Surgical Instructions

• Before Surgery or Anesthesia
• Post-operative Instructions

After Wisdom Tooth Removal

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. If you have questions, call the office during the day. One of our Doctors can always be reached after hours by calling the phone numbers given to you on the postoperative instruction sheet.

Immediately Following Surgery

• The gauze pad placed over the surgical area should be kept in place for one to two hours. After this time, the gauze pad should be removed and discarded.
• Vigorous mouth rinsing or touching the wound area following surgery should be avoided. This may initiate bleeding by causing the blood clot that has formed to become dislodged.
• Take the prescribed pain medications as soon as you begin to feel discomfort. This will usually coincide with the local anesthetic numbness becoming diminished.

Patient Care Instructions:

• Get plenty of rest for the first 48 to 72 hours after your surgery. Stay out of the sun and avoid strenuous activity. Elevate your head and apply ice to the affected area(s) as directed (on for 15 minutes, off for 15 minutes etc., alternate from side to side), repeat this procedure until bedtime. Do not use ice after 36 to 48 hours.
• If you had General Anesthesia or Intravenous Sedation, remember that you should not drive a car, operate machinery or perform any tasks which requires concentration or judgement for 24 hours after surgery.
• Drink lots of liquids for the first 2 to 3 days after surgery. Avoid alcoholic beverages. Clear liquids are best for the first 12 hours after surgery, then proceed with soft and solid foods as tolerated. Avoid any foods which contain seeds or hulls (popcorn, corn, sesame seeds, poppy seeds, granola, peanuts, blackberries, raspberries etc.) or other non-digestible components for three months after surgery.
• Do not smoke for 14 days after oral surgery. Smoking slows healing after surgery. Smoking also increases your chance of developing a “dry socket” after tooth extraction (loss or damage to blood clot which forms in the extraction socket and can cause significant discomfort for days while healing). Spitting and drinking thick liquids through a straw may also contribute to dry socket or prolonged bleeding.
• You may have numbness in your lip, teeth, tongue and gums which lasts for 48 hours after surgery. This is due to the local anesthetic used to numb your teeth/jaw for the surgery or swelling around the nerves which provide feeling. If you have numbness longer than 72 hours please call our office.
• Bruising and swelling will occur commonly after oral surgery. The swelling reaches maximum size around the 4th to 6th day after surgery. If you have swelling which is increasing after the 6th or 7th day, please call our office.
• You may use a mouthrinse after surgery. If you were given a prescription for mouthrinse, use it as directed on the pharmacy label. If the Doctor has determined that a prescription mouthrinse is not necessary, a salt-water mouthrinse is also acceptable (Dissolve one teaspoonful of salt in a glass of warm water. Hold this solution over the surgical area until cool then spit out). You may use this rinse every 2 to 3 hours as needed for up to 10 days after surgery.
• Bleeding is best controlled by pressure over the surgical site(s). This is accomplished by rolling one to two pieces of gauze to about one-fourth it’s original size, then placing the gauze over the extraction socket and biting firmly for one to two hours to apply pressure. You may have blood-tinged saliva for 24 to 36 hours after oral surgery. If bleeding cannot be adequately controlled with gauze, or persists longer than 24 hours, please call the office.
• You may feel tired or sore “all over” as a result of oral surgery and anesthesia. Adequate fluid intake and rest will help this feeling of fatigue.
• Some patients experience muscle soreness across the chest and/or arms and legs due to one of the medications given during general anesthesia. This often feels like the pain associated with “working out” and revolves without treatment within 48 hours. If you have a heart condition or severe shortness of breath associated with chest pain, you should call the office.
• Jaw soreness and stiffness may persist for 4 to 6 weeks after surgery. Normal mouth opening is often not reached until 6 to 8 weeks after surgery.
• If you have any questions about  about our surgery or anesthesia please call the main office number (740-450-2500). After hours this will also tell you how to reach your Doctor. Please refer to your post-operative instruction sheet for additional after hours phone numbers for each Doctor.

Our goal is to provide safe, professional and efficient Oral and Maxillofacial Surgery care four our patients. Open communication with our office is important to us and necessary for you. Please call if you have any additional questions or concerns.

Additional post-op considerations:

Sutures are placed in the area of surgery to minimize post-operative bleeding and to help healing. Sometimes they become dislodged.  This is no cause for alarm. Just remove the suture from your mouth and discard it. The sutures will dissolve away without removal. If the sutures need to be removed, the removal of sutures requires no anesthesia or needles. It takes only a minute or so, and there is no discomfort associated with this procedure. So it’s really nothing to worry about.

The pain and swelling should subside more and more each day following surgery. If your post-operative pain or swelling worsens or unusual symptoms occur, call the office for instructions.

There will be a cavity where the tooth was removed. The cavity will gradually fill in with new tissue over the next 2 to 3 months. In the meantime, the area should be kept clean especially after meals with salt-water rinses or a toothbrush.

Your case is individual.  No two mouths are alike. Do not accept well-intended advice from friends. Discuss your problem with the persons best able to effectively help you: Dr. Towning and Dr. Lee or your family dentist.

Brushing your teeth is okay – just be gentle at the surgical sites.

A dry socket is when the blood clot gets dislodged prematurely from the tooth socket. Symptoms of pain at the surgical site and even pain to the ear may occur three to five days following surgery. Call the office if this occurs.

If you are involved in regular exercise, be aware that your normal nourishment intake is reduced. Exercise may weaken you. If you get light headed, stop exercising. Avoid strenuous exercise or physical activity for one week after surgery.

Removal of multiple teeth

The removal of many teeth at one time is quite different than the extraction of one or two teeth. Because the bone must be shaped and smoothed prior to the insertion of a denture, the following conditions may occur (all of which are considered normal):

• The area operated on will swell, reaching a maximum in two days. Swelling and discoloration around the eye may occur. The application of a moist warm towel will help eliminate the discoloration. The towel should be applied continuously for as long as tolerable beginning 36 hours after surgery (remember ice packs are used for the first 36 hours only).
• A sore throat may develop. The muscles of the throat are near the extraction sites. Swelling into the throat muscles can cause pain. This is normal and should subside in two to three days.
• If the corners of the mouth are stretched, they may dry out and crack. Your lips should be kept moist with an ointment like Vaseline. There may be a slight elevation of temperature for 24-48 hours. If temperature continues, notify the office.

If immediate dentures have been inserted, sore spots may develop. In most cases, your dentist will see you within 24-48 hours after surgery and make the necessary adjustments to relieve those sore spots. Failure to do so may result in severe denture sores, which may prolong the healing process.

Keep physical activities to a minimum immediately following surgery. If you are considering exercise, throbbing or bleeding may occur. If this occurs, you should discontinue exercising. Keep in mind that you are probably not taking normal nourishment. This may weaken you and further limit your ability to exercise.