PATIENT INFORMATION

Post-Op Instructions

On this page:
After Wisdom Tooth Removal | After Exposure Of An Impacted Tooth | After Placement Of Dental Implants

After Wisdom Tooth Removal or Other Tooth Extractions

The removal of impacted teeth is a serious surgical procedure. Post-operative care is very important. Unnecessary pain and the complications of infection and swelling can be minimized if the instructions are followed carefully.

DOs

DO rest today and tomorrow; half speed on the third day.
DO place ice on jaws for 12 hours.
DO use pressure on gauze packs for 2 hours.

DON’Ts

DON’T smoke, dip, or chew tobacco.
DON’T use drinking straws.
DON’T drink carbonated beverages.
DON’T use alcohol or mouthwash.
DON’T lift, bend, or strain.

The above DON’Ts apply for 7 days after your oral surgery.

Immediately Following Surgery

  • Upon leaving our office, your first stop needs to be for a milkshake. Have the patient drink the shake with a spoon or “cup it.” Do not use a straw! Keep the gauze in the patient’s mouth and change after they finish the milkshake. When only a few swallows of the shake are left, have the patient take two pain pills and one antibiotic unless otherwise instructed.
  • The gauze pads placed over the surgical area should be kept in place for up to two hours after surgery, changing the pads as necessary.
  • Vigorous mouth rinsing or touching the wound area following surgery should be avoided. This may initiate bleeding by causing the blood clot that has formed to become dislodged.
  • Restrict your activities the day of surgery, as well as the second day, half speed on the third day.
  • Place ice packs to the sides of your face where surgery was performed for 12 hours. Refer to the section on Swelling for an explanation.

Bleeding

Following oral surgery, slight bleeding or oozing for the first day is common. Place a roll of gauze over the wound and bite down firmly for at least two hours. Do not spit or rinse. This only makes the bleeding worse. Swallow normally; the fluids will not hurt you. If bleeding continues after trying the above, bite on a moistened tea bag for 20 minutes. The tannic acid in the tea bag helps to form a clot by contracting bleeding vessels. Do not become excited, but rather lie down with your head elevated on three pillows. If bleeding does not subside, call for further instructions.

Swelling

The swelling that is normally expected is usually proportional to the surgery involved. Swelling around the mouth, cheeks, eyes and sides of the face is common. Swelling is a normal response following surgery but can be partially avoided by using an ice bag for the first 12 hours after surgery. Maximum swelling normally occurs on the 3rd day following surgery. A hot water bottle or heating pad should be used starting on the 3rd day after surgery to help bring the swelling down. Some mild temperature rise is to be expected after surgery.

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Pain

For severe pain, take tablets prescribed for pain. For moderate pain, take 800mg of Ibuprofen, 3 times a day with food or juice. IMPORTANT! Swallow tablets, they are not to dissolve in mouth. If a prescription was given, please use as directed. The prescription for pain will make you groggy and will slow down your reflexes. Do not drive an automobile or work around machinery. Move about slowly. If you suddenly sit up or stand up from a lying position, you may become dizzy or even black out for a few seconds. Without infection or other complications, the discomfort following an extraction or other oral surgery will usually disappear in a few days. However, if pain or swelling continues, it may require attention and you should call the office.

Diet

For the first 24 hours, cool liquids only may be consumed. Dehydration must be guarded against when having oral surgery, since a patient’s solid food intake is limited the first day. It is necessary to compensate for this by increasing the fluid intake (at least five to six glasses of liquid should be taken). Suggested food for the day of surgery: yogurt, pudding, jello, instant breakfast, milk, malts, ice cream, and applesauce. The day after surgery diet should consist soft foods such as soups, eggs, cottage cheese, and a hamburger patty.

Keep The Mouth Clean

Mouth cleanliness is essential to good healing. Clean your mouth thoroughly after each meal beginning the day after surgery. Brush your teeth as best you can. Rinse with warm salt water (one teaspoon of salt in a cup of warm water) six times a day. Continue this procedure until healing is complete.

REMEMBER: A clean wound heals better and faster.

Discoloration

You may develop black, blue, green, or yellow discoloration resembling a bruise in the tissue. This is due to slight bleeding beneath the tissues, is of little significance, and is a perfectly normal postoperative event. It should be treated the same as swelling.

Antibiotics

You may have been given a prescription for an antibiotic. Take the entire prescription as directed. The drugs you may be given will minimize swelling, reduce discomfort, prevent infection and promote healing. Discontinue only in the event of a rash or other unfavorable reaction and call our office immediately. NOTE: Antibiotics may reduce the effectiveness of birth control pills. Please use other forms of birth control until you start your next cycle.

Nausea & Vomiting

In the event of nausea from taking pain medication, keep something light in your stomach such as broth or saltines. Do not get up and move around more than necessary. Make sure to take your anti-nausea medication if one has been prescribed. Taking the anti-nausea pill 30-45 minutes before your pain pill will better cover your nausea. Call our office if nausea persists.

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. Miller if you have any questions.
  • A 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. Miller.
  • 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 uncomfortable. This will subside in two to three days.
  • Stiffness (trismus) of the jaw muscles may cause difficulty in opening your mouth for a few days following surgery. This is a normal post-operative event that will resolve in time.

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The removal of many teeth at one time is quite different than the extraction of one or two teeth. Because the bone must be shaped and smoothed prior to the insertion of a denture, the following conditions may occur (all of which are considered normal):

  • The area operated on may swell, reaching a maximum in two days. Swelling and discoloration around the eye may occur. The application of a moist warm towel will help eliminate the discoloration. The towel should be applied continuously for as long as tolerable beginning 36 hours after surgery (remember ice packs are used for the first 12 hours only).
  • A sore throat may develop. The muscles of the throat are near the extraction sites. Swelling into the throat muscles can cause discomfort. This is normal and should subside in two to three days.
  • If the corners of the mouth are stretched, they may dry out and crack. Your lips should be kept moist with an ointment like Vaseline. There may be a slight elevation of temperature for 24-48 hours. If temperature over 101°F continues, notify the office.

If immediate dentures have been inserted, sore spots may develop. In most cases, your dentist will see you within 24-48 hours after surgery and make the necessary adjustments to relieve those sore spots. Failure to do so may result in severe denture sores, which may prolong the healing process.

Finally

Sutures are often placed in 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. The sutures will otherwise dissolve on their own approximately 5-10 days after your surgery.

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 the office for instructions.

There will be a socket where the tooth was removed. The socket will gradually fill in with new tissue over the next month. In the meantime, the area should be kept clean especially after meals with salt-water rinses or a toothbrush.

Your case is individual. No two mouths are alike. Do not accept well-intended advice from friends. Discuss your situation with the persons best able to effectively help you: Dr. Miller 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 two to three days following surgery. Call the office if this occurs.

If you are involved in regular exercise, be aware that your normal nourishment intake is reduced. Exercise may weaken you. If you get light headed, stop exercising.

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After Exposure Of An Impacted Tooth

Do not disturb the wound. If surgical packing was placed, leave it alone. The pack helps to keep the tooth exposed. If it gets dislodged or falls out, do not get alarmed.

Bleeding

Following oral surgery, slight bleeding or oozing for the first day is common. Place a roll of gauze over the wound and bite down firmly for at least two hours. Do not spit or rinse. This only makes the bleeding worse. Swallow normally; the fluids will not hurt you. If bleeding continues after trying the above, bite on a moistened tea bag for 20 minutes. The tannic acid in the tea bag helps to form a clot by contracting bleeding vessels. Do not become excited, but rather lie down with your head elevated on three pillows. If bleeding does not subside, call for further instructions.

Swelling

The swelling that is normally expected is usually proportional to the surgery involved. Swelling around the mouth, cheeks, eyes and sides of the face is common. Swelling is a normal response following surgery but can be partially avoided by using an ice bag for the first 24 hours after surgery. Maximum swelling normally occurs on the 3rd day following surgery. A hot water bottle or heating pad should be used starting on the 3rd day after surgery to help bring the swelling down. Some mild temperature rise is to be expected after surgery.

Pain

For severe pain, take tablets prescribed for pain. For moderate pain, take 800mg of Ibuprofen, 3 times a day with food or juice. IMPORTANT! Swallow tablets, they are not to dissolve in mouth. If a prescription was given, please use as directed. The prescription for pain will make you groggy and will slow your reflexes. Do not drive an automobile or work around machinery. Move about slowly. If you suddenly sit up or stand up from a lying position, you may become dizzy or even black out for a few seconds. Without infection or other complications, the discomfort following an extraction or other oral surgery will usually disappear in a few days. However, if pain or swelling continues, it may require attention and you should call the office.

Diet

For the first 24 hours, cool liquids only may be consumed. Dehydration must be guarded against when having oral surgery, since a patient’s solid food intake is limited the first day. It is necessary to compensate for this by increasing the fluid intake (at least five to six glasses of liquid should be taken). Suggested food for the day of surgery: yogurt, pudding, jello, instant breakfast, milk, malts, ice cream, and applesauce. The day after surgery diet should consist soft foods such as soups, eggs, cottage cheese, and a hamburger patty.

Oral Hygiene

Mouth cleanliness is essential to good healing. Clean your mouth thoroughly after each meal beginning the day after surgery. Brush your teeth as best you can. Rinse with warm salt water (one teaspoon of salt in a cup of warm water) six times a day. Continue this procedure until healing is complete.

REMEMBER: A clean wound heals better and faster.

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After Placement Of Dental Implants

Do not disturb the wound. Avoid rinsing, spitting, or touching the wound on the day of surgery. There may be a metal healing abutment protruding through the gingival (gum) tissue.

Bleeding

Some bleeding or redness in the saliva is normal for 24 hours. Excessive bleeding can be controlled by biting on a gauze pad placed directly on the bleeding wound for 30 minutes. If bleeding continues, please call for further instructions.

Swelling

Swelling is a normal occurrence after surgery. To minimize swelling, apply an ice bag or towel filled with ice on the cheek in the area of surgery. Apply the ice continuously, as often as possible, for the first 12 hours.

Diet

Drink plenty of fluids. Avoid hot liquids or food. Soft food and liquids should be eaten on the day of surgery. Return to a normal diet as soon as possible unless otherwise directed.

Pain

For severe pain, take tablets prescribed for pain. For moderate pain, take 800mg of Ibuprofen, 3 times a day with food or juice. IMPORTANT! Swallow tablets, they are not to dissolve in mouth. If prescription was given, please use as directed. The prescription for pain will make you groggy and will slow your reflexes. Do not drive an automobile or work around machinery. Move about slowly. If you suddenly sit up or stand up from a lying position, you may become dizzy, or even black out for a few seconds. Without infection or other complications, the discomfort following an extraction or other oral surgery will usually disappear in a few days. However, if pain or swelling continues, it may require attention and you should call the office.

Do not take any medication if you are allergic to it, or have been instructed by your doctor not to take it.

Antibiotics

Be sure to take the prescribed antibiotics as directed to help prevent infection.

Oral Hygiene

Good oral hygiene is essential to good healing. The night of surgery, use the prescribed Peridex Oral Rinse before bed, if applicable. The day after surgery, the Peridex should be used twice daily, after breakfast and before bed. Be sure to rinse for at least 30 seconds then spit it out. Warm salt-water rinses (one teaspoon of salt in a cup of warm water) should be used at least four to five times a day, as well, especially after meals. Brushing your teeth with the healing abutments is not a problem. Be gentle initially when brushing the surgical areas.

Activity

Keep physical activities to a minimum for 48 hours following surgery. If you are considering exercise, throbbing or bleeding may occur. If this occurs, you should discontinue exercising. Keep in mind that you are probably not taking normal nourishment. This may weaken you and further limit your ability to exercise.

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