Wisdom teeth extraction is a common surgical procedure. The hours immediately following surgery focus on two primary goals: controlling post-operative bleeding and establishing the conditions necessary for proper healing. The initial recovery phase requires attention to the surgeon’s instructions to prevent complications and ensure the empty socket begins to close quickly.
Gauze: When to Stop and Why
The gauze applies gentle pressure to the wound to help a blood clot form. This clot is fundamental to healing, acting as a protective barrier over the exposed bone and nerves. Maintain firm, gentle biting pressure on the initial gauze for about 30 to 45 minutes after surgery before checking it.
If the gauze is saturated with blood when you check it, replace it with a fresh, sterile pad and continue applying pressure. Repeat this process every 30 to 45 minutes until the bleeding significantly slows down. You can usually stop using the gauze entirely once the bleeding has reduced to a slight pinkish tinge or a minor ooze mixed with saliva. Minor spotting may continue for up to 24 hours. If heavy, active bleeding persists for more than four hours, or if you need to use gauze constantly, contact your oral surgeon for advice.
Protecting the Extraction Site: Avoiding Dry Socket
The most significant complication to avoid is dry socket (alveolar osteitis), which occurs when the protective blood clot is dislodged or dissolves prematurely. Dry socket results in the painful exposure of the underlying jawbone and nerve endings, with symptoms often beginning three to five days after the procedure. The pain is intense and throbbing, radiating from the socket to the ear, temple, or neck, and may be accompanied by a foul taste or odor.
Preventing dry socket requires avoiding any action that creates negative pressure or irritation. For the first 48 to 72 hours, avoid drinking through a straw, as the sucking motion can easily pull the clot out. Smoking is also a major risk factor due to the sucking motion and chemicals that interfere with healing. You must also avoid forceful spitting or vigorous rinsing, as these actions disturb the newly formed clot.
After the first 24 hours, you may begin gentle rinsing with a warm salt water solution. Let the liquid passively spill out of your mouth rather than spitting. Avoid chewing near the extraction site for at least a week, as physical disruption compromises the clot’s stability. Managing these behaviors increases the chances of the clot remaining securely in place.
Managing Pain, Swelling, and Diet
Managing the expected post-operative discomfort is essential. Take pain medication as directed by your surgeon, which may include prescription or over-the-counter options like ibuprofen or acetaminophen. It is most effective to take medication on a schedule, ideally before the local anesthetic fully wears off, rather than waiting for the pain to become severe.
Swelling is a normal inflammatory response and is best managed with cold therapy applied to the outside of the face near the surgical site. During the first 24 to 48 hours, apply an ice pack or cold compress for intervals of 15 to 20 minutes, followed by a 15-minute break. Keeping your head elevated, especially when resting or sleeping, also helps minimize swelling by discouraging fluid accumulation in the face.
For the first 24 hours, your diet should be limited to liquids and very soft, cool foods like yogurt, mashed potatoes, or smooth soups to avoid irritating the surgical area. Gradually transition to semi-soft foods over the next few days, such as scrambled eggs or soft pasta, but continue to avoid anything crunchy, sharp, or excessively hot. Maintaining hydration by drinking plenty of water is important for healing, but you must drink directly from a cup, completely avoiding straws.