Wisdom teeth removal is a common oral surgical procedure that many individuals undergo, often in their late teens or early twenties. While the procedure itself is performed under anesthesia, a degree of discomfort and swelling is a normal part of the recovery process. Managing this post-operative pain effectively is important for a comfortable and smooth healing period. The approach to pain relief typically involves a combination of over-the-counter options, prescription medications, and non-medicinal methods. Understanding these various approaches can help individuals prepare for and navigate the post-surgical period.
Over-the-Counter Pain Relief
For managing mild to moderate pain following wisdom teeth extraction, over-the-counter (OTC) pain relievers are frequently recommended. Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen (e.g., Advil, Motrin) and naproxen (e.g., Aleve), are effective because they reduce inflammation at the site of injury, which is a primary cause of post-surgical pain. A typical adult dosage for ibuprofen is 200-400 mg every 4-6 hours, while naproxen is a longer-acting NSAID often taken twice daily. It is generally advised to take these medications with food to help prevent stomach upset.
Acetaminophen (e.g., Tylenol) is another widely used OTC pain reliever that works differently from NSAIDs. It works by blocking pain signals in the central nervous system. Acetaminophen is suitable for individuals who cannot take NSAIDs, as it does not typically cause stomach irritation. A standard dose is often 500-1000 mg every 4-6 hours.
Prescription Pain Medications
When over-the-counter options are insufficient, dentists and oral surgeons may prescribe stronger medications. This can include a higher dose of an NSAID, such as prescription-strength ibuprofen. These stronger NSAIDs continue to target inflammation effectively, which is a significant component of pain after wisdom teeth removal.
For more severe pain, opioid painkillers may be prescribed for a limited duration. These include combination medications like hydrocodone with acetaminophen (e.g., Vicodin, Norco) or oxycodone with acetaminophen (e.g., Percocet). Opioids alter the perception of pain and are typically reserved for short-term use due to potential side effects and dependence risk.
Common side effects of opioid medications include nausea, constipation, and drowsiness. Patients should follow dosage instructions precisely and avoid activities requiring alertness, such as driving, while taking them. Combining an NSAID with acetaminophen can enhance pain relief and potentially reduce the need for opioids.
Beyond Medication: Non-Pharmacological Approaches
Beyond oral medications, several non-pharmacological techniques can contribute to comfort and healing after wisdom teeth removal. Applying ice packs to the outside of the face during the first 24 to 48 hours helps reduce swelling and numb the area. This cold therapy constricts blood vessels, which minimizes inflammation and can alleviate discomfort. Ice packs should be applied for 15-20 minutes at a time, with breaks, and wrapped in a cloth to prevent skin irritation.
After the initial 24 hours, warm salt water rinses can be beneficial for promoting cleanliness and soothing the surgical sites. A common mixture involves dissolving half a teaspoon of salt in a glass of warm water. These rinses help to flush out food debris and bacteria, supporting the healing process and preventing infection. It is important to rinse gently to avoid dislodging the blood clot that forms in the socket, which is essential for proper healing.
Eating a soft food diet is also recommended to avoid irritating the surgical area, with options like mashed potatoes, yogurt, smoothies, and soft soups. Adequate rest is also important for recovery, and avoiding strenuous activities helps prevent increased bleeding and swelling. Keeping the head elevated, especially while resting or sleeping, can also assist in minimizing swelling.
Managing Side Effects and When to Contact Your Dentist
After wisdom teeth removal, common side effects include swelling, often peaking around 48 to 72 hours, which can be managed with ice packs. Bruising around the jaw or neck may occur. Jaw stiffness, or trismus, is common as jaw muscles can become inflamed, typically resolving within one to two weeks. Medication side effects, such as drowsiness from opioids or stomach upset from NSAIDs, should be anticipated.
While these effects are part of normal healing, certain signs warrant contacting your dentist or oral surgeon. Contact your dentist if you experience severe pain that worsens or is not managed by medication, especially after the first few days. Excessive or persistent bleeding that does not slow down with pressure is a concern.
Signs of a potential infection include:
Fever
Pus or unusual discharge from the extraction site
A foul taste or smell in the mouth
Swelling that increases after several days
Difficulty swallowing or breathing, or numbness that persists beyond the expected timeframe, also require prompt contact with your dental provider. These symptoms indicate complications requiring immediate attention.