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The removal of impacted wisdom teeth and surgical extraction of teeth is quite different from the extraction of erupted teeth. The following conditions may occur, all of which are considered normal:

The surgical area will swell.
Swelling peaks on the 2nd or 3rd post -operative day
Trismus (stiffness) of the muscles may cause difficulty in opening your mouth for a period of days.
You may have a slight earache.
A sore throat may develop.
Your other teeth may ache temporarily. This is ‘referred pain’ and is a temporary condition.
If the corners of the mouth are stretched out they may dry and crack. Your lips should be kept moist with cream or ointment.
There will be a space, or socket, where the tooth was removed. After 24 hours this area should be rinsed frequently and following each meal with warm salt water until it is healed. This cavity will gradually fill in with new tissue.
There may be a slight elevation of temperature for 24 to 48 hours. If temperature continues, notify us.
It is not unusual to develop bruising in the area of the cheek, chin or in the site of extraction.

*Please take all prescriptions as directed.

Women please note: There has been some suggestion in the literature that some antibiotics may interfere with the effectiveness of your birth control pills. Additional forms of contraception may be appropriate during the use of the antibiotic. If you have questions, please consult your physician.

What you should do following extractions
and other oral surgery procedures

A certain amount of bleeding, pain, and swelling is normal. Reduce your activity as much as possible for several hours. Avoid unnecessary talking. Do not rinse your mouth or brush your teeth for 24 hours. These activities may hinder formation of a blood clot that is necessary for proper healing.

Do not be alarmed if your vision is blurred for a time following anesthesia or if a "black and blue" bruise should appear at the site of an injection. The arm also may be "black and blue", swollen and tender to touch due to the IV.

To control bleeding

Immediately following procedure keep a steady pressure on the bleeding area by biting firmly on the gauze placed there by your doctor. Pressure helps reduce bleeding and permits formation of a clot in the tooth socket. Gently remove the compress after the local anesthesia has worn off and normal feeling has returned.

After 24 hours some oozing of blood may persist. It may be necessary to resume the use of moist tea bags. After bleeding has stopped cautiously resume oral hygiene.

To relieve pain

Immediately following procedure begin taking medication as directed by your doctor to minimize discomfort when the anesthesia wears off and feeling is back to normal. Application of an ice bag can also help relieve discomfort. After 24 hours continue to take your medication if pain persists, and use an ice bag if needed.

To minimize swelling

Immediately following procedure apply an ice bag over the affected area. Use 20 minutes on and 20 minutes off for 24 hours to help prevent development of excessive swelling and discomfort. If an ice bag is unavailable simply fill a heavy plastic bag with crushed ice. Tie end securely and cover with a soft cloth to avoid skin irritation. After 24 hours it should not be necessary to continue with cold applications. Keep head elevated.

Special considerations following removal of impacted teeth:

Removal of impacted teeth is a surgical procedure. Postoperative problems are not unusual, and extra care must be taken to avoid complications. Severity of postoperative pain will depend on the procedure and your physical condition. Take medication for pain precisely as directed.

Healing of the surgical site is variable.
Swelling can be expected. Be certain to apply ice bags as directed above.
Difficulty in opening your mouth widely and discomfort upon swallowing should be anticipated.
Numbness of lips and/or tongue on the affected side may be experienced for a variable period of time.

Oral hygiene is important

Twenty-four hours after surgery, rinse mouth gently with a solution of one-half teaspoonful of salt dissolved in a glass of water. Repeat after every meal or snack for seven days. Rinsing is important because it removes food particles and debris from the socket area and thus helps prevent infection and promote healing. Brush tongue with a dry toothbrush to keep bacteria growth down, but be careful not to touch the extraction site. Resume your regular tooth brushing, but avoid disturbing the surgical site so as not to loosen or remove the blood clot.

Maintain a proper diet

Have your meals at the usual time. Eat soft, nutritious foods and drink plenty of liquids with meals and in between. Have what you wish but be careful not to disturb the blood clot. Add solid foods to your diet as soon as they are comfortable to chew.

In case of problems

You should experience no trouble if you follow the instructions and suggestions as outlined. But if you should have any problems such as excessive bleeding, pain, or difficulty in opening your mouth, call our office immediately for further instructions or additional treatment or the after-hours numbers on your instruction sheet.

Remember your follow-up visit

It is often advisable to return for a postoperative visit to make certain healing is progressing satisfactorily. A follow up visit will be scheduled. In the meantime, maintain a healthful diet, observe rules for proper oral hygiene and visit your dentist for regular checkups.

Care of Mouth After Oral Surgery

1. Do not rinse or spit the rest of the day after surgery.
  2. Keep fingers, tongue and utensils away from socket or surgical area.
   3. Use ice packs on surgical area (side of face) for first 24-48 hours; apply ice 20 minutes on - 10 minutes off. Bags of frozen peas work well.
  4. For mild discomfort take Aleve or Ibuprofen, if you can tolerate it, every three to four hours (follow package instructions) or Tylenol if necessary.
5. For severe pain use the prescription given to you. Do not mix Tylenol with prescriptions.
6. Drink plenty of fluids. (Do not use a straw)
7. If the muscles of the jaw become stiff, gentle stretching, as well as the use of warm, moist heat to the outside of your face over these muscles may help in regaining range of motion.
8. After the first post-operative day, use a warm salt-water rinse following meals for the first week to flush out particles of food and debris that may lodge in the surgical area. (1/2 teaspoon of salt in a glass of warm water. Mouthwash can be added for better taste.)
9. Diet may consist of soft foods, which can be easily chewed and swallowed. No seeds, nuts, rice, popcorn, etc.
10. A certain amount of bleeding is to be expected following surgery. Applying pressure to the surgical area using small rolled gauze for 90 minutes controls bleeding. After that time remove the gauze and then you may eat or drink. If bleeding persists, a moist teabag should be placed in the area of bleeding and bite firmly for one hour straight. This will aid in clotting of blood. Repeat if necessary. If bleeding still persists call our office.
11. Smoking is a real threat to the healing process. If you smoke you are more likely to experience severe pain and delayed wound healing. Smoking should be ceased at least during the first five days following surgery.
12. Feel free to contact us if any doubt arises as to your progress and recovery.