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.
The gauze pad placed over the surgical area should be kept in place for 20 minutes after you are discharged from our office. After this time, the gauze pad should be removed and discarded. Refer to the section on bleeding for further instructions. Place ice packs to the areas of your face where surgery was performed. Restrict your activities the day of surgery and resume normal activity when you feel comfortable.
For the first 72 hours, do not:
Some bleeding is expected after tooth extractions. It’s important for a blood clot to form to stop the bleeding and begin the healing process. That’s why we ask you to bite on a cold, damp gauze pad for 30 minutes after the appointment. If the bleeding or oozing persists, you will need to moisten the gauze with ice-cold water, squeeze out the excess water, and bite down with firm pressure for 20-30 minutes. If bleeding continues, moisten a tea bag with ice-cold water and bite down for 20-30 minutes. The tannic acid in the tea bag helps to form a clot by contracting the blood vessels. A small amount of bleeding can continue intermittently for a couple of days especially if the area is stimulated by movement. After the blood clot forms, it is important not to disturb or dislodge the clot, as it aids in healing.
Swelling is also a normal part of post-operative healing and can increase for 2-3 days following any surgery, slowly resolving after this. You may apply an ice pack to the area for 20 minutes at a time for the first 24 hours; this will help minimize pain and swelling during this time. After 24 hours, you may switch to warm, moist heat.
If you have been sedated for your procedure, you may not drive for 24 hours. If you have been prescribed a narcotic pain medication, you also cannot drive while taking this. If an antibiotic mouth rinse is prescribed, do not begin using until the day after your procedure to avoid stimulating further bleeding. If an antibiotic was prescribed, make sure to take as directed and until completely gone to help prevent infection.
You should begin taking pain medicine as soon as you feel the local anesthetic start wearing off. For mild to moderate pain, ibuprofen (Advil® or Motrin®) may be taken. Ibuprofen bought over the counter comes in 200mg tablets: 3 tablets may be taken every 6 hours as needed for pain. You may alternate with 2 Extra Strength Tylenol® as needed (example: 12 PM—Ibuprofen, 3 PM—Tylenol, 6 PM—Ibuprofen, 9 PM—Tylenol). For severe pain, the prescribed pain medicine should be taken as directed with food. Tylenol may be in the prescribed pain medication; therefore, do not take Extra Strength Tylenol when taking prescribed pain medication. Do not take any of the above medications if you are allergic or have been instructed by your doctor not to do so.
For children, use over-the-counter Children’s Tylenol® or ibuprofen as directed per instructions on the bottle as needed for pain.
Hydration and nutrition are important for healing following surgery. You may be more comfortable with a soft diet initially, but you can eat what you like. You are only limited by your discomfort. Stick to cold and/or soft foods and liquids while you are numb. Remember to always eat prior to taking any pain medication to avoid nausea. Return to a normal diet as soon as possible unless otherwise directed.
Good oral hygiene is essential for healing. Continue brushing and flossing your teeth, avoiding the surgical site(s) initially; remember, no vigorous swishing or spitting for 72 hrs.
An irrigating syringe will be given to you on the day of surgery. Start using an irrigating syringe to lower extractions sites 72 hours (3 days) after surgery. You will fill the syringe with warm water or Peridex® (if prescribed), insert the tip gently into the opening at the lower extraction site, and flush out any trapped food or debris after every meal and as needed. You will need to do this until there is no longer an opening to trap food.
Keep physical activities to a minimum immediately following surgery. If you are considering exercise, throbbing and/or bleeding may occur. If this occurs, you should discontinue exercising. Keep in mind that you are probably not taking in normal nourishment, which may weaken you and further limit your ability to exercise. Limit any vigorous exercise for 24 hours after surgery, as this will increase blood pressure and may cause more bleeding from the extraction sites.
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