as possible on the second or third day after surgery. Do not drink fluids through a straw for 4 days; the sucking motion can cause more bleeding by dislodging the clot. High-calorie, high-protein intake is very important to feel better and heal faster. Avoid seeds, nuts, and popcorn for about 2 weeks. You should prevent dehydration by taking fluids regularly. Drink at least 5–6 glasses of liquid daily.

For the first day of surgery:

  • Milkshakes (add fruit such as a banana)
  • Carnation® instant breakfast
  • Creamy soups and broths
  • Jamba juice (avoid seeds such as strawberry, raspberry, blackberry)
  • Yogurt
  • Applesauce
  • Ensure®/Boost® dietary supplement drinks

For the second day following surgery:

  • Soft-cooked pasta
  • Mashed potatoes
  • Macaroni and cheese
  • Scrambled eggs
  • Pancakes/waffles
  • Steamed rice
  • Chili with melted cheese on top
  • Oatmeal/cream of wheat
  • Ice cream
  • Jell-O®
  • Pudding

For the first 3 weeks, avoid popcorn, nuts, uncooked vegetables, such as carrots, etc.

Other instructions

  • Please leave retainer out for about 4 days.
  • Do not play musical instruments (e.g., trumpet, saxophone, horn instruments) for 10 days after surgery.
  • Stop taking oral antibiotics (doxycycline, tetracycline, etc.) for acne while taking our antibiotics.

IF THERE ARE ANY QUESTIONS OR CONCERNS, PLEASE DO NOT HESITATE TO CALL OUR OFFICE IMMEDIATELY.

(408) 245-6010

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