I had my wisdom teeth removed this morning and I’m still bleeding. What should I do?
Believe it or not, some bleeding after tooth extractions is beneficial; good blood flow usually means good healing. The purpose of the gauze that you were given is to apply firm, consistent pressure to the extraction sites for 30-45 minutes at a time. If you have gauze in your mouth and you are not biting down firmly, the gauze is doing no good. Likewise, taking the gauze in and out every five minutes to look at it just tends to stir up more bleeding. Often, when patients are removing their gauze after surgery, they are surprised at how wet and red the gauze appears, and this is often perceived as excessive bleeding. Most of the time, the gauze is saturated with saliva with a few drops of blood that give it the appearance of a lot of bleeding when it really isn’t. If you run out of gauze, most pharmacies sell it or you can bite on tea bags; the tannic acid in tea helps in clot formation. If your mouth is rapidly filling up with blood and the above measures are not helping to slow down the bleeding, call our office for assistance. Also, it is not unusual to notice small episodes of bleeding for several days after having teeth removed. If this occurs simply bite on gauze again in the area of bleeding.1
How often do I change my gauze?
Change your gauze every thirty minutes until the bleeding in that area has stopped. It is recommended that you wet the gauze, squeeze out the excess water, and then apply firm bite pressure to surgical site. If there is no bite pressure on the gauze, then bleeding will not be controlled. Once bleeding stops, there is no need for gauze.1
What is a “Dry Socket,” and how do I know if I have one?
The term “dry socket” refers to a condition called alveolar osteitis which is a premature breakdown of the blood clot present in an extraction site. Smoking, poor oral hygiene, and over-exertion in the post-operative period can contribute to this condition, but sometimes there is no obvious cause. Typically, a “dry socket” presents itself 3-5 days after the surgery with increased pain, foul odor and taste, and bad breath. This condition is very easily treatable and requires that we wash out the socket and place a medication dressing. This provides pain relief usually within an hour after placement. These medicated dressings typically are replaced every 2-3 days in our office until the condition subsides in one to two weeks. If you are experiencing symptoms consistent with a “dry socket,” the best solution is to call our office when it opens in the morning at 8:00am so that we can arrange to have you seen that day for treatment.1
My child had their wisdom teeth removed today under IV sedation, and they are experiencing severe nausea. What is causing it, and what should I do?
There are several causes of post-operative nausea and vomiting. First, if you were sedated with IV medications, nausea is a side-effect of nearly all the medications used for sedation. The best treatment is to start out with clear liquids (water or Gatorade) on the day of the surgery. The goal is to maintain good hydration in order to prevent dehydration. After holding down clear liquids for several hours without nausea, your diet can progress to soft foods. Dairy products (milkshakes) are not the best food on the day of the surgery and may contribute to nausea and vomiting. Second, the narcotic pain medication is also a major culprit for causing post-operative nausea and vomiting. The best treatment is prevention by using a non-narcotic medication (like ibuprofen), and only using narcotic if it is absolutely necessary for pain control. If you find that you are experiencing nausea within an hour after taking a narcotic pain medication, simply stop taking the medication or take a smaller dose (cutting pills in half) if the non-narcotic medication is not sufficiently controlling your discomfort. Third, and most importantly, dehydration is a cause of post-operative nausea and vomiting. Again, the best treatment is prevention. Clear liquids are very important in maintaining an adequate level of hydration. If you are simply not able to hold anything down and your condition is worsening, call us for assistance. If you are diabetic and are experiencing post-operative nausea and vomiting, strict blood sugar control is vital post-operatively.1
I had surgery this morning, and one of my stitches already came out. Is this OK?
Yes, in most instances, the stitches are placed at the time of surgery simply to assist with initial control of bleeding and clot formation. This is especially true with wisdom tooth surgery and other tooth extractions. Thus, loss of a stitch is not considered an emergency, even if it occurs on the day of surgery. If your surgeon has performed a bone-grafting procedure and the stitches are coming out prematurely, please contact our office so that the doctor may determine whether or not you need to be seen on that day.1
Can my ride come into surgery with me?
We cannot allow more than the patient alone into the surgical area. Under HIPAA, there is a need to maintain patient’s privacy, therefor only the surgical staff and the patient is allowed in the surgical area. There are also multiple procedures occurring and there is no “waiting area” in the surgical suite. If there is a medical/legal necessity to have someone with the patient, please include this information in the initial exam so preparations can be made.
What can I take into surgery?
Your dentures/partials, your inhaler if you have one, and if you do not have a ride, you can bring your items to sit on the back shelf until the end of your surgery with your phone turned OFF.
Why can’t I eat or drink before surgery with IV sedation?
Since you are unable to control your gag reflex, if you eat something before surgery, your stomach contents could regurgitate into your airway, causing complications such as pulmonary aspiration which, in severe cases, can be fatal.2
Can I keep my teeth?
If the teeth are whole, you can take your extracted teeth with you. It is important that you let the surgical team know before surgery that you want to keep your teeth, crowns, or caps.
Can I take my daily medications before surgery?
At the time of your exam, your surgeon should go over what you can and cannot take. In most cases, you will continue your normal home medications as prescribed without alteration. If you have additional questions, call the office to confirm before your surgery date.
When can I eat after surgery?
You can eat as soon as you get home. We recommend starting with soft, light foods such as soups, mashed potatoes, and apple sauce. Make sure the food you eat is not HOT, as you will be numb and unable to feel if your tongue or lip has been burnt.
I am a busy person. Can I run errands after my surgery?
We suggest that you take the rest of the day to rest, particularly if you have been sedated intravenously. Many people can feel tired and should not be allowed to drive or exercise for 24 hours after sedation. For wisdom tooth extraction, it can take several days to fully recover. If dry sockets develop, the healing period will be extended beyond one week.
How long before being sedated do I need to stop eating?
You should stop eating no less than 6 hours prior to your surgery unless otherwise instructed by your doctor, who may recommend a longer period.
Why can’t I smoke after removing a tooth?
The chemical nicotine is a vasoconstrictor, which means that it restricts proper blood flow which hinders nutritional blood from the surgical site, impairing healing. The smoke dehydrates the mouth, and also brings into the mouth smoke debris which can infect the surgical site. This inability to properly heal can lead to a dry socket or infection.
How long do I have to wait for the results of my biopsy?
Please allow up to 2 weeks for the results. If you are scheduled for a follow-up appointment, then the results will be discussed with you at that time. If you are not scheduled, our office will call you as soon as the doctor reviews the results.