Surgical Instructions

After Wisdom Tooth Removal

Post-operative care is very important. Unnecessary pain and the complications of infection and swelling can be minimized if the instructions are followed carefully.

Immediately Following Surgery

Bleeding

Place a guze pack directly over the surgical site and apply pressure by biting down firmly for 30 minutes. Repeat as necessary, changing the gauze every 30 minutes till bleeding stops.  Bleeding can last several hours.  Avoid rinsing, splitting or sucking on straws for 24 hours, as this can loosen the clot needed for proper healing.  Smokers should avoid smoking for 3 - 4 days, as smoking will slow the healing process and may cause increased discomfort.
 
Pain
 
Begin using pain medication before the numbness wears off and start with half a pill after consuming food.  Take any other prescribed medication as instructed after surgery.  Do not take any of the above medication if you are allergic or have been instructed by your doctor not to take.  Specific instructions for postoperative pain management will be discussed following surgery by Dr. Crinzi and his surgical team to the driver. Pain or discomfort following surgery should subside more and more every day. If pain persists, it may require attention and you should call the office.
 
Swelling
 
Expect swelling to increase for 2 - 3 days after surgery. Place an ice pack firmly against the outside of the face as soon as you get home.  Continue using ice packs for the first 48 hours after surgery, applying them for 30 minutes on and 10 minutes off, using a cloth between the ice pack and skin.  When lying down, elevate yourhead, using two pillows.
 
Diet
 
After general anesthetic,  IV anesthesia, and local anesthesia, soft cool foods should be available.  Numbness can last for 4 hours or more post surgery.  Do not use straws.  Drink from a glass.  The sucking motion of a straw can cause more bleeding by dislodging the blood clot.  You may eat anything soft by chewing away from the surgical sites.  High calorie, high protein intake is very important. Nourishment should be taken regularly.  You can prevent dehydration by taking fluids frequently.  You will feel better, have more strength, less discomfort and heal faster if you continue to eat and stay hydrated.  Caution: If you suddenly sit up or stand from a lying position following surgery you may become dizzy.  If you are lying down following surgery, make sure you sit for one minute before standing.

Keep the mouth clean

No rinsing of any kind should be performed until the day following surgery. The day after surgery you should begin rinsing at least 5-6 times a day especially after eating with a cup of warm water mixed with a teaspoon of salt.

Discoloration

In some cases, discoloration of the skin follows swelling. The development of black, blue, green, or yellow discoloration is due to blood spreading beneath the tissues. This is a normal post-operative occurrence, which may occur 2-3 days post-operatively. Moist heat applied to the area may speed up the removal of the discoloration.

Antibiotics

If you have been placed on antibiotics, take the tablets or liquid as directed. Antibiotics will be given to help prevent infection. Discontinue antibiotic use in the event of a rash or other unfavorable reaction. Call the office if you have any questions.

Nausea and Vomiting

In the event of nausea and/or vomiting following surgery, do not take anything by mouth for at least an hour including the prescribed medicine. You should then sip on 7-Up, ginger ale or water. You should sip slowly. When the nausea subsides you can begin taking solid foods and the prescribed medicine.

Other Complications

  • If numbness of the lip, chin, or tongue occurs there is no cause for alarm. As stated before surgery, this is usually temporary in nature. You should be aware that if your lip or tongue is numb, you could bite it and not feel the sensation. So be careful. Call Dr. Crinzi if you have any questions.
  • Slight elevation of temperature immediately following surgery is not uncommon. If the temperature persists, notify the office. Tylenol or ibuprofen should be taken to reduce the fever.
  • Occasionally, patients may feel hard projections in the mouth with their tongue. They are not roots, they are the bony walls which supported the tooth. These projections usually smooth out spontaneously. If not, they can be removed by Dr. Crinzi.
  • If the corners of your mouth are stretched, they may dry out and crack. Your lips should be kept moist with an ointment such as vaseline.
  • Sore throats and pain when swallowing are not uncommon. The muscles get swollen. The normal act of swallowing can then become painful. This will subside in 2-3 days.
  • Stiffness (Trimus) of the jaw muscles may cause difficulty in opening your mouth for a few days following surgery. This is a normal post-operative event which will resolve in time.

Finally

Sutures are placed the area of surgery to minimize post-operative bleeding and to help healing. Sometimes they become dislodged, this is no cause for alarm. Just remove the suture from your mouth and discard it. Most sutures are dissolvable.

The pain and swelling should subside more and more each day following surgery. If your post-operative pain or swelling worsens or unusual symptoms occur call my office for instructions.

There will be a opening where the tooth was removed. This opening will gradually fill in over the next month with new tissue. In the mean time, the area should be kept clean especially after meals with salt water rinses.

Your case is individual, no two mouths are alike. Do not accept well intended advice from friends. Discuss your problem with the persons best able to effectively help you: Dr. Crinzi or your family dentist.

Brushing your teeth is okay - just be gentle at the surgical sites.

A dry socket is when the blood clot gets dislodged prematurely from the tooth socket. Symptoms of pain at the surgical site and even pain to the ear may occur 2-3 days following surgery. Call the office if this occurs.