Post-operative oral hygiene requires a precise and careful approach following wisdom teeth removal. The objective of cleaning is to maintain a sterile environment while protecting the blood clot that forms in the extraction socket. This clot acts as a biological dressing necessary for bone and tissue regeneration; disruption can delay healing or lead to painful complications like dry socket. These guidelines detail the necessary changes to your routine to keep the surgical sites clean without compromising the healing process.
Oral Hygiene During the First 24 Hours
The first day after surgery focuses entirely on preventing the dislodgement of the blood clot. During this period, all activities that generate negative pressure or force within the mouth must be strictly avoided. This means refraining from using straws, smoking, or forceful spitting, as these actions can easily pull the clot out of the socket.
Do not rinse your mouth on the day of surgery, as the movement of liquid can interfere with the initial clotting process and prolong bleeding. Managing initial bleeding involves gently biting down on the gauze pads placed over the surgical sites with firm, steady pressure. If you continue to experience active bleeding, replace the gauze and maintain pressure for 30-minute intervals. A moistened black tea bag can also be used, as the tannic acid it contains can help to constrict blood vessels and promote clotting. Beyond this, avoid touching the extraction sites with your fingers or tongue, and avoid pulling on your cheek to inspect the area.
Gentle Rinsing and Irrigation Techniques
Starting 24 hours after the procedure, you can begin active cleaning with warm saltwater rinses. To prepare the solution, dissolve about half a teaspoon of salt into eight ounces of warm tap water. This saline solution promotes healing and minimizes the risk of infection by gently bathing the mouth.
The technique for rinsing must remain gentle; instead of vigorous swishing and spitting, take a mouthful of the solution, tilt your head from side to side to let the liquid wash over the extraction sites, and allow the water to passively drip into the sink. Perform this gentle rinse three to four times a day, particularly after meals, and continue for up to one week. If your surgeon has provided a prescription mouthwash, such as chlorhexidine, use it exactly as directed, being careful not to exceed the recommended frequency.
For lower extraction sites, which are prone to trapping food debris, your surgeon may provide a small, curved-tip plastic syringe for targeted irrigation. This tool is typically introduced between Day 3 and Day 7 after surgery. To use it, fill the syringe with the warm saltwater solution and insert the tip only one to two millimeters into the socket opening. Slowly depress the plunger to flush out any trapped particles, repeating this action until the fluid returning from the socket is completely clear. This irrigation process should be done two to three times daily, usually after eating, and continued for two to three weeks or until the socket opening has closed sufficiently.
Resuming Normal Brushing and Flossing
You can resume brushing your teeth the day after your surgery, but this must be done with caution. Focus on cleaning the teeth and gums away from the surgical sites to prevent the accumulation of plaque and bacteria in the rest of your mouth. Use a soft-bristled toothbrush and mild toothpaste, employing slow, careful movements.
When brushing the teeth adjacent to the extraction site, use minimal pressure and avoid touching the stitches or the open socket itself. After brushing, avoid the reflex to spit forcefully; instead, let the residual toothpaste and water simply dribble out of your mouth to prevent creating suction that could damage the clot. You can resume routine flossing on all teeth, but avoid flossing near the surgical area until the site has fully healed (which can take several weeks). By Day 4 to Day 7, as initial healing progresses, you can gradually begin to brush nearer to the surgical area, maintaining caution until your surgeon confirms the site is fully closed.