Wisdom Tooth Removal Instructions

It is important that you watch both videos all of the way through!

Before general anesthesia or IV sedation

• If you have been scheduled to have general anesthesia for your surgery it is essential that you do not eat or drink anything for 8 hours before surgery. Any liquid or solid food in your stomach during anesthesia can have life-threatening consequences. If you have accidentally eaten anything prior to surgery, inform the doctor immediately.
• Do not smoke or ingest alcoholic beverages for at least 8 hours prior to surgery.
• Please brush your teeth prior to your appointment. This will help reduce the amount of bacteria in your mouth and lower your chance of an infection.
• You must bring a responsible adult who can drive you home. You will be groggy for several hours after your surgery and unable to drive. If you have been given a prescription to take prior to surgery, make arrangements to be driven to the office. Do not drive yourself. Sedative medications can act quickly and seriously affect your driving ability.
• Wear loose fitting and comfortable clothing. We recommend a shortsleeved shirt for ease in taking your blood pressure and applying monitors. A T-shirt, sweat pants and gym shoes are always a good choice.
• Take care of financial arrangements, ask questions and use the bathroom before surgery. You will be too sleepy to remember these things afterward. Call if you have any questions concerning these instructions or your scheduled appointment.
• While the thought of any surgery can be a little frightening, our patients usually find it to be a comfortable, pleasant and painless experience. Please let us know if there is anything that we can do to accommodate you.

Pre-Operative Instructions – Download PDF

• Pain. Some discomfort is normal after the extraction of teeth. 400-600 mg every 4 to 6 hours of ibuprofen (Advil, Motrin or generic) is usually an excellent choice – IF you are not allergic or intolerant to non-steroidal anti-inflammatory drugs. If you are asthmatic, do not take ibuprofen unless you have tolerated it in the past. If we have prescribed narcotic medicine for you, alternately taking the ibuprofen and narcotic when needed will improve your pain control. Some liquid/food in your stomach before taking pain medicine is usually a good idea in preventing nausea. Remember, pain medicines that contain a narcotic which can impair judgment and reflexes. Avoid driving or doing anything potentially dangerous while taking these medications.
• Gauze pads. Gauze pads should be placed over the surgery site(s) with gentle pressure applied to the pads when you bite down; proper placement helps you avoid swallowing blood, which can make you more nauseated. The gauze pads should be replaced every 20 to 40 minutes. When the gauze pads have little or no blood on them, they are no longer necessary. The amount of bleeding will vary from person to person. Any heavy bleeding should slow within 3 to 4 hours. A small amount of blood is common up to 24 hours after your surgery and occasionally during sleep the first night. AVOID touching the area with fingers or your tongue.
• Rinsing. Do not rinse your mouth on the day of surgery, it may prolong your bleeding. Begin salt-water rises the day after surgery and continue for one week. Rinse with warm salt water 6 to 8 times each day, with approximately 1/2 teaspoon dissolved in a glass of warm water (a pre-made bottle each morning will lessen the amount of work.!) Do not use full-strength mouthwashes of any kind during the first week (mouthwashes contain alcohol which will retard healing)
• Swelling. Swelling is a normal occurrence after oral surgery and is a major cause of discomfort. Swelling normally reaches its peak by the 3rd day and then starts to resolve; it can be reduced by the use of an ice pack (or bag of frozen peas) over the affected area. Apply the ice pack for 10 minutes- avoiding heavy pressure, then remove or transfer it to a different area for 10 minutes. Do not freeze the skin. Apply the ice continuously, as much as possible, for the first 24 hours. Ice packs are useful for the first 24 hours only. Also, keep your head elevated on 2 pillows for 4 days. These measures won\’t eliminate swelling, but help immensely to reduce its severity.
• Diet. Do not eat for 2 hours after surgery (to allow blood clotting to begin undisturbed) then start with clear liquids, such as apple juice, tea or broth. Gradually ramp up your diet as tolerated. Always cool down any hot foods or liquids during the first 24 hours. If you were sedated for surgery, avoiding fatty, creamy or oily foods helps minimize, nausea. You should eat only soft food for the first few days: for example, soups, juices, mashed potatoes and meatloaf are fine. For 2 weeks, avoid any hard & chewy foods such as European breads, pizza crust, steak or jerky, and nuts or popcorn. To help prevent dry socket, do not use a straw for the first 3 days after surgery.
• Oral Hygiene. Begin brushing your teeth the day after surgery. It is important to brush all your teeth, even if the teeth and gums are sensitive. It is important to proper healing that plaque and food are not allowed to accumulate near the extraction site. Smoking is strongly discouraged for at least a week. As with the use of straws, suction causes increased bleeding AND the nicotine and tar can cause delayed healing and loss of blood clot. Warm salt water rinses (1/2 teaspoon of sat in a cup of warm water) should be used at least 4-5 times a day, especially after meals.
• Activity. Unless told otherwise, do no vigorous physical activity for three days following your surgery. Physical activity increases your blood pressure, which will cause an increase in your swelling, pain, and bleeding. You may increase your activity, such as jogging or tennis, 5 to 7 days after your surgery.
• Emergencies. If there are any serious problems or questions which need a doctor\’s immediate attention, one of our group\’s doctors is available 24 hours through the answering service at (707) 545-4625.

Post-Operative Instructions – Download PDF