Wisdom tooth removal is a common surgical procedure. While the extraction is performed by a qualified professional, the subsequent healing process depends on diligent post-operative care at home. Understanding the necessary steps for recovery ensures proper healing and minimizes the risk of complications. Following specific instructions regarding bleeding, swelling, diet, and hygiene helps the body repair the surgical site.
The Critical First 24 Hours
The immediate aftermath focuses on controlling bleeding and encouraging a stable blood clot within the empty socket. You will be sent home with gauze pads placed over the surgical sites; maintain firm, consistent pressure for 30 minutes to an hour. Minor oozing or redness in the saliva is normal during the first full day. Excessive bleeding that rapidly fills the mouth requires immediate attention and the application of a fresh, tightly compressed gauze pad for another 30 minutes.
Rest completely during these first hours and avoid strenuous activity, which could increase blood pressure and dislodge the protective clot. Elevating the head with extra pillows while resting can also help minimize swelling. Strictly avoid spitting, rinsing the mouth, or drinking through a straw, as the suction created can easily destabilize the forming clot. You should also refrain from smoking, as the chemicals and the physical act of inhaling severely impede healing.
Managing Pain and Swelling
Pain management typically begins before the local anesthesia wears off, with the first dose of prescribed or recommended medication taken shortly after the procedure. Over-the-counter options, such as ibuprofen, are often effective for moderate discomfort and can be taken in conjunction with prescription medication. Taking medication with a small amount of soft food is advisable to prevent stomach upset or nausea.
Swelling is a standard biological response to the surgery, usually peaking around two to three days post-operation. To minimize this, apply ice packs to the outside of the face, using a cycle of 20 minutes on and 20 minutes off throughout the first 24 to 36 hours. After the initial 36-hour window, cold therapy loses effectiveness, and the focus shifts to reducing stiffness and residual swelling. Switching to moist heat, such as a warm compress, helps relax the jaw muscles and promote circulation.
Preventing Dry Socket and Infection
The primary goal of care is to protect the blood clot, which is the foundational scaffolding for new bone and tissue growth. A dry socket, or alveolar osteitis, occurs when this clot dissolves prematurely or is dislodged, leaving the underlying bone and nerve endings exposed. This condition results in a distinct, throbbing pain that worsens three to five days after surgery, when discomfort should otherwise be improving.
To prevent this painful complication, maintain a soft-food diet for several days, avoiding anything crunchy, hard, or requiring excessive chewing. The creation of negative pressure in the mouth—from using a straw, spitting forcefully, or smoking—must be avoided for at least 72 hours. Oral hygiene must be managed carefully; gently brush teeth away from the surgical area. Begin gentle rinsing with warm salt water (one-half teaspoon of salt in lukewarm water) only after the first 24 hours to keep the area clean and reduce infection risk.
When to Seek Professional Advice
While some discomfort and minor symptoms are expected, certain signs indicate a potential complication requiring professional attention. Excessive or heavy bleeding that cannot be controlled by biting down on gauze for a sustained period is a serious concern. If pain is severe, unrelenting, and not mitigated by prescribed medication, it may signal a dry socket or infection.
Monitor for signs of infection, such as a fever or the presence of a foul odor or bad taste that persists despite gentle rinsing. Swelling typically peaks and then subsides after the third day; localized swelling that increases dramatically after 72 hours could indicate a spreading infection. Persistent numbness in the lips, chin, or tongue that lasts longer than the first day should be reported, as it may signify temporary nerve involvement.