Wisdom teeth / Extractions
Surgical instructions for post-operative wisdom teeth extractions.
Medications
You will have received a prescription for a pain medication and possibly an antibiotic. Take these medications as prescribed. One possible side effect of any pain medication is constipation, drinking lots of fluids will help avoid this, but if it does occur the use of an over the counter stool softener will help.
Pain
Post-operative discomfort is a normal response to any surgical procedure. The local anesthetic or freezing administered during your surgery will probably last from two-six hours and may last up to twelve hours. Ketorolac is most effective if taken every 6 hours. Please continue the Ketorolac for 7 days even if you are experiencing no discomfort. Tylenol #3 / Tramacet is to be taken as prescribed ONLY if the ketorolac is not controlling the pain. The discomfort usually peaks after the first 72 hours. If in fact the pain is increasing after this period of time, please contact our office for further instructions
Please note: pain medications taken on an empty stomach often results in an unsettled feeling and or nausea and vomiting. Please attempt to take food or fluids either with your pain tablet or as soon after as possible. If vomiting persists, discontinue use of the Tylenol #3 and replace with regular Tylenol and the use of Gravol can help with the nausea.Bleeding
It is normal to bleed or ooze for some time following oral surgery. It is also not unusual to have blood on the pillow or see streaks of blood in the saliva for 3-4 days after surgery. To control bleeding use the supplied gauze and bite down with firm constant pressure directly over the surgical site. Change the gauze every 30 minutes. Once bleeding is minimal, gauze may be removed. Ensure that gauze is removed prior to going to bed for the night. It is not unusual to taste blood for a few days. AVOID SPITTING. If the bleeding is excessive, (i.e. gauze soaked with blood every 5 minutes) place damp gauze in the freezer until cold; rinse mouth with ice cold water and place the cold gauze over the surgical site. The cold temperature will cause constricting of the blood vessels which will help stop the bleeding. If heavy bleeding persists, call our office.
If the oozing or bleeding continues the following day, then simply re-apply firm gauze pressure as directed above. If gauze packs are not available, then a clean cloth folded as a pack or tea bag may be used as a substitute. Again, while applying pressure, do not "chew" the gauze, but rest quietly with firm pressure and with your head elevated slightly.
Facial swelling and stiffness
This occurs following nearly all extractions and oral surgery. This is nature's way of helping the healing process by splinting and resting the surgery area. The swelling is at its peak on the third day following surgery and begins to disappear on the fourth day.
Use the cold packs provided for the next 48 hours. After 48 hours, switch to moist heat to the jaw to help with discomfort in the jaw muscle. It is not uncommon to experience moderate bruising of the facial tissues. This will resolve on its own over time. Return of normal jaw movement may take up to two to three weeks.
Infection
Post-operative infections are rare. Signs of infection may include: Sudden increase of swelling, elevated temperature, and feeling ill. If this should occur, please contact our office.
A slight post-operative temperature elevation for two-three days is normal following surgery and anesthesia. Careful attention to oral hygiene will greatly reduce the possibility of infection.
Bruising
Moderate bruising of the facial tissues following oral surgery of extractions is not uncommon. The bruising may appear as a dark purple to a greenish yellow color. Normally the bruising will disappear in seven to ten days. Gentle massage with a hot face towel applied to the area for 15 minutes each waking hour will aid in a gradual return to normal coloration.
Diet and nutrition
Day of surgery:
Cool soft foods are usually tolerated well (i.e. milkshakes (using a spoon: NO STRAWS), ice cream, applesauce, pudding, Jell-O, yogurt, mashed potatoes, oatmeal, pasta etc. AVOID hot liquids (i.e. coffee, tea, soup etc.) for at least four - five hours or until freezing is gone.
Days following surgery:
Following extractions or other surgery, your body requires adequate fluids and nourishment. Drink ample fluids (2-3 liters/day). Avoid alcohol as it delays healing. Gradually progress to more solid foods. Hard or crunchy foods are NOT a good idea for 3-4 weeks. DO NOT USE A STRAW FOR AT LEAST 6-7 DAYS.
SMOKING/ VAPING
DON'T!!
Smoking /vaping is discouraged during the healing period (2-4 weeks). Smoke is a tissue irritant and it can lead to increased risk of infection, delayed healing and dry sockets.
Oral Hygiene
The day following your surgery, you can start gently brushing your teeth and tongue. If you were prescribed a mouth rinse please continue using it for the first 1o days after the surgery. It is best to rinse 2-3 times a day. Warm salt water rinses should be done after you eat (½ -1 tsp. salt in a large glass warm water). SPIT GENTLY On your follow-up visit, you MAY be given a curved tip syringe. The purpose of this syringe is to clean food-debris out of the lower sockets. Fill the syringe with warm, salty water, pull the cheek out to one side and insert the tip of the syringe into the lower sockets and GENTLY flush.
Numbness or Tingling in the lip or tongue
Due to the position of many impacted teeth, sensory nerves supplying the lip, chin or tongue may be affected. In the unlikely event that the nerve was affected at surgery, you may experience numbness, tingling or an altered sensation in the lower lip, chin and/or tongue. This indicates that the involved nerves are regaining normal function. It may, however, require several months for normal function to return. In extremely rare situations, normal sensation may not return.
Intravenous sedation and general anesthetic pain
Patients who have a general anesthetic may experience muscle pain especially around the neck and shoulder, but this can occur anywhere, including the chest, back, legs and arms. The pain is often like that which occurs after heavy exercise. Although it is inconvenient and uncomfortable, it is not unusual or dangerous to experience these symptoms. The stiffness and discomfort usually last for only two to three days, but has been known to linger for up to one week. It is best treated by rest, heat and your post-operative pain pill.
General anesthetic and intravenous sedation
1. Do NOT leave the patient alone for the remainder of the surgical day. Accompany the patient home where he or she is to rest.
2. ABSOLUTLEY NO driving or operating machinery for the first 24 hours following your surgery.
After a general anesthetic, you may experience an irritated nose and throat because of the breathing tube that was inserted while you were asleep. This will resolve over the next couple of days.
If you have any questions or concerns, do not hesitate to contact our office at 403 347 4440 or 1800 662 7175. There is an after-hours contact number on the answering machine.
For post-operative concerns, please call our office rather than your own dentist or family doctor. If, however, this is a life - threatening emergency, do not delay: dial 9-1-1
If you are admitted to the hospital for any reason within 10 days of surgery, please notify us immediately.
FOR PATIENTS WHO ARE GETTING AN IMMEDIATE DENTURE AFTER FULL MOUTH EXTRACTIONS
Oral Hygiene
Day of surgery:
DO NOT TAKE YOUR DENTURE OUT FOR 24 HOURS FOLLOWING YOUR SURGERY
Rinse your mouth with your dentures out with the mouthwash that was prescribed for you or with warm salt water (1 tsp. of salt to 1 cup of warm water) if nothing was prescribed.
Days following surgery:
For the next week, you should wear your denture as long as possible. Removing the dentures for more than several minutes at a time may allow the gum tissues around the extracted tooth sockets to swell, preventing you from re-inserting your dentures. Remove your denture ONLY to clean it and rinse out your mouth. This may be done 3 times a day, or more if required.
Other General Instructions
