After wisdom teeth removal when can i stop using gauze

After Wisdom Tooth Removal

After Wisdom Tooth Removal

Surgery of the mouth, like surgery in other parts of the body, requires careful attention to post-operative care in order to minimize the normal after-effects.

Emergencies

If you have any questions or problems, call our office at 604 924-8088. There is always an Oral and Maxillofacial Surgeon on call if you have an emergency after hours.

Bleeding

• Some oozing is normal for 24 – 48 hours. Excessive bleeding can frequently be controlled by biting with pressure on a pad of damp sterile gauze directly on the bleeding wound for 60 minutes.
  
• Change gauze every 30-60 minutes as needed until bleeding subsides (usually 2 – 3 hours after your procedure). If bleeding starts again, it’s often controlled by these above measures.
  
• Ensure that you DO NOT sleep with gauze in your mouth.
  
• Keep head elevated, minimize activity, avoid spitting. Do not touch or brush the wound in the first 24 hours.

Swelling

• Some swelling may occur several hours after surgery, reaching a maximum within 3 days.
  
• Apply an ice pack on the cheek as much as tolerated for 48 to 72 hours. After the third day, warm packs applied to cheeks may help to diminish swelling and stiffness.

Pain

• Before the anaesthetic diminishes and the sensation starts to return, begin the take the prescribed pain medication, only as directed.
  
• Experience in pain is extremely variable. Take prescribed pain medication as needed.
  
• Taking your pain medication with food helps to prevent nausea.
  
• If an antibiotic is prescribed, finish the prescribed medication.
  Note: antibiotics decrease the effectiveness of the birth control pill.

Diet

• Soft, cool foods and liquids will be easier to eat. Return to a normal diet as tolerated unless otherwise directed.  Avoid hot fluids and the use of a drinking straw for 1 week.

Oral Hygiene

• Mouth and wound cleanliness is essential to good healing. Rinse your mouth with warm salt water (1/2 tsp salt in a glass of warm water) on the evening of surgery and continue to rinse after eating until healing is complete. Brush your teeth normally on the evening of surgery, avoiding the wound. The day after surgery, brush the teeth normally, and also gently brush the wound, even if stitches are present.
  
• Stitches will dissolve on their own.
  
• Avoid antiseptic mouth wash for 1 week.
  
• Continue to rinse with salt water after meals until the wound is completely healed.
  
• Start use of the syringe 4 days after surgery to irrigate lower tooth extraction sites with warm salt water. Use syringe 3 times per day after meals until unable to do so.

Safety

• DO NOT DRIVE for the remainder of the day if you have had IV sedation or general anaesthetic. You are legally impaired.
  
• DO NOT DRIVE OR OPERATE MACHINERY if taking Tylenol #3 and this medication can cause drowsiness.

Miscellaneous

• Difficulty in opening and closing the mouth, bruising, and difficulty swallowing are conditions which sometimes occur. These are normal post-operative conditions and will resolve in time. Avoid smoking for 1 week to prevent complications in healing, such as dry sockets. The trend should be improvement beyond the third day. If after the third day, there is obvious worsening of the symptoms, please call the office.

• Bite hard on the gauze for 30 minutes if you are dismissed with gauze in your mouth. Remove the gauze after 30 minutes and do NOT place new gauze in your mouth if bleeding has stopped. A trail of blood in your saliva is NOT bleeding. Residual bleeding can last up to 36 hours. Bleeding is saturated blood constantly oozing out of the extraction site and it would outflow when you try to speak. If you have bleeding, then place new gauze over the extraction site (NOT between the teeth) and bite hard on it for one hour. Make sure that you swallow your saliva as you bite on the gauze during that time. (Only about 5% of our patients have to apply new gauze after leaving our office.) If you still bleed after doing this, contact our office immediately.

• SWALLOW YOUR SALIVA!!!!!!! Swallowing your saliva will create enough pressure to stop the residual bleeding and stabilize the blood clot. Swallowing your saliva will prevent DRY-SOCKET PAIN.

• To reduce swelling, apply a cold compress in the area—10 minutes on, 10 minutes off in the first hour after surgery. It is normal to develop swelling after the surgery. Just know that the peak of the swelling is around noon the next day. The swelling should resolve slowly after the afternoon the next day. If the swelling gets worse after the next day, you must contact our office immediately. We would like to bring you in for evaluation.

• Do not spit, suck on extraction site, smoke cigarettes, rinse your mouth vigorously, or drink through a straw for at least 4 days. These activities or anything you do to disturb the blood clot will lead to delayed healing and DRY-SOCKET PAIN.

• Take pain medication and other medications as directed. We recommend taking pain medication before the surgery. But if you did not, then it is very important that you take pain medication ASAP before numbness wears off. Just remember that when you have pain, it takes longer for pain medication to take effect. So take pain medication ASAP.

• Wait for numbness to wear off before you eat. This may take a few hours.

• Eat soft food. Chew on the opposite side if appropriate. Do NOT eat temperature hot and spicy food. Return to normal diet as you feel comfortable.

• Limit strenuous activity and exposure to the hot sun heat for two days after the extraction surgery.

• Brush and floss your teeth without disturbing the extraction site. Do NOT use the Waterpik for one week after surgery.

• Rinse your mouth with Chlorohexidine if dispensed you. Rinse with Chlorohexidine for 30 seconds twice daily after you brush your teeth in the morning and at night. You can substitute Chlorohexidine with warm salt and water as well.

• Nausea is not uncommon after surgery. It is sometimes caused by the pain medication. To reduce nausea, you must eat before you take the pain medication and take the pill with a lot of water. If you do not feel better or vomit repeatedly, please call our office immediately.

• If you feel sharp edges in the surgical areas with your tongue, it is probably small slivers of bone working themselves out during the first week or two after surgery. They are not pieces of the tooth. If they bother you, we will remove them. Please come in for an evaluation.
• Do not disturb or touch the wound.

• Avoid rinsing or spitting for 2 days (48 hours) to allow blood clot and graft material stabilization.

• Do not apply pressure with your tongue or fingers to the grafted area, as the material is movable during the initial healing.

• Do not lift or pull on the lip to look at the sutures. This can actually cause damage to the wound site and tear the sutures.

• Do not smoke.

• For mild discomfort, take Tylenol® or ibuprofen every 3–4 hours.

• For severe pain, use the medication prescribed to you.

• If you develop DRY-SOCKET PAIN, you need to come in for treatment. DRY-SOCKET PAIN is noticeable, distinct, persistent, throbbing pain in the jaw often radiating toward the ear. DRY-SOCKET PAIN can develop days after you have been feeling better. DRY-SOCKET PAIN can easily be treated in the office so don’t wait.

EXTRACTION SITE 101

After the tooth is extracted, the bony extraction socket is exposed. Blood fills up the bony socket and solidifies into a clot. The clot is the healing tissue. This clot is necessary for healing. Anything you do to lift or dislodge this clot, you will develop DRY-SOCKET PAIN. Just how painful is DRY-SOCKET PAIN? How do you rate pain when your bone socket is exposed to the air? Let’s avoid developing DRY-SOCKET PAIN.

TOP THREE MISTAKES LEADING TO DRY-SOCKET PAIN

3. Smoking cigarettes

2. Spitting

1. Placing dry gauze over extraction site after bleeding has stopped. The blood clot will stick to the gauze and you will remove it. Just bite, we mean really bite hard on that same gauze that we dismiss you with for 30 minutes and then toss it. Swallow your saliva after that. Swallowing your saliva will create enough pressure to stop the rest of the bleeding and swallowing your saliva will ensure that the precious blood clot is intact and stable.

SHOULD YOU FORGET WHAT YOU JUST READ SO FAR, JUST REMEMBER ONE SIMPLE RULE AND YOU ARE FAR BETTER OFF AFTER EXTRACTION SURGERY – SWALLOW YOUR SALIVA!!!!!!

If you have prolonged or severe pain, swelling, bleeding, or fever contact our office immediately. We will give you exact instructions on how to care for your problem.