AFTER EXTRACTION:

Bleeding:

Biting on the gauze pads will probably be necessary at least for the first few hours to control bleeding -- changing them every 20 minutes or so. Keep the head elevated and rest. Do not spit or rinse excessively or engage in physical activity since this stimulates bleeding. Some oozing could last up to 24 hours. NOTE: If heavy bleeding persists, replace the gauze with a clean folded gauze pad placed over the surgery site and maintain pressure until the bleeding stops. In rare cases, a moistened tea bag (tannic acid) may need to be used to encourage clotting. Only black tea is effective. Call Dr. Mina Levi if bleeding doesn’t stop or is heavy for too long.

Swelling:

This is normal following a surgical procedure in the mouth. It should reach its maximum in 48 hours and then diminish by the fifth post-operative day. The anti-swelling medicine we usually give cuts it way down to less than 1/4 of what it would normally be. Place ice or cold compresses on the face in the region of the surgery intermittently (20 min on and 20 min off). Ice is only effective on the day of surgery.

Discomfort:

The most discomfort that you will experience will occur as the anesthetic wears off -- usually 1-2 hours after surgery. If a long-acting anesthetic was used, you may be numb for much longer than normal. Do not wait for the pain to become severe before taking the medications since the medicine will require about 30-45 minutes to take effect. Pain will gradually diminish over the next few days. The maximum dose of Lortab in 24 hours is 40 mg (for the average size person).

Smoking:

If you smoke, avoid smoking during the first week after surgery.

Diet:

A nutritious liquid diet is necessary for the first day. Hard foods eaten while you are numb can dislodge the gums that were lifted up and then sutured in place. When the numbness wears off, you can gradually progress to harder foods. Activity: For the first 24-48 hours, you should rest. Patients who have sedation should refrain from driving an automobile or from engaging in any task that requires alertness for the next 24 hours.


STARTING THE DAY AFTER SURGERY:

  1. Brush teeth but avoid the surgery area. As healing takes place, you can gradually brush teeth near the surgery site. Soften the bristles by placing them under hot water.
  2. Use warm salt water as a mouth rinse 3-5 times per day for 5-7 days after surgery. (1 tsp salt in a glass of warm water)
  3. If antibiotics are prescribed, be sure to take them all as directed. Note: They can render birth control pills ineffective.
  4. Usually absorbable sutures are used and do not need to be removed. However, it is good if you can be seen by your dentist about 5-6 days after surgery to be checked. If you have a dry socket or other problem, it can be treated to prevent unnecessary pain.
  5. Dry socket is a delayed healing response which may occur during the 3rd to 6th post-operative day. It is in a lower socket and associated with a throbbing pain on the side of the face which may seem to be directed up toward the ear. In mild cases, simply increasing the pain medication for a few days can control the symptoms. If this is unsuccessful, please call your doctor to arrange for some medication to be temporarily placed in the socket. They generally get better whether treated or not. Dry sockets can be brought on by rising or spitting too much the first day, too much physical activity, using a straw, smoking, birth control pills, particularly difficult surgery, and pre-existing infection. They are twice as common in patients over 30.
  6. Don’t chew hard (even on a hard crust of bread or on ice) for 4-6 weeks after having lower wisdom teeth removed or participate in sports where you may be hit in the jaw. The lower jaw is temporarily weaker and the bone may crack requiring the jaws being wired together for healing.
  7. Residual IV drugs in your body may make you light-headed for a few days -- especially if you take a hot shower. Be careful. Call Dr. Mina Levi if there is any inflammation or pain with your IV injection site (arm or hand).

CONTACT THE DOCTOR IF:

  1. Bleeding is excessive and cannot be controlled.
  2. Discomfort is poorly controlled.
  3. Swelling is excessive, spreading, or continuing to enlarge after 48 hours.
  4. Allergies or other reactions to medications occurs.