Wisdom Tooth Extractions – Proper Care After Surgery

Bleeding

Bleeding is normal following wisdom tooth extractions. It may last two hours or several hours, either way is normal. Gauze should be folded into a tight square and placed directly on top of the extraction sites. Then bite firmly on the gauze for 45 minutes. The gauze should be sufficiently thick so that pressure is placed on the sockets when biting. Remove the gauze and repeat until there is just pink left on the gauze. If this doesn’t completely control the bleeding after several attempts, a moistened tea bag can be used in place of the gauze.
Do Not Rinse while still bleeding. Rinsing will keep the blood clot from forming and prolong bleeding.
Do Not Spit while still bleeding. Spitting will keep the blood clot from forming.
It is normal to have small amounts of bleeding for up to 24 hours.

Do not rinse during the first 24 hours following wisdom tooth extractions.
Perioguard Antimicrobial Mouth rinse: If this prescription mouth rinse was provided, rinse twice a day for one week. If this is used for longer than two weeks it can begin to lightly stain the teeth. If staining occurs it can be polished with a dental cleaning.
Salt Water: Rinse gently with salt water up to 4 times a day for the first week as well. One teaspoon of salt in a cup of warm water should be sufficient.
Irrigation Syringes: An irrigating syringe will be provided and should not be used during the first week. Fill the syringe with warm salt water and irrigate directly into the extraction site several times a day to keep debris and bacteria out of the socket. The sockets should be irrigated until they no longer collect food and debris. This is different for each patient but may be necessary for several weeks following surgery.

Facial swelling is normal following wisdom tooth extraction. It is variable depending on the difficulty of the surgery as well as the individual patient’s response. Swelling typically peaks on the third day following surgery. It is normal to have one side be slightly worse than the other. The swelling can take over a week to completely resolve.
Ice packs: Ice packs should be used for the first two days following surgery. Place the ice on one side for 10 minutes and then transfer to the other side and repeat throughout the day. Ice will not prevent the swelling but will help reduce it.
Elevate head: Keeping your head elevated during the first 2-3 days after surgery will help reduce the swelling in the face. Sleeping with multiple pillows is a good way to do this.

Discomfort is normal following any surgery and is dependent on the difficulty of surgery and the patient’s individual response.
Start your pain medication before the numbing wears off. This will keep you ahead of the pain. It is easier to stay ahead of the pain than to try to catch up to it.
NSAIDS: Non-steroidal anti-inflammatory drugs (NSAIDS) are a good way to control post-operative pain and swelling if you are not allergic or intolerant. Start taking Motrin (Ibuprofen) as prescribed immediately after surgery and as often as allowed during the first two days after surgery. It can be taken at the same time as prescribed narcotics and will often work better when combined with either the narcotic or Tylenol. Since Ibuprofen can also help prevent swelling it is recommended to continue this for mild discomfort after narcotic use has ended.
Prescribed Narcotic Pain Medicine: If the Motrin does not control the discomfort alone, take the prescribed narcotic as well. The two drugs can be taken together. You should not drive or make important decisions while taking the narcotic pain medicine. Common side effects of narcotic pain medicine include nausea and vomiting, constipation and dizziness.

Nausea can be a side effect of both general anesthesia as well as narcotic use. If you have a history of nausea following surgery please let Dr. Loveless know and we will provide preventative medication.
Nausea caused by prescription narcotic use can often be prevented by taking your medications with food or eating a light meal prior to taking medication. If vomiting occurs immediately rinse with salt water or antibiotic rinse. Vomiting can cause dry sockets and infections. If it persists please call Dr. Loveless and a prescription will be called in.

Start with clear liquids and gradually increase you diet as you are able to based on your comfort. We recommend eating as soon as possible following surgery to help prevent nausea.
It is important to drink lots of fluids to replenish your body after fasting.
Soft foods will be more comfortable while you are healing during the first few days: eggs, soups, soft pasta, meatloaf, mashed potatoes, ice cream, shakes, etc.
Do not use a straw for one week as this can dislodge the blood clots.

Do not smoke for one week following extractions. The nicotine and tar in the cigarette smoke can contribute to dry sockets and can delay healing and increase bleeding.
Do not use e-cigarettes for one week as well. These still contain nicotine that will contribute to dry sockets, delay healing, and increase bleeding.

Do not do any vigorous activity for three days following surgery. This includes sports, exercise, or heavy lifting. Vigorous activity can increase bleeding, slow healing, and predispose to dry sockets. Gradually increase your activity as you feel comfortable, returning to normal activity about one week after surgery.

Begin brushing your teeth on the day following surgery. It is important to brush all of your teeth including the teeth and gums near the extraction sites, even though they will be sensitive. Keeping nearby teeth clean will help prevent bacteria and plaque from delaying the healing of the extraction sites.