When to start salt water rinse after wisdom teeth removal

Precautions to be taken after wisdom tooth removal

After a wisdom teeth removal procedure, unnecessary pain and complications of infection and swelling can be minimized if the instructions are followed carefully.

Immediately Following Surgery

1. Eat COLD, SOFT FOOD as soon as possible and take medications as instructed.

2. Change your GAUZE every 30-60 minutes until there is no more bleeding and then remove.

3. REST, APPLY ICE and ELEVATE your head with pillows

4. Evaluate need for PAIN MEDICINE in 2 to 3 hours. Take medications as prescribed with food.

GAUZE PACKS

Remove gauze packs from your mouth when you eat. Continue to replace them every 30-60 minutes until bleeding has stopped. Then remove gauze.

ORAL HYGIENE

Continue to floss your teeth and brush thouroughly at least twice a day with a soft bristled brush so that you do not injure the tissues in your mouth. Following extraction, clean the teeth next to the healing tooth socket very gently for two days, carefully avoiding the surgical area.

MOUTHWASH AND RINSING

You may use rinse your mouth gently with water or mouth rinse. After the first 24 hours, frequent rinsing with a warm dilute salt solution will aid in your healing.

ICE

You may use an ice bag over the operated area for the first 24-48 hours following surgery. Apply to the affected area for 20 minutes and remove for 20 minutes; repeat as necessary. Elavate your head with 2-3 pilllows. This will help minimize swelling, bleeding and disccomfort.

PAIN

Ibuprofen (includes Motrin and Advil) may be recommended by your doctor to help control your discomfort. A stronger pain medication may also be prescribed for severe discomfort. If the pain medication makes you feel nauseated,discontiue and substitute with Tylenol or Ibuprofen. Discomfort usually subsides three to five days following surgery.

BLEEDING

Some bleeding following extraction of teeth is normal. Tooth sockets may continue to ooze a little during the night and even through the next day. If bleeding seems excessive,rinse the mouth thouroughly with cold water, removing any superficial masses of clottted blood. Then place a tightly folded piece of clean gauze over the bleeding area using enough gauze to apply firm pressure to the tissues when the jaw is closed. Maintain pressure with the gauze pack for 30-60 minutes,keeping head elevated. Should this not control bleeding, wrap a moist tea bag in gauze, place this over the socket and bite firmly.

SUTURES (STITCHES)

If sutures are present, most of them dissolve. Any remaining sutrues will be removed at the postoperative appointment.

SWELLING

Swelling is common after oral surgery. It will usually peak at approximately 48-72 hours and resolve 7- 10 days following surgery. Should the swelling persist for an exteded time, please call our office.

NUMBNESS

Numbness of the facial region following surgery is normal. Take care not to chew or bite your lips

ANTIBIOTICS

If you have been placed on antibiotics, take them as directed with food.

******Warning for Women****** While taking antibiotics, your birth control pills may become ineffective. It is recommended that you use an assitonal form of birth control for the remainder of your current cycle.

REST AND NOURISHMENT

Frequent small meals are recommended: cold, soft foods (yogurt, ice cream, Ensure, applesauce, milshakes, smoothies etc.) the first day of your surgery, progressing to warm, soft foods (pasta,soup, oatmeal,scrambled eggs, etc.) the following days. Hydration is essential with non acidic juices and water.

NAUSEA

Nausea can occur after surgery. Make sure to take medications with food.

DISCOLORATION

Discloration of the skin frequently seen in patients who “bruise” easily. It is due to bleeding from the operative site into the tissues. This often present two to three days after surgery and may take five or more days to fade.

After Your Surgery

Post-Operative Instructions

General Anesthesia Precautions

**If general anesthesia or IV sedation was utilized, do not leave the patient unattended for the first 12 hours.

**Please closely supervise the patient when getting up or going to the bathroom.

Medications

Please refer to your medication information sheets if you were given prescriptions. If you have any reaction to medications prescribed, call the doctor immediately.

Managing Bleeding After Surgery

For the first hour after surgery:

Keep firm pressure on the surgical site with the gauze that was placed in your mouth after surgery. Remove gauze after 1 hour.

If Bleeding Continues

Take 1 piece of gauze and fold it in quarters, creating a firm pad. Place the pad over the surgical site. Use firm biting pressure where possible (extraction site), or direct finger pressure by holding the gauze (biopsy site). You may have to repeat this procedure several times. The bleeding should stop within 2-3 hours, but you can expect to see blood-tinged saliva for up to 24-48 hours following surgery. If bleeding is heavy, or continues after 2 hours, moisten a tea bag, place on surgical site, and apply pressure or bite firmly for 30 minutes. This usually stops the bleeding. Please remember, most bleeding is controlled and stopped with a well-positioned gauze or tea bag with direct pressure. If bleeding is heavy or continues after 24 hours, call the doctor. Do not rinse, spit, or use a straw the day of surgery, as this can cause bleeding to resume.

To Reduce Swelling

Ice for the initial 24 hours. Use ice packs applied to the face for 20-minute intervals (20 minutes on, 20 minutes off). If oral surgery was performed on both the right and left sides, it is recommended to use one ice pack and alternate sides every 20 minutes. This is the most effective way to reduce swelling. Do not exceed 20 minutes in one area as this can cause tissue injury. Swelling usually reaches its maximum 2 days following surgery. To help reduce swelling, sit semi-reclined in a reclining chair; if lying down, keep your head elevated with 2-3 pillows. Icing should be discontinued after 24 hours. While icing your face may feel good, it will act to increase swelling. Again, DO NOT ice beyond 24 hours.

Orthodontic Retainers

If you have orthodontic retainers, please do not use them immediately after surgery. Use of your retainers can resume 1-3 days after the procedure or as comfort allows.

Diet

Resume your diet immediately following surgery. When you get home, start with a milkshake, smoothie, or other thick liquid using a spoon, NOT a straw. Your diet should be limited to cool and soft foods for the first day. Sometimes numbness from local anesthesia may last for hours; therefore, hot foods and liquids should be avoided, as they can cause a burn. A normal diet can be resumed as tolerated. Most foods can be eaten as long as care is taken to avoid the surgical sites. The following are some suggested softer foods: pancakes with syrup, eggs, and pastas like macaroni and cheese or spaghetti.

Oral Hygiene

Rinse with warm salt water or tap water beginning 3 days after surgery. To make a salt water rinse, add 1 teaspoon of salt to 4-5 oz of warm water. Rinse at least 3 times per day: in the morning, after meals, and before bed. Do not gargle. With extractions, you may have been given a plastic irrigating syringe. Begin using this syringe 3 days after your extraction. Using tap water or salt water, gently irrigate only the lower extraction site(s) once a day to remove any food debris that may persist after rinsing. Continue until all debris is removed. Do not use over-the-counter mouthwash, such as Scope® or Listerine®, as these can irritate the surgery site and slow healing. Resume brushing your teeth the day after surgery, being careful to avoid the surgical sites. It is not unusual to see traces of blood on your toothbrush.

Activity and Smoking/Vaping

Physical activity should be limited after oral surgery procedures. Vigorous exercise or organized sports should not be resumed until 3-5 days after surgery or as your condition allows. Please contact our office if a written excuse is needed for organized sports or gym class. The nicotine from smoking and vaping can significantly delay healing and cause an increase in post-operative pain. Therefore, you should refrain from smoking as long as possible.

Stitches

Stitches that have been placed are usually dissolvable and will fall out on their own within the first 4 days, possibly longer. It is not unusual for one or more to loosen and fall out before dissolving, especially in moving areas of your mouth, such as the tongue or cheek areas. If the stitches come out and the wound opens and creates a hole, it is typically not of concern unless there is excessive bleeding. Fortunately, incisions in the mouth do heal very quickly, and any wound that does open will close naturally.

Follow-Up Visits

If a follow-up visit is necessary, an appointment would have been scheduled for you. Post-operative appointments are always available. Please call the office during business hours if you would like to be seen.

When You Get Home

1. Remove gauze packing.
2. Drink at least ¼ of your milkshake (or smoothie, or other cool, thick liquid) using a spoon—NOT a straw.
3. Take pain reliever immediately, as explained in the “Pain Management” instruction sheet, unless you were already given ibuprofen in recovery.
4. Take the antibiotic (if prescribed) as directed.
5. Replace the gauze packing, if necessary.
6. Begin ice packs to the outside of your face, as explained previously, no longer than 20 minutes on one side.
7. Increase your fluid intake throughout the day.

Typical Recovery

With most oral surgery procedures, post-operative discomfort can actually worsen between the third and sixth days. This discomfort is considered normal and should be managed with your pain medication. If you have significant discomfort, even with pain medication, or you cannot tolerate the pain medication, please call the office.

When to Call the Doctor

If there is a drug reaction, significant swelling, persistent pain or bleeding, or any other unusual reactions, call the office immediately. Additionally, if you have any questions during the post-operative period, do not hesitate to call. There is an answering service to respond to emergencies at all times when the office is closed

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