Wisdom teeth removal is a common surgical procedure that requires careful management during the recovery period. Thoughtful support from a caregiver significantly affects the patient’s comfort and healing trajectory. Understanding the specific steps for care ensures a smooth transition through managing immediate post-operative effects, discomfort, and the gradual return to normal activities.
Managing the First 24 Hours
The hours immediately following the procedure focus on controlling bleeding and ensuring the initial blood clot forms securely. Gauze pads placed over the extraction sites must be bitten down upon with firm, consistent pressure to encourage coagulation. After 30 to 45 minutes, the gauze should be gently removed and checked for saturation. If significant bleeding continues, a fresh, folded gauze pad must be repositioned and firm pressure reapplied. A moistened black tea bag, which contains tannic acid, can be substituted for gauze to help slow persistent oozing.
Once home, the patient should rest quietly with their head elevated on several pillows to minimize expected facial swelling. Patients who received general anesthesia or deep sedation may experience grogginess, dizziness, or nausea, requiring close monitoring to prevent falls. During this period, avoid having the patient spit or rinse their mouth forcefully, as this action creates suction that can dislodge the newly forming blood clot.
Pain, Swelling, and Medication
Managing discomfort involves a two-pronged approach utilizing pain medication and temperature therapy. It is recommended to administer the prescribed pain medication before the local anesthetic completely wears off to maintain consistent pain control. For post-surgical dental pain, a combination of nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen and acetaminophen is often more effective than single-entity opioid formulations, while presenting fewer side effects.
Swelling is a predictable response to the surgery, typically peaking around 48 to 72 hours post-procedure. To reduce inflammation, a cold compress or ice pack should be applied to the outside of the cheek over the surgical area in cycles (e.g., 20 minutes on and 20 minutes off) for the first 24 to 48 hours. After this initial period, cold therapy is less effective. Caregivers should switch to applying gentle, moist heat, which helps alleviate muscle stiffness in the jaw and promotes the reabsorption of residual swelling.
Diet and Oral Hygiene
The patient’s diet must be restricted to soft foods that require minimal chewing to prevent irritation of the surgical sites. Acceptable foods include yogurt, mashed potatoes, applesauce, well-blended soups, and smoothies. Ensure all items are cool or lukewarm. Hot liquids and crunchy, chewy, or acidic foods should be avoided for the first several days as they can disrupt healing or cause discomfort.
Protecting the blood clot that forms in the socket is necessary for proper healing. Caregivers must ensure the patient avoids any sucking motion, such as drinking through a straw or smoking, as the negative pressure can pull the clot free, leading to dry socket. Gentle oral hygiene should commence the day after surgery, including brushing teeth away from the surgical area with a soft-bristled brush. Beginning 24 hours after extraction, the mouth should be gently rinsed three to four times daily with a warm salt water solution (a half teaspoon of salt dissolved in eight ounces of warm water). This rinsing keeps the area clean and supports tissue healing without disturbing the clot.
Recognizing Complications
Caregivers should remain vigilant for signs that indicate a developing complication requiring a call to the oral surgeon. While minor, dark reddish oozing is common for up to 24 hours, active, excessive bleeding that rapidly fills the mouth should be reported immediately. A slight elevation in temperature during the first 24 to 36 hours is not unusual, but a persistent fever above 101 degrees Fahrenheit may signal an infection.
Other signs of infection include the presence of pus (a thick, yellowish or whitish discharge), or swelling that increases after the first two to three days. The most recognizable sign of a complication is the onset of severe, throbbing pain several days after the procedure, which is the hallmark of a dry socket. If the patient experiences difficulty swallowing or breathing, or if swelling spreads down the neck, immediate medical attention is necessary.