After Wisdom Tooth Removal

THE DAY OF SURGERY:

1. Bleeding: If given gauze, change it every 30-40 minutes until active bleeding has subsided (usually 2-3 hours).

• Make sure to apply good, firm pressure to the gauze.
• You may remove gauze to begin drinking but return fresh gauze to extraction site(s) if bleeding is still present.
• It is normal to experience light bleeding for up to 24 hours. If there is severe bleeding follow instructions at the bottom of this form under “Excessive Bleeding”

2. Do not brush your teeth, rinse your mouth or spit for 24 hours.
3. DO NOT drink through a straw for 7 days post surgery.
4. No strenuous exercise for 5 days or until otherwise recommended by your doctor.
5. Ice packs may be used to reduce swelling. Rotate ice packs on and off, or side to side every 20 minutes for 24 hours.
6. If you were sedated for your procedure, begin to drink once you arrive home. Start first with clear liquids then gradually advance to soup and soft foods.
7. If you were sedated for your procedure, do not drive for 24 hours following surgery.
8. Smoking / Alcohol: Do not smoke or drink alcohol for 7 days following surgery.
9. Numbness: You will probably remain numb for several hours after surgery, so it is recommended that you begin to drink fluids, and take pain medication (over the counter or prescribed) before the anesthetic wears off (or when you begin to feel a tingling sensation).
10. Pain: Take Ibuprofen 600mg and Tylenol 500mg every 6 hours OR Ibuprofen 800mg and Tylenol 500mg every 8 hours. No more that 4,000mg of Tylenol should be taken per day. Be aware that some narcotic pain medications might contain Tylenol.
11. Medications: You may have been given the following medications:

• Narcotic pain medicine: This should be taken as needed and only when Ibuprofen and Tylenol are not enough to control the pain. While taking prescription pain medication, do not drive or operate heavy machinery. Be sure to eat something prior to taking pain medication to prevent nausea.
• Antibiotic: If prescribed, this should be taken as directed until gone. Be aware that some antibiotics can reduce the contraceptive effect of birth control pills.  Please contact your gynecologist or pharmacist if you have concerns.
• Mouth Rinse: Use according to the directions on the bottle. Start using the mouth rinse 24 hours after surgery.

*No prescriptions will be called in after hours.  If you anticipate the need for a medication refill or new prescription, please contact our office during regular business hours. Please have your pharmacy phone number available before you call.

12. After hours: There is a doctor on call 24 hours a day.  If a situation develops after our office hours that is a medical emergency, you may call our office, follow the prompts, and a doctor will be paged.  It is only necessary to leave the patient name and phone number on the message.  Please be aware that the doctor will return your call as soon as possible.  Most calls are returned in 30 minutes, but if the doctor is in the emergency room or surgery, the response may be delayed.

The First Day After Surgery:

1. Hygiene: Return to your normal brushing routine. Make sure you are very careful when brushing around the extraction site(s).
2. Avoid using full-strength mouthwashes (Scope, Listerine) for 2 weeks.
3. Begin using warm salt-water rinse (1/4 teaspoon salt in a glass of warm water) every 2-3 hours for 3 days.
4. Pain and swelling is normal and expected following surgery and may last 7-14 days. Don’t be alarmed if the third day following surgery is the worst.
5. Continue eating soft foods. You may gradually return to your normal diet as tolerated.
6. Avoid spicy foods for 2 weeks.

The Following Days After Surgery:

1. Sutures/stitches may have been placed in your mouth to control the bleeding and hasten healing. They will dissolve on their own over 1-2 weeks. Occasionally non-resorbable sutures are placed & will need to be removed in 1-2 weeks.
2. If you have been given an irrigation syringe, beginning using it on day 4. Fill the syringe with salt water and use it to gently flush the extraction sockets. Repeat the process 1-2 times daily for 7 days or until food stops accumulating in the socket.
3. If bruising is present after 5 days, begin using a warm moist compress for the next 3 days. Do not use a warm compress during the first 4 days after surgery.

Excessive Bleeding (Only follow these instructions if you are experiencing severe bleeding)

1. Rinse your mouth with cool water and gently wipe away blood clots with a clean piece of gauze or tissue.
2. Take a large piece of gauze or 2 black tea bags, moistened them with water, and place them over the area that is bleeding. Close your mouth and apply constant pressure to the gauze or tea bags.
3. Remain quiet and in a sitting position for 30-40 minutes.
4. Repeat steps 2 and 3 until the bleeding is controlled.
5. If excessive bleeding persists after following these instructions in detail you should call our office.