St. Louis County Oral and Maxillofacial SurgerySt. Louis County Oral and Maxillofacial Surgery
 
 

Richard W. Weber Sr., DDS
Robert R. Stemme, DDS
Richard W. Weber Jr., MD, DDS
Timothy M. Weber, MD, DMD
Brent L. Kincaid, DDS

Surgical instructions after removal of wisdom teeth (third molars)


Immediately following surgery

  • Bite firmly on the gauze pads covering each extraction site to help stop the bleeding. We will change the gauze pads before you leave the office. You may change the gauze pads once more at home, leaving gauze in 30 additional minutes. Remember to remove gauze before eating or drinking.

  • You may have difficulty feeling your lips, cheeks or tongue due to numbness. This is a temporary feeling and will wear off within 2 to 6 hours. Please take care not to bite your lips, cheeks or tongue.

  • Apply ice packs to your face to reduce swelling for the first 12 hours after surgery. Ice should not be used after the first 24 hours.

  • Take pain medications as prescribed as soon as possible.

  • Do not rinse or spit the day of the surgery, as this may prolong the bleeding.

  • Rest is the order of the day.

Bleeding

Some bleeding is to be expected following surgery. If you are bleeding excessively, apply pressure by folding and placing a gauze pad directly over the extraction site and biting firmly on gauze for one hour. Excessive bleeding is defined as pooling or dripping blood out of the extraction sites within 15-20 seconds of removing the gauze. If excessive bleeding continues, apply a gauze pad for an additional 30 minutes. Don't use the amount of blood on the gauze as a guide, because minimal bleeding may persist for up to 24 hours. To minimize further bleeding, sit upright and avoid vigorous activity. If bleeding continues, call our office for further instructions.

Minimal bleeding may persist for up to 24 hours. It is not unusual for saliva to be slightly blood-tinged for several days following surgery.

Medication

You may receive a prescription for an antibiotic and/or a pain reliever. You may fill these prescriptions at the pharmacy of your choice. Take all medications as instructed by your doctor.

The first does of your prescribed pain medication or ibuprofen may be taken with a liquid only, but it is important to get some soft food (milkshake, pudding, yogurt, scrambled eggs, pasta) in your stomach as soon as possibl. Take all subsequent doses along with food to minimize nausea.

Pain Management

Some amount of discomfort is to be expected following any surgery. If your surgeon feels you will benefit from a prescription pain medicine, you will receive a prescription following your surgery. Please follow the instructions carefully. Ibuprofen (such as Advil, Nuprin, Motrin) works very well for many patients following oral surgery and can reduce the amount of narcotic pain medicine needed significantly. You may find taking 400-600mg every six hours on a regular schedule for the first 2-3 days is all the pain medicine you need. You may alternate your prescription pain medicine with ibuprofen for maximum pain relief. Those who are allergic to aspirin or other NSAIDs cannot follow this regimen.

Diet

You should have a soft food diet on the day of surgery and the day following surgery. Soft foods include ice cream, pudding, jello, yogurt, soup (lukewarm), pancakes, mashed potatoes, scrambled eggs and pasta. Drink lots of fluids to rehydrate. Avoid hard, crunchy foods such as chips that may disturb the extraction site for at least three days. After the third day, you may eat anything you wish, unless given other specific instructions by the doctor. No alcoholic beverages should be consumed for at least twenty-four hours following general anesthesia or as long as you are taking pain medications.

Smoking

Do not smoke for at least 3 days following surgery.

Brushing/Rinsing

Avoid all brushing, rinsing or spitting the day of the surgery. The day after your surgery, you may brush your teeth, but avoid brushing near the surgical site(s) for 3 days. Rinse with ½ cup warm water and a pinch of salt beginning 3 days after surgery.

Swelling

Swelling around the mouth, eyes and cheeks is normal following any surgery, and usually takes 2-3 days to fully develop. Applying ice to your face and keeping your head elevated for the first 24 hours will help reduce swelling. Ice serves no useful purpose after 24 hours and may contribute to stiffness in the jaw. Beginning seventy-two hours after surgery (the third day), a heating pad or moist heat may be used for relief of swelling, bruising and stiffness of the jaw. Heat should be continued for thirty minute intervals, three or four times daily, until the symptoms subside.

Straws

Do not use a straw for 3 days following surgery.

Sutures/"stitches"

Your sutures dissolve on their own and may come out any time after surgery. You may notice that they are loose after the swelling of your gum tissue decreases. This is completely normal.

Irrigating

If you have been provided with an irrigator (small plastic syringe), you should begin using it on the third day after surgery on the lower extraction sites after each meal and at bedtime. Fill the irrigator with lukewarm water. You may add a small amount of salt. Make sure to get the tip of the irrigator into the extraction site and flush out the extraction site completely. This may be uncomfortable at first, but keeping the site clean reduces the chance of infection or dry socket.

Resuming activities

If you have undergone general anesthesia, you should go home immediately and rest for the remainder of the day. Do not drive or engage in strenuous activities for at least 24 hours. You may return to work or school when you feel you are recovered. We can supply a doctor's note if necessary.

Dry socket

After tooth extraction, it's important for a blood clot to form to stop the bleeding and begin the healing process. A dry socket occurs when the blood clot is dislodged from the surgery site exposing the bone and fine nerve endings. This condition is more common in back teeth, particularly wisdom teeth, although it can occur in any extraction site. Dry socket occurs two or more days after an extraction and can last 5-6 days.

Avoiding dry socket

  • Do not smoke.
  • Clean the extraction site as instructed and follow all at-home instructions.
  • Avoid sucking action from smoking, spitting or using straws for the first 24 hours.

  • Do not rinse mouth excessively; it interferes with blood clotting.

Follow-up appointment

You may be asked to return to our office for a post-operative follow-up visit 10 to 14 days following surgery. There is no additional charge for this follow-up visit. Please make every effort to return to have your surgical sites examined for proper healing.

Emergencies

If any unusual symptoms should occur, you may reach one of our doctors 24 hours a day at (314) 533-5858.

Questions?

Please do not hesitate to contact the office if you have any questions or concerns. Our surgeons can be reached 24 hours a day in case of emergency.

West County: (314) 434-0493
South County: (314) 842-5340
St. Charles County: (636) 928-1222

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dental xray
dental xray
WEST COUNTY
St. Luke’s Doctors’ Office Building North
222 S. Woods Mill Road, Suite 720
Chesterfield, MO 63017
(314) 434-0493
FAX (314) 434-7883
SOUTH COUNTY
Sunset Hills Professional Building
11810 Gravois Road, Suite 102
St. Louis, MO 63127
(314) 842-5340
FAX (314) 849-9567
ST. CHARLES COUNTY
Barnes St. Peters Hospital Campus
6 Jungerman Circle, Suite 202
St. Peters, MO 63376
(636) 928-1222
FAX (636) 928-2293