Wisdom teeth removal is a common procedure addressing issues like impaction, crowding, or infection of the third molars. While the surgery is routine, the recovery period requires specific aftercare to ensure proper healing. A successful recovery hinges on closely following instructions designed to minimize complications and manage discomfort. Understanding the stages of healing is key to a smooth return to normal function.
The First 24 Hours: Bleeding and Initial Rest
The immediate hours following surgery focus on controlling bleeding and maintaining a stable blood clot. Gauze pads placed over the surgical sites must be bitten down on firmly for approximately 30 minutes to maintain pressure. If the gauze becomes soaked with bright red blood, replace it with a fresh pad and continue applying pressure until the bleeding slows to a pinkish ooze. Rest is mandatory, and strenuous activity should be avoided for at least 48 to 72 hours to prevent increased bleeding or dislodging the blood clot. Keep the head elevated with extra pillows when resting or sleeping to minimize facial swelling. For the first 24 hours, the diet must consist only of liquids and very soft foods that require no chewing, such as broth, yogurt, or applesauce.
Controlling Discomfort: Pain and Swelling Management
Managing pain and swelling is crucial for recovery. Swelling is a normal inflammatory reaction that typically peaks between 48 and 72 hours after the procedure. To reduce this, cold compresses or ice packs should be applied to the outside of the cheek over the surgical area. The recommended schedule for applying cold is 20 minutes on, followed by 20 minutes off, maintained consistently for the first 48 hours post-surgery. Pain management often begins with over-the-counter anti-inflammatory medications like ibuprofen, sometimes combined with acetaminophen for enhanced relief. If prescription pain medication is provided, the first dose should be taken before the local anesthesia fully wears off to maintain comfort. After the initial 48-hour period, gentle, moist heat application may help reduce stiffness and soreness in the jaw muscles, promoting circulation.
Protecting the Site: Preventing Dry Socket and Infection
Preventing a complication known as dry socket is a primary concern in aftercare. This painful condition occurs if the blood clot that forms in the empty socket is lost or fails to develop, which exposes the underlying bone and nerve endings. Actions that create suction or pressure within the mouth are the most common cause of clot dislodgement. Patients must avoid using straws, spitting forcefully, or excessive rinsing for at least the first 24 to 48 hours after the surgery. Smoking or using tobacco products should also be avoided for a minimum of 72 hours, as the sucking motion and chemicals interfere with the healing process. Gentle oral hygiene can begin the day after surgery, including carefully brushing the teeth while deliberately avoiding the surgical sites. A gentle salt water rinse, made by dissolving a half-teaspoon of salt in warm water, should be started 24 hours after the procedure. To rinse, tilt the head to let the water flow over the extraction site, allowing it to pour out into the sink without spitting.
The Path to Full Recovery and Dietary Changes
The full healing timeline for the soft tissue is typically about one to two weeks, though the bone itself takes longer to remodel. Swelling and discomfort generally begin to subside after the third or fourth day. Stitches, if present, are often dissolvable and disappear on their own, or they may be removed at a follow-up appointment around the one-week mark. Dietary progression should be gradual and guided by comfort level, moving from the initial liquid diet to soft and then semi-soft foods. Soft foods like mashed potatoes, scrambled eggs, or soft pasta can be introduced on days two and three. By the fourth to seventh day, the diet can expand to include semi-solid items like soft steamed vegetables or tender meats, as long as they do not require aggressive chewing. Strenuous exercise or heavy lifting should be postponed for three to four days to avoid increasing blood pressure, which could trigger bleeding at the surgical site.