Surgical Instructions

• Before Anesthesia
• After Implants
• After Wisdom Teeth
• After Exposure
• After Extractions
• After Multiple Extractions

After Wisdom Tooth Removal

The removal of wisdom teeth is a serious surgical procedure. The removal of impacted wisdom teeth and surgical extraction of teeth is quite different from the extraction of erupted teeth or simple extractions. Post-operative care is very important. Unnecessary pain and the complications of infection and swelling can be minimized if the instructions are followed carefully. Reduce your activity as much as possible for 48 hours. Physical activity may hinder formation of a blood clot with is necessary for proper healing.

The following conditions may occur, all of which are considered normal:

• The surgical areas will swell and a certain amount of bleeding, pain, and swelling is normal. Swelling usually peaks on the 2nd or 3rd post-operative day.
• Tismus (stiffness) of the muscle may cause difficulty in opening your mouth for a few days. The use of warm, moist heat to the outside of the face over these muscles will help relieve this.
• You may have a slight earache.
• A sore throat may develop.
• Your other teeth may ache temporarily. This is "referred pain" and is a temporary condition.
• If the corners of the mouth are stretched, they may dry and crack. You lips should be kept moist with cream or ointment.
• There will be a space where the tooth was removed. The day following surgery, irrigation rinses of the extraction sites should be started following meals with warm salt water until it is healed. The cavity will gradually fill with new tissue.
• There may be a slight elevation of temperature for 24 to 48 hours. If temperature continues, contact our office.
• It is not unsual to develop discoloration in the area of an extraction.

SUMMARY OF POST-OPERATIVE INSTRUCTIONS

PRESCRIPTIONS

Please fill the prescriptions provided. It is best to take pain medication and antibiotics with some food in the stomach such as milk shakes, lukewarm soups, etc.; otherwise, these medications may cause some degree of nausea.

Pain medication:

The patient is to take ½ to 1 tablet of the pain pill approximately four hours after the procedure and then every four to six hours thereafter, if needed for discomfort.

Antibiotics:

If given, antibiotics should be initiated within one hour of the procedure and then taken as directed thereafter.

Oral Mouth Rinse:

The directions for any oral rinsing with prescription mouthwash will be covered in the section under Wound Care.

CONTROL OF BLEEDING

Place a folded gauze pad over the surgery site and place pressure over the surgery site itself. Make sure the gauze is properly positioned by moving it with your finger so that it is directly over the surgery site and not just between the teeth. Change the gauze about every hour until the bleeding slows down. This usually takes at least three to four hours.

WOUND CARE

The prescription mouthwash provided is to be used beginning the night of the surgery and is to be used morning and evening thereafter. The prescription mouthwash can have somewhat of a bitter taste and it is best to eat, drink, brush your teeth and then utilize the mouthwash. It is best not to eat or drink anything for an hour after using the mouth rinse.

A syringe is provided for your use in maintaining cleanliness of the surgery site. This syringe is to be filled with a salt-water solution and irrigation of the surgery sites should be started the morning after your procedure. A salt-water solution of ½ tsp. of salt dissolved in a cup of warm water should be drawn into the syringe and the tip of the syringe placed over the surgery site or within the surgery site if a hole is present. The salt-water solution should be forcefully irrigated into the surgery site to flush out any debris or food particles that may be present in the area. This helps to prevent both infections and dry sockets.

DIET

While the numbness from local anesthesia is present, we request that the patient have only liquids, milk shakes, lukewarm soups, etc. When the numbness goes away – which is usually four to eight hours after the procedure – very soft foods can be chewed. Usually nothing harder than spaghetti noodle consistency is best. A few days after the procedure, firmer foods can be chewed. If it is uncomfortable to chew a particular item, then we suggest that the diet be changed to a softer food.