Upper Wisdom Tooth Extraction (English)

keyword:
prepare wisdom tooth extraction upper nose

https://www.texasoralsurgery.com/preparing-for-wisdom-tooth-surgery/
ice cream, smoothies

https://www.napervilleoms.com/surgical-instructions/wisdom-tooth-removal/
milkshake (banana), ground meat
Bleeding:
Apply moistened sterile gauze (a thumb-size roll) or a teabag over the wound. Bite hard with constant pressure for an hour, using 80% of your maximum bite force.
It may take as long as 3 to 4 hours for the bleeding to stop.
Determine if the wound is still bleeding by looking at the socket directly for 20 to 30 seconds.
During the hour of gauze placement, the patient should not talk or open the mouth since these activities can cause the gauze to move out of position.
At the end of each hour, the gauze should be removed and the wound needs to be checked for further bleeding. Look at the wound directly for 20–30 seconds, using a flashlight and spoon handle (as a retractor) if needed.

Ice can be used in 30-minute intervals: 30 minutes on, 30 minutes off. Start the ice pack treatment on the day of the surgery and continue as needed – up to 72 hours after the surgery. After 72 hours, you can bring the swelling down by placing moist, warm, heat applications on the sides of the face.

Do not rinse or brush your teeth for 24 hours after surgery. After 24 hours, clean the mouth by brushing and following the salt-water rinses as directed below. Keep in mind that good hygiene after surgery is essential to help your mouth heal faster and to reduce the pain as quickly as possible. If you are too “shy” to brush and rinse, then it increases the likelihood of the development of a postoperative wound infection and pain that worsens.

Twenty-four hours after tooth extraction, all of the teeth should be brushed (including the teeth adjacent to the surgical site). Don’t scrub too hard. Instead, carefully clean the surface of all teeth, including “nooks and crannies” where food can get stuck.
At this time, you should also start using salt-water rinses. Mix 1/2 teaspoon salt in a glass of warm water, then gently “swish” to remove food that gets stuck in the surgical wounds. You should brush and rinse – saltwater swishing does not replace brushing.

For upper wisdom teeth, saltwater rinses are suggested for three weeks.

These rinsing techniques are important for removing food that might become trapped in the sockets. Food particles can cause an infection to develop, which could extend your pain and recovery time.
If you find it difficult to open your stiff jaw 4–5 days after surgery, then stretching exercises can be used so you can open your mouth wider. Not only will opening your mouth wider make it easier to clean your teeth, but it also improves your ability to eat.
REMEMBER: A clean wound heals better and faster.

The IV anesthesia or extractions can cause the development of a sore throat. The throat muscles are near the surgical site, and it can cause pain when these muscles swell. This pain is normal and should subside in 2–3 days. Saltwater gargling can help to reduce the pain.
During the surgery, the corners of the mouth can be stretched – causing them to crack and dry out. This discomfort can be managed by applying lip balm or an ointment (such as Vaseline) to keep the corners of the mouth moist.

Post-Operative Instructions: Sinus Care After Tooth Extraction
https://www.unionsquareoralsurgery.com/instructions/post-operative-instructions-sinus-care-after-tooth-extraction/

Your sinus may have been exposed when the tooth was removed. It is not uncommon to have blood in the nasal discharge for several days. Notify the office if any symptoms develop that seem unusual to you.

PLEASE FOLLOW THESE INSTRUCTIONS FOR 14 DAYS:
DO NOT blow your nose. Air pressure must not be increased in the nasal or sinus cavities.
TRY NOT to sneeze. If you should, keep your mouth open to prevent an increase in air pressure in the sinus cavities.
DO NOT use a straw.
DO NOT spit.
DO NOT rinse vigorously for several days. Chew on the opposite side as much as possible.

https://www.stlouisoms.com/instructions/sinus-instructions/
Sinus Instructions
There is a close relationship to the sinus and the upper back teeth. Many times when a tooth is extracted, it will leave a small communication between the mouth and the sinus.

It is important to follow these instructions:
Over the Counter Decongestant (Sudafed) or Afrin Nasal Spray
Antibiotics
Avoid any Positive Pressure in your mouth.
Refrain from blowing your nose for two weeks.
Try not to sneeze. If a sneeze is unavoidable, keep your mouth open and do not close your nose.
Do not use a straw or smoke for two weeks.
Do not blow a musical Instrument.
Eat soft food for several days – chewing on the opposite side as much as possible.
Do not rinse the mouth vigorously for several days.

It is not uncommon to have a slight amount of bleeding from the nose for several days. Keep your follow-up appointment.

https://www.lehmanmenis.com/post-operative-instructions-sinus-involvement

Post-Operative Instructions
Sinus involvement is common with upper molar extractions and procedures that are located at the back portion of the upper jaw.

A sinus opening may occur because the bone which is shared between the tooth socket and the sinus is very thin, and may even be absent. If an opening occurs between the socket and sinus, a closure procedure may have been completed.

This closure can require additional stitches and can be very delicate. Ultimately, to maintain the closure, special instructions are needed to reduce pressure between the mouth and sinus.

Activities that increase sinus pressure must be avoided. This includes the use of straws, blowing your nose, and “holding in” sneezes. If you have sinus congestion, over-the-counter oral decongestant medications, such as Sudafed®, may be helpful. If you have high blood pressure or take blood pressure medications, check with your physician before taking decongestants.

When there is an opening between the sinus and tooth socket, blood from the tooth socket may enter the sinus. The sinus will clear this blood, and it will be discharged either down the throat or from your nose. This will often be a dark-colored discharge. Do not be alarmed, as this is normal.

If you have an increase in pain, swelling, drainage, or an unusual feeling of air passing in the socket, please call the doctor.

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.

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.

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

https://www.elevatedoralsurgery.com/wisdom-teeth-prepost-operative-instructions.html

Contact our office if there are any changes in medical history including new medications or recent cough, cold, stuffy nose/congestion, fever, chills, sore throat.

SWELLING: Pain and swelling go hand in hand, so if we can minimize the swelling, we can limit the pain. The peak pain and swelling is generally 2-4 days after treatment. To help reduce swelling, keep your head elevated with an extra pillow or two while resting. Do not lay flat as this will increase the swelling and discomfort. As listed above Motrin, Advil, or Ibuprofen 600mg should be taken every 6 hours (for the first 3 days), this is not only to help reduce discomfort, but is also a great anti-inflammatory which will help keep the swelling to a minimum. Keep ice to the area (20 minutes on/20 minutes off while awake) for the first 72 hours (3 days). After the 3rd day change to a moist heat compress on the area with massage and stretching to get the jaw muscles moving again.

eggs, yogurt,

ORAL CARE: no rinsing or brushing during the first 24 hours (as doing such may disturb the blood clots). After the first 24 hours you may resume brushing and rinsing your teeth. We encourage you to brush gently around the surgical site, do not avoid brushing the area as plaque and food debris will accumulate and increase risk of pain and infection. Keep fingers and tongue away from the surgical site. Rinse as instructed with the prescription mouth rinse for 7-10 days (the rinse may stain you teeth, generally only with use longer than 2 weeks, and tongue, however this is not permanent staining and can easily be removed with a dental cleaning). Warm salt water after meals is also encouraged: ½ teaspoon of salt in 8oz. warm water
DRY SOCKET: dry socket is an unlikely complication of tooth extraction, but if it occurs can delay healing and cause significant pain that does not respond to pain medication. Ways to help avoid a dry socket include avoiding the following for 7 days: spitting, straws, smoking or vaping, sucking or drawing actions as these may cause the blood clot to become dislodged and lead to a dry socket. A dry socket typically occurs during days 3-5 of recovery. If you think you may be experiencing a dry socket please call us so we can help treat you.

LIMITED OPENING: within the first 1-2 weeks after surgery your mouth opening may be limited due to the swelling and inflammation around your jaw muscles. The warm-moist compress to the sides of the face after the 3rd day along with massage and stretching of the muscles (simply opening and closing the mouth) will usually allow you to get back to your normal opening within 1-2 weeks after surgery.

**Specific for wisdom tooth patients—you will be given a plastic syringe to rinse out your extraction sites. You may start rinsing with warm salt water filled syringes after the 5th day. You should rinse after each meal and once before bed. To rinse, wash your hands, fill syringe with warm salt water & pull cheek to the side & aim for the wisdom tooth area (behind last tooth in mouth—you may see a small black opening—do not put syringe into opening, just aim for it). Irrigate until site is clean & free of debris. We recommend rinsing as directed above until holes close (approximately 2-4 weeks after surgery). Keeping the sites clean of food & debris will reduce the risk of infection. Brushing and rinsing will greatly reduce your risk of post-operative infection. However, if you do feel pressure, pain or notice swelling call immediately as it could be a sign of a post-operative infection and must be treated in a timely manner. Post-operative infections often occur 4-8 weeks after treatment.

TIPS FOR HEALING AFTER WISDOM TOOTH EXTRACTIONS
https://www.pineypointoms.com/blog/healing-after-wisdom-tooth-extractions/

Soups
Vegetable purees
Smoothies
Milkshakes
Vegetable juice
Mashed potatoes
Pudding and Jell-O

Have a few pillows on hand to keep your head elevated for the first three days as you rest. This will help to minimize swelling in the hours right after the extraction, and that means you need to keep your head elevated as you rest. You may also find it comfortable to rest in a recliner, and some people find that using an airline pillow is an easy and effective way to keep their heads comfortably elevated.

Keep Your Surgical Site Clean
One cup of warm water with one teaspoon of salt. Once these ingredients are combined, gently rinse your mouth. Do this several times a day at least once in the morning, once before bed, and after meals.

#17 Don’t Blow Your Nose
Blowing your nose may seem like an innocuous behavior, but while you’re healing, this can lead to unnecessary pain. We encourage you to avoid blowing your nose for at least the first week or two after surgery. Instead, gently wipe the nose if there is nasal drainage.

#18 Avoid Dry Mouth
Following wisdom tooth extraction, you may find yourself struggling with dry mouth. This dryness can increase the number of oral bacteria. The greater number of oral bacteria can increase risk of infection at the extraction site. To avoid dry mouth, you should breathe through your nose as much as possible. Drink plenty of water and use a saltwater rinse as directed to keep your mouth clean and moisturized. In some cases, we may recommend using a moisturizer, like Biotene, for those who struggle with dry mouth before we begin treatment.

After Extraction of Wisdom Teeth
https://highdesertoralsurgery.com/procedures/wisdom-teeth/after-extraction-of-wisdom-teeth/

surgical risks (i.e., sensory nerve damage, sinus complications)
postoperative kit will include postoperative instructions, a prescription for pain medication, antibiotics, and a follow-up appointment in one week for suture removal.

swelling usually peaks on the second day and should begin resolving on the third day.
You can limit the amount of swelling you will have by using ice for the entire first day.
The more ice you use the first day, the less swelling you are likely to have on the second day.
Please remember to put ice on the first day even if it is somewhat uncomfortable to have the cold next to your skin.
On the third day, you will notice that your jaw muscles are stiff, and it is difficult to open your mouth normally.
You can apply moist heat to your face on the second and third day allowing your muscles to relax more and open wider.
Most of the time you will want to limit your activities for a few days.
Allow time for your body to begin healing before resuming an active social, academic, or athletic schedule. Most patients feel like they are over the hump and on their way to recovery in 3 to 5 days.

Some complications that patients undergoing wisdom tooth extraction may experience include:

Damage to the sensory nerve that supplies sensation to the lips and tongue
Sinus communication
Infections
Dry sockets

Damage to Sensory Nerve
aving these teeth out between the ages of 12 and 18 usually provides shorter roots so that the nerve is not so close to the roots of these teeth.

Sinus Communication
If the teeth are removed at an early age, the root formation is minimal, and this complication is very unlikely.
Avoid blowing your nose for two or three days following the surgery. You can wipe your nose, but don’t blow your nose. If you have to sneeze, you should sneeze with an open mouth into a tissue. Pressure should not be created in the sinus area, which may dislodge the healing blood clot. If you sense this condition occurring after the surgery, please contact the office. An additional procedure may RARELY be necessary to close the opening.

Dry Sockets
Dry sockets continue to be the most common problem people experience following dental surgery. They arise due to premature loss of a blood clot in the empty tooth socket. This seems to occur with greater frequency in people who smoke or are taking birth control pills. While both jaws can be affected, they usually occur in the lower jaw on the third to fifth day. They cause a deep, dull, continuous aching on the affected side(s). Patients may first notice the pain starting in the ear radiating down towards the chin.

The symptoms frequently begin in the middle of the night, and your pain medication regimen may not help. Treatment can involve changing your prescription. Occasionally it is helpful to place a medicated dressing in the empty tooth socket. This will help decrease the pain and protect the socket from food particles. The effectiveness in alleviating the pain lasts for 24-48 hours and may require dressing changes every day or two, for five to seven days. Dressings usually are removed when you have been pain free for 2 to 3 days.

The dressing doesn’t aid in healing. The only reason to place a dressing is for pain control. If medication is controlling the pain, the socket will heal without a dressing. Following removal of the dressing, an irrigation device may be provided to help you to keep food particles from lodging in the extraction site.

Sinus Precautions
https://www.chinookoralsurgery.com/surgical-instructions/sinus-precautions/

When these teeth are removed, this can cause sinus congestion for up to a week. In unusual cases a sinus infection or a persistent opening can develop. A persistent opening is called an oral antral fistula.

Please follow these instructions for 7-10 days or until your surgeon instructs you otherwise. This will minimize any chance of unfavourable healing.

DO NOT blow your nose at all for the first 7-10 days or until instructed that it is safe to do so. Wipe your nose as needed, BUT DO NOT BLOW.
DO NOT smoke or use a straw in the first 7 days following surgery. These activities cause negative pressure in the mouth that may contribute to an opening of the socket into the sinus (oral antral fistula).
DO use a nasal decongestant if recommended by your oral surgeon. Sudafed (pseudoephedrine), Dimetapp, or another decongestant can be used regularly for the first 7 days to promote proper sinus drainage. An antihistamine is not necessary. If you are using a combination product, check with a pharmacist for any potential interaction with other medications you have been prescribed.
DO rinse your mouth gently 3 – 4 times daily with salt water (one teaspoon of salt mixed with a glass of lukewarm water). If you notice fluid going into your sinus or nose, stop rinsing and contact the office for further instructions.
DO sneeze, if you have to, but do so with your mouth open. This will help prevent pressure build-up within the sinuses. Be considerate and cover your mouth, but do not try to be polite and hold back the sneeze.
DO elevate your head with several pillows while sleeping. This is usually more comfortable for the first 4-7 days.