Post-wisdom teeth extraction care guide
#include "e2stddisclaimer.h" :
This writeup is not intended to be medical advice, although it is reconstructed from what my doctor told me after my surgery. It is to be used for educational purposes only. If you have any questions, contact a medical professional. The after-effects of oral surgery vary from individual as should be evident from the number of "getting my wisdom teeth pulled" writeups. Reader discretion is advised. Don't sue anyone over what you read here.
Day of Surgery
If you received a general anesthetic (i.e., you went all the way under), have someone else drive you home, then lie down with your head elevated until all effects of anesthesia have disappeared. Just put some calm music on and enjoy the trip. Again, effects vary from individual to individual, and you may feel drowsy for several hours. DO NOT operate a motor vehicle or any mechanical equipment for at least 12 hours after the surgery. Don't node, either ;-).
Do not disturb the surgical area. You probably got gauze to bite down on. Keep it in, and keep firm pressure on the sockets (if it hurts, you're biting too hard). This is very important! Blood clots need to form down in the sockets, and if you knock them loose or prevent them from forming, you're going to be in for a few painful weeks.
After the first hour you've been home or so, you can change the gauze. You probably still won't be able to feel anything, so be careful! Gently remove the bloody gauze, and the just pack a few pieces of fresh gauze back in. Gently! But be sure the gauze is going over the sockets, and not being clenched between your remaining molars. Steady pressure is what it takes to form clots. If you change the gauze after another hour and there still seems to be a bit of blood, soak a tea bag in moist water, squeeze it dry, wrap it between gauze, then bite down on that for 30 minutes. The tannin will aid in the healing. If after the first two hours you feel the bleeding is still severe, please call your doctor/dentist/oral surgeon (see disclaimer above)!
Swelling is to be expected, and usually peaks around 48 hours after the surgery. To reduce swelling, wrap cold packs, ice bags, or bags of frozen vegetables in a towel and apply to your face near the surgical site, 20 minutes on, 20 minutes off. I recommend alternating either side of the face in this matter. Put the ice pack on your bed and lay your cheek on it. After 20 minutes, roll over. After an hour, change the ice and check the gauze. Keep this up for 2 days (during the day only) and you'll be in good shape. On the third day, switch to heat, either in chemical hot packs, hot water bottles, microwaved moist towels, or electric blanket-type heating pads. By now the swelling should be going down, so use heat until you get tired of it. If you were prescribed medicine for swelling (lucky S.O.B....), take it as directed.
You may have a few bruises, but they'll go away after a week. Your jaw muscles will feel tight and you may have difficulty opening your mouth. This too should subside within a week or two. Use lip balm (like Chap-Stick) to keep your lips from cracking.
Resist the urge to probe the sockets with your tongue, finger or anything else! Although it may seem convenient to do so, do not suck anything through a straw! Do not smoke cigarettes (or anything else; now could be that excuse to quit you've been looking for...). Do not spit (let it drain out of your mouth). If you play any wind instrument, woodwind or brass, give it a rest for at least a week. Ignore the urgings of your band director or fellow musicians, and forget about festival, contest, or the Friday night football game. It's not worth sacrificing your health!
All these actions will put pressure on the sockets and could dislodge the clots, which will put you in a world of pain.
Diet
A few after surgery, once you've changed the gauze and made sure there's no severe bleeding, you'll probably be feeling a little hungry. Eat anything that fits the following descriptors: Soft, Bland, Nourishing, Mushy, Pureed, Liquid, Cool, Lukewarm. Good examples are pudding, ice cream, gelatin, vegetable or fruit puree. Bananas, soups. One food I particularly enjoyed was a combination between a virgin daiquiri and a fruit smoothie: Fill up a blender with ice, and crush it finely. Add any of the following: Frozen orange juice concentrate, kool-aid mix, fresh fruits, ice cream. Blend some more. Pour into a cup; eat with a spoon. Goes down easy and the cold will soothe the pain and swelling.
Avoid anything really hot (caliente) or spicy (picante). Avoid anything that will force you to chew or move your mouth too much. Avoid anything with small, hard pieces that could get stuck in the sockets, like nuts or popcorn.
As the days go on gradually progress to more solid foods as you feel comfortable chewing them. Remember, proper nourishment is essential to the healing process!
Pain and Medications
The local anesthetic the doctor gave you (probably Novocain or Lidocaine) will wear off after a few hours, and then your mouth is going to hurt. If you were prescribed a painkiller like vicodin, now's the time to start taking it, preferably with your first meal. Resist the urge to take it any more often than the bottle recommends, you'll just run out faster and on day three you'll be sorry.. You'll have trouble getting a prescription like that renewed, as any painkiller strong enough for oral surgery is likely to be habit-forming. If you feel the standard dose is not enough, supplement it with an analgesic like aspirin or Tylenol. Taking your pain medication with food and water will help lessen any nausea.
Some painkillers are likely to mess up birth control pills; ask your doctor.
If you wear any orthodontic appliances (you have all the luck, dontcha?), put them in as soon as you get home. Putting them in after the swelling kicks in will not be fun.
For the Next Few Days
Keep your mouth clean! You don't want to be fighting an infection along with the rest of the pain from surgery. The day after surgery the blood clots in your sockets should be in place, and you can start rinsing your mouth with warm salt water. Mix 1/2 teaspoon NaCl with 1 cup H2O. Rinse gently every 2 hours for the first week, then 3 times a day for the next 2 weeks. Also being your normal toothbrushing routine the day after surgery, as long as it's comfortable to do so. Remember not to spit! Let the salt water/toothpaste drain out of your mouth. Don't swoosh water around in your mouth either. Roll your head around. You'll feel silly, but you'll be better off in the long run.
When you want to go back to work/school or whatever your normal daily routine consisted of is up to you. I stayed home for three days. I know guys who were back on the job the day after. I know other people that had it so bad they stayed home for two weeks. Use your best judgement, and be careful.
Bad stuff: Dry sockets. If you go ahead and smoke, or do any of the other stuff I said not to, or maybe just have bad luck, around the third day you'll probably lose a blood clot out of one of the sockets, exposing the soft tissue and nerves to the air. This will hurt. You'll feel the pain spiking down your jaw and back to your ear. Call your doctor.
Skin discoloration: Probably a bruise. Aspirin and heat will help it clear up. If you had an IV, there may be swelling and chemical irritation in the vein.
Numbness: If your lower wisdom teeth are taken out (and they usually are no matter what, for a number of reasons), you may experience some loss of sensation in your lips or jaw (after the Novocain has worn off). This is because the main nerve that supplies sensation to your mouth runs right beneath the roots of your teeth, and it may be damaged in the extraction. It usually disappears after a few weeks. It may continue for months. In rare cases the damage is permanent. As always, call your doctor if you have any questions.
And in the end..
After two or three weeks your sockets should be healed enough that you can safely use your tongue to poke out bits of food that will get stuck down in them. Go easy in them, and remember if don't like this you can always go back to the saltwater rinses. After two months you'll forget the holes are even there, and after 3 or months they'll be completely closed over. YMMV.
That's pretty much the drill I went through when I had all four of my wisdom teeth out. Read wisdom teeth and getting my wisdom teeth pulled for other noders' experiences. But only trust the advice of a trained medical professional!