Oral Surgery Home Care Instructions
Tooth Extraction, Impacted Canines and Wisdom Teeth
Proper and safe recovery at home following oral surgery is just as important as the surgery itself. Taking care to follow these instructions closely will minimize pain, swelling and the risk of infection and dry socket complications following tooth extractions, impacted canine exposure and wisdom teeth removal.
- Gauze: Keep the gauze in place for half an hour following surgery. Then remove the gauze and throw away. If there is still bleeding then replace with MOIST gauze until the bleeding is minimal.
- Ice: Apply ice to the outside cheeks where surgery was performed and keep it there periodically the first day while awake.
- Rest: Be prepared to rest for the remainder of the day following surgery – it is a very important part of your recovery.
- Blood Clot: It is critically important that the extraction site forms a good clot. Do NOT rinse the mouth vigorously and avoid touching the wound for several days following the surgery.
- Pain: Once able to take your medications do so to allow a smooth transition as the anesthesia starts to wear off.
- Antibiotics: If we prescribed antibiotics, follow their instructions for use carefully.
- NO Straws or Tobacco. This can dislodge the blood clot and cause a very painful condition called “dry socket”.
What is normal?
- Bleeding: You may see some blood or oozing from the surgery site and in your saliva – this is normal. If bleeding is excessive, place MOIST gauze (or a moistened tea bag) over the area and bite firmly for half an hour. Then check and repeat if necessary. If bleeding doesn’t stop after several gauze cycles, please call us for further instructions.
- Swelling: Swelling is normal and expected, and may affect the mouth, cheeks, eyes and sides of the face. Typically, after wisdom teeth removal, swelling starts the day after surgery but does not reach maximum levels until 2-3 days after. Ice the outer cheeks 20 minutes on and 20 minutes off for days 2-3 post-op. On days 3-4, you may use moist heat packs to further assist in minimizing swelling.
- Discoloration: Sometimes, discoloration of the skin occurs (black, blue, green or yellow) due to blood spreading underneath the tissue. Often this occurs on days 2-3.
- Nausea: Some patients have nausea or vomiting after surgery. If this happens, do not eat or drink or take medicine for one hour. Then begin sipping on water or ginger ale (NO straw) and see how you feel. As you are able to hold down liquids and begin to feel better, you may introduce soft foods and medicines as needed.
- Loose Stitches: Sometimes sutures become dislodged. Simply remove them and discard them if this happens. If they remain intact, wait until they dissolve on their own.
- Numbness: You may feel numb in the lip, chin or tongue. This is normal and will go away as you recover. Be careful when eating however, as you are at risk for biting soft tissues when they are numb.
- Fever: You may experience a slight rise in temperature following surgery. If it persists please let us know.
- Dizziness when Standing: As the anesthesia wears off, you may have dizziness when standing up. Move slowly from lying down to sitting up, and then from sitting to standing, pausing in between for a minute.
- Bony Walls at Extraction Site: You may feel hard projections at the extraction site with your tongue – these are normal and will smooth out on their own.
- Sore Throat: Your muscles are tired and swollen, so it may be uncomfortable to swallow for a few days.
- Stiff Jaw: It is normal for the jaw to feel stiff and difficult to open for a few days. It will resolve on its own.
Ibuprofen: if you can take it, Ibuprofen will be the most effective pain medication. The key is to start it prior to the anesthesia wearing off and to take it on a consistent schedule instead of waiting until you have pain to take it. Typically, you will be given high dose ibuprofen to take every 8 hours. You should stick very strictly to this schedule by setting a timer or alarm and even waking up in the middle of the night to take the ibuprofen if that is when your schedule dictates.
Opioids: Ideally, you would avoid the use of opioids. If you are taking your ibuprofen on schedule as instructed and you are having pain that is significant or prevents you from sleeping then take the opioid pain medications. If you need them they can be combined with the ibuprofen-so stay on schedule with the ibuprofen even if you need the opioids and only take the opioids when needed.
Ice Packs: The use of ice packs can distract and soothe the sites and decrease pain. Use these 20 minutes on and 20 minutes off while awake to assist with pain control and swelling.
Resuming Regular Activities
- Hygiene: Do not rinse the day of surgery. Starting on the day after surgery, begin gently rinsing 5-6 times a day with a teaspoon of salt mixed into one cup of warm water. You may use a toothbrush as well, just be gentle and avoid the extraction site for a few days.
- Diet: Stick to cold soft foods the day of surgery and the next day. This can be ice cream, pudding, yogurt, apple sauce, cold soup, cold coffee, etc. Two days after your surgery should be a transition day where you start with light chewing and warm foods. Then, progress to more chewing and hot foods as you feel comfortable.
- Activities: Rest the first day, and then resume activities slowly on the days following surgery as you feel comfortable.
This is a painful condition that occurs when the blood clot becomes dislodged. Call us if you have severe pain in the extraction area or radiating near the ear – it often occurs 2-3 days after surgery.