The removal of wisdom teeth is a common surgical procedure, and pain and swelling are expected parts of the healing process. Managing the recovery carefully determines how quickly and smoothly you return to normal activity. Successful healing depends on proactive steps to control pain, reduce inflammation, and prevent complications. Following specific post-operative instructions for medication, physical care, diet, and activity is necessary for minimizing discomfort.
Managing Pain with Medication
Controlling pain begins immediately, often before the local anesthetic completely wears off. The most effective strategy involves alternating over-the-counter (OTC) medications, specifically ibuprofen and acetaminophen. This approach maximizes pain relief by targeting different biological pathways while staying within safe dosage limits.
An adult can begin with 600 milligrams (mg) of ibuprofen, and approximately three hours later, take 500 to 1,000 mg of acetaminophen. Continuing to alternate between the two medications every three hours provides continuous pain coverage. Strict adherence to the schedule is necessary to avoid overdose, as the maximum daily dose for ibuprofen is typically 3,200 mg, and for acetaminophen, it is 3,000 to 4,000 mg.
If the pain is severe, your oral surgeon may prescribe a stronger medication, often a narcotic or opioid pain reliever. Since prescription pain medications frequently contain acetaminophen, do not take additional OTC acetaminophen with the prescription to avoid exceeding the daily maximum dose. These prescription drugs should be used only for breakthrough pain that the alternating OTC regimen cannot control. As pain lessens, usually after the second or third day, transition back to the OTC regimen and discontinue the narcotic medication entirely.
Physical Methods for Swelling and Discomfort
Swelling is a normal reaction to the surgery, often peaking around 48 to 72 hours post-procedure. To manage initial inflammation, apply cold therapy to the outside of your cheek in the surgical area. Use ice packs for the first 24 to 48 hours, applying them for 20 minutes on and 20 minutes off, with a cloth barrier.
After 48 hours, switch to applying moist heat. Warm compresses or a heating pad set on low can be applied to the jaw area for 20-minute intervals. This warmth helps alleviate jaw stiffness and muscle soreness and encourages blood flow, which aids recovery.
Starting 24 hours after the procedure, begin gentle rinsing with a warm salt water solution. This helps keep the extraction site clean and reduces the risk of infection. Rinsing must be extremely gentle, without vigorous swishing or spitting, as forceful action can disrupt the blood clot forming in the socket.
Preventing Complications Through Diet and Activity
A primary goal of post-operative care is to protect the blood clot that forms in the empty socket, as this clot is necessary for proper healing. If this clot becomes dislodged, a condition known as “dry socket,” can occur, causing severe throbbing pain. To prevent this, strictly avoid creating suction in the mouth for at least the first week.
Do not drink through a straw, forcibly spit, or smoke any tobacco products. Smoking is particularly harmful as it restricts blood flow and introduces contaminants, significantly increasing the risk of dry socket. Restrict your diet to soft, non-chewy foods like yogurt, mashed potatoes, and smoothies for the first few days, avoiding hard, crunchy, or hot foods.
Physical activity must also be limited to promote healing and prevent additional bleeding. Plan for rest and avoid strenuous exercise or heavy lifting for several days, as increased blood pressure from exertion can dislodge the clot. Keeping your head elevated while resting, especially during the first two to three days, also helps minimize swelling.
When to Contact Your Oral Surgeon
While some discomfort is normal, certain symptoms indicate a complication requiring professional attention. Contact your oral surgeon if you experience heavy or persistent bleeding that cannot be controlled by biting down firmly on gauze. Swelling that worsens after the third day or suddenly returns after subsiding may signal an infection.
Signs of a possible infection include a persistent fever, pus or foul-smelling discharge from the socket, or a bad taste in your mouth that gentle rinsing does not resolve. The most distinct sign of a dry socket is severe, throbbing pain that radiates toward the ear, temple, or neck and is unrelieved by prescription pain medication. Also contact the office if you experience numbness in your lip, tongue, or chin that lasts longer than 24 hours, as this may indicate temporary nerve involvement.