Surgical Instructions

Please read these instructions carefully. Sometimes the after effects of oral surgery are quite minimal, so not all of these instructions may apply. Common sense will often dictate what you should do. However, when in doubt, follow these guidelines or call our office for clarification.

  1. First Hour – Bite down gently but firmly on the gauze packs that have been place over the surgical areas, making sure they remain in place. Do not change them for the first hour unless the bleeding is not being controlled. If active bleeding persists after 1 hour, place enough new gauze to obtain pressure over the surgical site for another 60 minutes and continue to check every hour and replace if necessary.
  2. First Day – Do not disturb the surgical area today. DO NOT rinse vigorously or probe the area with any objects or your fingers. You may brush your teeth gently. DO NOT SMOKE for at least 48 hours; it is very detrimental to healing.
  3. Bleeding – Bleeding should never be severe. If it is, usually it means that the packs are being clenched between your teeth rather than exerting pressure on the surgical areas or socket sites. Try re-positioning fresh packs. If bleeding persists or becomes heavy, you may substitute a regular tea bag (soaked in warm water, squeezed damp dry and wrapped in moist gauze) for 30 to 45 minutes. If bleeding remains uncontrolled, please call our office.
  4. Swelling – Swelling of varying degrees is expected. After removal of impacted teeth or trimming of bone, swelling if often quite marked. The swelling reaches its maximum on the 2nd or 3rd day and begins to resolve on the 4th day. Ice packs applied firmly to your cheek adjacent to the surgical area for the first 12 to 24 hours often help to reduce swelling significantly. Do not lie flat but keep your head elevated. This will not only help reduce swelling but will help control persistent oozing of blood during the first 24 to 48 hours. Heat applied after 48 hours can help stiffness and swelling.
  5. Numbness – After removal of lower impacted teeth, numbness about the corner of the mouth and lower lip (on operated side) may develop. This is called paresthesia and is usually a temporary condition which will correct itself. It may remain for a few days to several months. The incidence of permanent numbness is less than 1%.
  6. Sympathetic pain in other teeth – The remaining teeth may ache temporarily. This minor aching is referred to as sympathetic pain and may last 2 to 3 weeks.
  7. Pain – For several days immediately following surgery some discomfort is expected. By the 5th day, the pain should be considerably diminished. Many patients tell us that the pain is worse the 2nd or 3rd postoperative day. You will usually have a prescription for pain medication – take them as directed.
  8. Dry Sockets – A dry socket occurs when the clot is lost from the socket of the impacted tooth, and the surface of the exposed bone becomes inflamed. It has been shown statistically that approximately 5% of the patients having impacted wisdom teeth removed will experience a “dry socket”. We know that people who smoke and women on birth control pills have a much higher incident of dry socket, approaching 25%. The chief symptoms produced are pain in the surgical area (almost always in the lower jaw), referred pain to the ear on that side, and a throbbing ache. A dry socket is not an infection. In fact, it is a self-limiting problem which, if left alone, will resolve spontaneously in 3-5 days after it begins. However, occasionally the pain from a dry socket may be severe and for your comfort can be treated in the office with a medicated dressing in the socket site.
  9. Nausea – Nausea is not uncommon, and is most often caused by swallowing blood or as a side effect of pain medication. It may be reduced by continuing to sip clear liquids. Cola drinks that have less carbonation may help to ease nausea as well. Usually nausea is self limiting, passing within 3-4 hours. If repeated vomiting persists however, call us.
  10. Diet – Eat any nourishing food that can be taken with comfort. Be sure to drink plenty of liquids today (remove packs prior to drinking). Temperature doesn’t matter, but avoid extremely hot foods. It is sometimes advisable, but not required, to continue the first day’s intake of bland liquids or pureed foods, such as pasta, pudding, apple sauce, jello, sherbet, etc. Avoid foods like nuts, seeds, popcorn, etc., that may get lodged in the socket areas. Over the next several days you can progress to solid foods at your own pace. It is important not to skip meals! If you take nourishment regularly, you will feel better, gain strength, have less discomfort and heal faster. If you are a diabetic, maintain your normal eating habits as much as possible and follow instructions from us or your physician regarding your insulin schedule.
  11. Sharp Edges – If you feel sharp edges in the surgical areas with your tongue, it is probably the bony walls which originally supported the teeth. Occasionally small slivers of the bone may work themselves our during the first week or two after surgery. They are not pieces of tooth and if necessary, we will remove them. Please call the office if you are concerned about these.
  12. Oral Hygiene – Keeping your moth clean surgery is essential. Starting the day after surgery, do not be afraid to brush your teeth. Even though it will be sore, it is extremely important that your teeth remain clean. Proper healing of the soft tissues surrounding the extraction site, as well as avoidance of post operative infections, require that you make every effort to maintain excellent oral hygiene during the healing phase.
  13. You are advised not to operate machinery or drive for 24 hours after general anesthesia or IV sedation.

It is our desire that your recovery be as smooth and pleasant as possible. Following these instructions will assist you, but if you have questions about your progress, please call our office. Calling during office hours will afford a faster response, however, a 24-hour answering service is available for after-hours contact with the doctor.