Wisdom teeth removal is a common surgical procedure that requires careful attention to post-operative instructions for proper healing. A successful recovery minimizes discomfort and reduces the risk of complications. Following a specific care regimen protects the delicate blood clot that forms in the socket, which acts as a foundation for new bone and tissue growth. This approach addresses immediate concerns like bleeding and swelling before transitioning to long-term oral hygiene.
Managing the First 24 Hours
The first day focuses on controlling bleeding, managing inflammation, and initiating pain management. Upon returning home, maintain firm, gentle pressure on the gauze placed over the extraction sites for about 30 minutes. Replace the gauze only when it becomes saturated, usually every 20 to 30 minutes, until the heaviest bleeding subsides. Oozing or slight redness in the saliva is normal for up to 24 hours, but severe, uncontrolled bleeding requires immediate contact with the surgical office.
Swelling is a natural response and typically peaks between 48 and 72 hours post-operation. To limit inflammation, apply ice packs to the cheeks using a cycle of 20 minutes on and 20 minutes off for the first 24 hours while awake. Keeping your head elevated with pillows, even while resting, also helps reduce fluid accumulation in the facial tissues.
Take prescribed pain medication as soon as you begin to feel discomfort, ideally before the local anesthesia fully wears off. Taking medication with a small amount of soft food is advisable to prevent nausea. Rest is paramount during this initial period, and you should avoid any strenuous activity that could increase blood pressure and restart bleeding.
Essential Restrictions for Safe Healing
The primary goal is keeping the protective blood clot intact within the socket to prevent dry socket. Any mechanical disruption or negative pressure can dislodge this clot. Therefore, avoid using straws, spitting, or rinsing vigorously for at least the first week. When rinsing is permitted, simply let the liquid passively drool out of the mouth rather than forcefully spitting.
Dietary restrictions are strictly enforced to avoid irritating the surgical area. For the first few days, consume only soft foods like yogurt, mashed potatoes, applesauce, and broth. Avoid crunchy, chewy foods or those containing small seeds that could become lodged in the sockets, such as nuts, popcorn, and rice. Let hot liquids and foods cool down before consumption, as heat can disrupt the clotting process.
Smoking or using any tobacco or vaping products is strictly prohibited for at least one week. The sucking motion can dislodge the clot, and the chemicals impair healing. Physical activity should also be restricted for several days, as excessive exertion raises blood pressure, increasing the risk of swelling, pain, and bleeding. You can gradually reintroduce light activity after the first three to four days, based on comfort level.
Cleaning and Care After the First Day
Maintaining meticulous oral hygiene is necessary to prevent infection after the initial 24-hour period. Begin gentle brushing of the teeth the day after surgery, taking care to avoid directly brushing the surgical sites. Keeping the rest of the mouth clean limits the bacterial load, which promotes faster healing.
Starting 24 hours after the procedure, begin rinsing the mouth gently with a warm saltwater solution. A mixture of one-half teaspoon of salt dissolved in eight ounces of warm water is recommended. This rinse should be performed five to eight times a day, especially after eating, to flush out food particles and leverage salt’s natural healing and antimicrobial properties.
If the oral surgeon has provided an irrigation syringe, delay its use until the blood clot has stabilized, usually around day five to seven. Using the syringe too early can damage the protective clot, but delaying use allows food debris to accumulate and potentially cause infection. The syringe is used to gently flush the lower extraction sites with warm water or the prescribed rinse to remove trapped food.
Recognizing Signs of Abnormal Recovery
While some discomfort is expected, a sudden increase in pain intensity requires professional attention. The most common complication is alveolar osteitis, or “dry socket,” which occurs when the blood clot dissolves or is dislodged, exposing the underlying bone and nerve. This condition causes severe, throbbing pain that worsens two to four days after surgery and can radiate to the ear or temple.
Signs of a possible infection include a persistent fever, increasing swelling that continues past the third day, or pus draining from the socket. If swelling or pain continues to worsen rather than gradually improve after the third day, this indicates a deviation from the normal healing trajectory. Excessive bleeding that saturates gauze quickly after several hours of gentle pressure is also a reason to contact the oral surgeon immediately.