Post Op Instructions for Removal of 3rd Molars, Impacted Teeth & Complicated Extractions
For emergencies and problems, call us at 410-337-7755.
DRIVING/WALKING: Patients who have received intravenous medication or gas should not drive for 24 hours. They should also walk with assistance to avoid stumbling and injury until fully recovered from the anesthetic. Showering and bathing should be delayed until the following day after surgery.
BLEEDING: Bite on gauze for twenty to thirty (20-30) minutes at a time. Initially the gauze will be bloody, but this should lessen by the third or fourth change of gauze. Do not spit or use a straw for 72 hours. Talking and general activity will cause continued oozing. You should feel light, moderate pressure when biting.
If bleeding recurs or continues, place a damp tea bag directly on the wound and bite for one hour. Positioning of the gauze or tea bag is very important. For wisdom teeth, the gauze or tea bag must press directly on the gum at the surgical site. Realize that blood-tinged saliva is normal and to be expected for 24 hours.
MEDICATION: Immediately after surgery, remove gauze and drink 6-8 oz. of a milkshake (use a spoon) or eat something cool and soft, (DO NOT USE A STRAW) then take medications as prescribed. This way the pain medication will take effect before the numbness wears off. After that, take pain pills as prescribed, or substitute milder medication (Advil, Tylenol, Aspirin, etc.) instead. Take with food. An upset stomach is usually due to the pain medication. If stomach upset occurs, stop the pain medication, take 25 mg. of Benadryl and allow the stomach to settle. If upset stomach continues or rash and/or itching occurs, call our office. Do not drive after taking pain medication. In addition, BIRTH CONTROL PILLS may not be effective for the cycle in which you take antibiotics; you need to take additional contraceptive precautions for that cycle. 25 mg. of Benadryl and 2 Advil will substitute for pain medicine in many patients.
ICE: Apply ice to jaws following all surgical procedures. The position of the ice pack should be changed every 30 minutes. Ice packs are most helpful during the first 24 hours.
ORAL HYGIENE: After 24 hours, begin very gentle rinsing with warm saltwater (1/4 teaspoon of salt in 8 oz. of warm water). Do not swish the water in your cheeks. Just move your head and allow water to passively move across the stitches. Do not spit. In most cases, brushing may be resumed the following day. Do not brush in the area of stitches or the wound area. Carefully brush only the teeth not involved in surgery. Vigorous rinsing of your mouth will cause loss of clot, dry sockets and pain!
ORAL HYGIENE WITH GRAFT PROCEDURES: The graft is delicate and can be damaged by rinsing or normal brushing. We suggest no rinsing around grafts. Do not use an electric toothbrush around the graft. Place a normal toothbrush under warm water. Delicately brush the teeth adjacent to the graft and the sutures. You may use toothpaste on the remainder of the teeth. Take care not to spit vigorously. Just allow water to fall out of the mouth.
SMOKING: Smoking delays healing and increases your chances of infection and pain. It is recommended that you do not smoke for a minimum of 5-6 days following extractions.
DIET: After the milkshake, your diet should consist of soups, juice and even scrambled eggs or pasta the next day. Avoid very hot foods, but warm is OK. Nothing harder than pasta should be eaten for one week following wisdom teeth extractions and for three days following other surgery. Increase the texture gradually after that time, testing for after-effects. Avoid peanuts and crunchy foods for six weeks. Avoid popcorn for two months.
ACTIVITY: No heavy lifting or exercise for one week following removal of wisdom teeth. For graft procedures, no exercise until seen by Dr. Cameron on your post-op visit. This can be up to 2-3 weeks for graft procedures and implant surgery.
STITCHES: Absorbable sutures may fall out in 3-10 days. There is no problem if they are swallowed. If they are bothersome, we will remove them at your postoperative appointment.
DRY SOCKETS: If pain increases or is referred to the ear on the third or fourth day following surgery, call us and come in. A dressing could be placed that will relieve or eliminate the pain. You will lessen your chances of dry socket and bruising and improve healing by not smoking.
SWELLING: We use medications at surgery to reduce pain and swelling. Swelling and bruising are normal following surgery and will peak on the third morning following surgery, then gradually dissipate.