The removal of impacted third molars is a serious surgical procedure. You can minimize pain and swelling and avoid unnecessary complications by carefully following post-operative instructions.
Immediately Following Surgery
- Keep the gauze pad that is over the extraction site in place for a half hour. After that, remove it and throw it away.
- Avoid touching the surgical site and vigorously rinsing your mouth. These activities can dislodge the blood clot and cause bleeding.
- As the anesthetic wears off, you will begin to feel discomfort. Immediately take the prescribed medication.
- Limit your activities for the rest of the day, and resume normal activity when you’re comfortable.
- Place an ice pack on the side of your face where the surgery was performed.
It’s normal to have slight bleeding or oozing at the extraction site, or redness in your saliva.
If you have excessive bleeding, do the following:
- Gently rinse your mouth
- Wipe away and old clots
- Place a gauze pad over the extraction site and bite firmly for 30 minutes
- Repeat if necessary
If the bleeding continues:
- Bite on a moistened tea bag for thirty minutes. Tannic acid in the tea bag helps contract bleeding vessels so a clot will form.
- Sit upright
- Avoid exercise
If the bleeding does not subside, call us for further instructions.
The swelling you experience depends on the extent and complexity of the surgery. Swelling is the body’s normal reaction to surgery and is part of the healing process. Swelling becomes noticeable the day after surgery and reaches its maximum two to three days after surgery.
It’s common to experience swelling around your mouth, cheeks, sides of your face, and eyes. You can minimize swelling with the following steps.
- Immediately apply ice to the affected sides of your face. Use ice packs or small sandwich bags filled with ice.
- Leave the ice packs on continuously while you are awake.
- If swelling or jaw stiffness persists for several days, don’t be alarmed. It’s a normal reaction to surgery.
- After 36 hours, the ice has no benefit. Apply moist heat to the affected sides of your face instead of ice to reduce swelling.
- If swelling worsens or increases, call our office.
- Moderate – Take one or two tablets of Tylenol or Extra Strength Tylenol every three to four hours, or take two-four 200 mg tablets of Ibuprofen (Motrin or Advil) every three to four hours.
- Severe – Take the prescribed medication as directed. It will make you groggy and will slow down your reflexes, so avoid driving an automobile or operating machinery. Also, avoid alcoholic beverages. The pain or discomfort should decrease each day. If it persists, call our office.
- Sudden severe pain – If you have sudden severe pain at the surgical site or in your ear two to three days after surgery, it could be a symptom of dry socket. Dry socket can occur if the blood clot prematurely dislodges or dissolves from the extraction site. Call our office if this happens.
Initially drink liquids only. Your food intake will be limited for the first few days.
- Drink from a glass. Avoid using a straw because it can dislodge the blood clot and increase bleeding. You can prevent dehydration by drinking fluids regularly.
- Drink at least five to six glasses of high-protein liquid daily.
- Try not to miss a single meal. You will feel better, have more strength and less discomfort, and heal faster if you continue to take in nutrition.
- Limit your food intake for the first few days, and compensate for it by increasing your fluid intake.
- After a few days, add soft food to your diet, but chew away from the extraction sites. It’s important to eat high-calorie, high-protein food.
- Keep in mind that while your normal nourishment is reduced, exercise may weaken you.
Keep Your Mouth Clean
- Do not rinse your mouth vigorously.
- The night of surgery, you can gently brush your teeth and lightly rinse your mouth.
- The day after surgery, rinse your mouth at least five to six times a day, especially after eating. Rinse with a cup of warm water mixed with a teaspoon of salt.
Two to three days after surgery, skin discoloration can occur. As blood spreads beneath the tissues, the discoloration can be black, blue, green, or yellow. Apply moist heat to help the discoloration fade more quickly.
If you received a prescription for antibiotics, take it as directed. Antibiotics help prevent infection. Discontinue use if you get a rash or an adverse reaction. Call our office if you have questions.
Nausea and Vomiting
If you experience nausea or vomiting after surgery, closely follow these directions:
- Wait an hour before taking anything by mouth, including the prescribed medicine.
- Over a 15-minute period, slowly sip on cola, tea, or ginger ale.
- When nausea subsides, you can start drinking liquids and taking the prescribed medicine.
- Dizziness – You may get dizzy if you quickly sit up or stand from a lying position. Sit up for one minute before standing. Dizziness can be caused by fasting before surgery, or the medication prescribed. Exercising without adequate nutrition can cause dizziness. It might be best to wait a few days before resuming your exercise routine.
- Numbness – Numbness of the lip, chin, or tongue is common and usually temporary. Take care to avoid biting your lip or tongue, because if they are numb, you will not feel the sensation. Call our office if you have any questions.
- Low fever – A low fever following surgery is not uncommon. If the fever persists, take Tylenol or ibuprofen and notify our office.
- Hard projections in your mouth – You might be able to feel hard projections in your mouth. They are the bony walls that supported your wisdom teeth. These projections usually smooth out over time. If not, your oral surgeon can remove them.
- Dry and cracked lips – The corners of your mouth are stretched during surgery. Keep your lips moist with an ointment or moisturizer to prevent them from getting dry and cracking.
- Sore throat – Swollen muscles after surgery can cause a sore throat or pain when swallowing. The discomfort will subside in two to three days.
- Stiff jaw muscles – For a few days after surgery, stiff jaw muscles can make it difficult to open your mouth.
- Sutures – Sutures at the extraction site minimize post-operative bleeding and promote healing. Sutures are removed in approximately one week after surgery. It only takes a few minutes to remove them. You will have no discomfort, and no anesthesia or needles are required. If a suture comes out on its own, just remove it and discard it.
- Surgical site – There will be an indentation, or hole, where the tooth was removed. It will gradually fill in with new tissue over the next month. Meanwhile, use salt water rinses, especially after meals, to keep the area clean.
If you experience unusual symptoms or problems, discuss them with your doctor at Oral Surgery Associates.