Wisdom Teeth Extraction

BEFORE YOUR WISDOM TEETH EXTRACTION

• Plan to take time off from work or school, as you will need at least a day to rest after the surgery.
• You should tell your surgeon all the medications you are taking as he may ask you to make some changes.
• Patients taking aspirin will sometimes need to discontinue their medication after consulting with their medical doctor.
• Your surgeon will give you instructions on what to eat. He or she may ask you not to eat or drink from midnight before the procedure to be prepared for the anesthetic you will receive before surgery.
• Wear loose-fitting and comfortable clothing, preferably with short sleeves, as it will be easier to insert the intravenous line if you will be receiving medication in this way to help you relax and ease any discomfort.
• You should plan to have a responsible adult take you home after your surgery, as you should not drive for a period of 24 hours after the procedure.
• There are certain surgical risks associated with wisdom tooth extraction. Your surgeon will discuss these with you in person. Each case is different depending on the extent to which the wisdom teeth are impacted.

AFTER YOUR WISDOM TEETH EXTRACTION

You will need to rest for a while in the office after the general anesthesia or sedation. Once the anesthesia has worn off, most patients can go home escorted by a responsible adult. However if you have had general anesthesia you should have someone drive you home and stay with you for a period of 12 hours. Please follow the recommendations of your surgeon:

Medication

• Your jaw may feel stiff and sore but if needed, you will be given pain medication to make you more comfortable. Start your pain medication as soon as you return home before the freezing completely wears off.
• Take your pain medication every 6 hours for first 48 hours, then as needed. With exception of the first doses, try to not have an empty stomach.
• Some pain medication will make your feel sleepy, so it is advised that you do not drive or operate machinery.

Head position

• Prop up your head with a pillow, when in bed for the first two nights after your surgery to help reduce swelling: lying flat could also make you to continue bleed for longer a period of time.

Bleeding

• You can expect some bleeding for 24-48 hours after the surgery.
• Continue to bite gently on gauze squares folded in four off and on for 20 minutes at a time. Change the gauze as it becomes soaked with blood.
• Sitting upright, avoiding excitement and exercise will help control the bleeding.
• You should call your surgeon if the bleeding continues beyond this period.

Swelling

• You may experience some bruising and swelling of your face during the first week. Be assured that this is a normal part of the recovery process.
• Hold an ice pack to your face (30 minutes on and 30 minutes off) for the first 48 hours to reduce the swelling. You can expect the swelling be greatest within 24-48 hours after surgery. Generally icing is helpful for the first 36 hours. After this time, applying moist heat to the sides of the face may bring down the swelling further. It is not unusual for swelling and jaw stiffness to last for 4-5 days.
• If the swelling disappears and then returns after a few days, please contact your surgeon immediately. Although this is not common, it may be a sign of infection.

Hygiene

• You will initially notice a cavity or empty space in the area where you tooth was removed. It is important to keep it clean by rinsing your mouth after meals and before going to bed.
• At the time of your follow up appointment, your doctor may provide you with special instructions on how to flush out this healing socket to avoid food entrapment and speed up the healing of the area.
• Starting the day after surgery, a salt water rinse (1 teaspoon of salt in one glass of warm water) should be used after meals and before bedtime.
• Gentle tooth brushing can be resumed the day after surgery using a soft brush.
• The areas near the incision should be cleaned, but do so very gently.

Nutrition

• To ensure a quick recovery, you should rest, eat a nutritious diet and follow your surgeon’s instructions for the care of the extraction site.
• Eat a light diet including soft foods such as yogurt, soup, milk products and Jell-O for the first few days.
• Avoid hot food and do not use a straw as this may lead to bleeding.
• You may slowly resume a normal diet when you feel you are able to.

Smoking

• You should not smoke or drink alcohol as this can increase bleeding and delay your recovery. Smoking can also reduce the blood supply to the area and bring germs to the extraction site.

Activity

• Get plenty of rest for the first 24 hours. Avoid any physical activity as it could prolong the bleeding. Also remember that your nutritional intake has been reduced and you may feel tired and lightheaded upon exercise.
• Be careful to resume exercise gradually.

Stitches

• Dissolving stitches are used for most operations. These normally begin to fall out after three to four days.

Other Sensations

• Your chin, lip or tongue may feel numb, but this generally is a normal and temporary condition.
• Take care not to bite the inside of your cheek, lip or tongue while you mouth is still frozen.
• You may have a slight fever body temperature after the procedure. Acetominophen or ibuprofen can be taken to bring it down. If fever persists, please call the office at 514-931-7077.
• You should move carefully from the lying to the standing position. Remember that you had not eaten and limited your fluid intake before the surgery and now you may be using medications that make you feel dizzy. Standing up suddenly could make you feel light-headed so wait a minute before changing position.
• You may feel that your throat is sore and have pain on swallowing. This is due to muscle swelling in the area and should disappear within two to three days.
• If the skin around corners of your mouth gets dry and cracks, moisten these areas with an ointment such as Vaseline.
• Your jaw muscles may feel stiff for a few days, a condition we call “Trismus” and as a result it may be more difficult to open your mouth. This part of the normal healing process and will resolve with time.
• Dry socket is a painful condition that sometimes occurs when the blood clot in the surgical site becomes dislodged too soon, usually appearing within 2-3 days AFTER the extraction. This can be easily treated with a special type of socket dressing or packing to ease the discomfort. Please contact the office [(514) 931-7077] if this occurs.

Most people experience no problems after a wisdom tooth extraction, but contact your surgeon or the hospital immediately if you:

• Experience bleeding that is difficult to control.
• Have severe pain that is not controlled by the medication.
• Have fever or chills.
• Experience new swelling of your cheeks, jaw or face after the original swelling has begun to decrease.
• Develop itching, a rash or other symptoms suggesting you are having an allergic reaction to your medication.
• Experience continuous nausea or vomiting.

Follow-up Appointments

• Our office coordinator will set up an appointment for you within 10 to 14 days after your surgery so that your surgeon can check on how you are healing.

Questions

• If you have any questions or problems, call our office (514) 931-7707 and we will be pleased to help you.
• In emergency situations, you may reach Dr. Chehade, Dr. Shenouda or one of the members of their team directly by calling the office number (514) 931-7707 and following the instructions provided by the answering service.