Surgical instructions after removal of wisdom teeth (third molars)
Immediately following surgery
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.
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.
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.
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.
Do not smoke for at least 3 days following surgery.
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 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.
Do not use a straw for 3 days following surgery.
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.
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.
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.
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
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.
If any unusual symptoms should occur, you may reach one of our doctors 24 hours a day at (314) 533-5858.
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