The removal of wisdom teeth is a common procedure that requires careful attention to post-operative instructions for a smooth recovery. While the surgery is routine, the success of the healing process depends significantly on the care provided in the hours and days following the extraction. Understanding the necessary actions to take after leaving the dental office can prevent complications and manage the expected discomfort, ensuring your mouth heals quickly and effectively.
Immediate Post-Operative Priorities
The most important goal immediately following wisdom tooth removal is ensuring a stable blood clot forms in the socket. To encourage this, apply firm, continuous pressure to the surgical site by biting down on a gauze pad for 30 minutes to an hour upon returning home. If slight bleeding continues when the original gauze is removed, replace it with a fresh one and bite down until the seepage subsides.
Limit all physical activity and maintain an elevated head position for the first 24 hours to minimize bleeding and swelling. Any activity that creates suction or pressure in the mouth must be strictly avoided as it can easily dislodge the protective blood clot, leading to a painful condition called dry socket. Do not spit, rinse vigorously, use a straw, or smoke during this period.
Pain and Swelling Management Strategies
Managing discomfort and facial swelling is a primary concern during the first few days of recovery. Swelling is a normal part of the healing response and typically peaks 48 to 72 hours after the procedure. Immediately begin applying ice packs to the outside of your face near the surgical area to minimize initial inflammation. Apply the cold compress for cycles of 20 minutes on and 20 minutes off throughout the first 24 to 48 hours.
Pain control often involves a combination of prescribed medication and over-the-counter options like ibuprofen or acetaminophen. Take these medications as directed before the local anesthesia fully wears off, and maintain a schedule rather than waiting for the pain to become severe. After the first 48 hours, when swelling has peaked, switch to gentle moist heat application on the jaw and cheeks to soothe muscle stiffness and reduce lingering swelling.
Dietary and Activity Restrictions
For the first 24 hours, stick to a liquid diet, such as broths, smoothies, or milkshakes, which require no chewing. Gradually progress to soft foods like yogurt, mashed potatoes, scrambled eggs, and applesauce for the first three to five days. Avoid foods that are sharp, crunchy, or have small seeds or grains, as these can irritate the surgical sites or become lodged in the sockets. Also, avoid drinking very hot liquids or alcohol, as these can increase swelling and disrupt healing.
Strenuous activity or heavy lifting must be restricted for at least five to seven days following the extraction. Increased physical exertion raises blood pressure, which can cause throbbing at the surgical site and potentially lead to increased bleeding or dislodging the protective blood clot. You can slowly return to low-impact exercise once the initial recovery period has passed and you no longer experience any bleeding.
Oral Hygiene and Recognizing Warning Signs
A clean mouth is necessary for healing, but you must be extremely gentle around the surgical sites. Do not rinse your mouth at all on the day of surgery to protect the forming blood clot. The day after the procedure, begin gentle rinsing with a warm salt water solution (a half teaspoon of salt mixed into a cup of warm water). Use this rinse several times a day, especially after eating, by gently tilting your head rather than vigorous swishing or spitting.
You can brush your teeth gently, taking care to avoid the extraction sites for the first few days. As healing progresses, a plastic syringe may be provided to gently flush out any food debris from the sockets, typically starting around day three.
Be aware that a sudden, severe, throbbing pain that begins two to five days after surgery, often radiating toward the ear, is the most common sign of a dry socket. Other warning signs that require you to contact your surgeon include:
- A fever.
- Excessive or prolonged bleeding.
- A foul odor.
- Visible bone in the socket.