The removal of wisdom teeth is a common surgical procedure that creates open sockets in the jawbone. Following specific post-operative instructions is paramount to minimize pain, control swelling, and prevent complications like infection or dry socket. Understanding the expectations for the initial hours and days following the procedure ensures proper healing.
Managing Bleeding, Pain, and Swelling
Immediate post-operative care focuses on controlling expected physical symptoms, starting with managing bleeding. Maintain firm, continuous pressure on the gauze placed by the surgeon for thirty to sixty minutes to encourage blood clot formation. If bleeding persists, replace the gauze with a fresh pad, biting down firmly for another 30 to 45 minutes, and repeat until the bleeding slows to a pinkish oozing.
Pain management involves a combination of prescription and over-the-counter medication, which should be taken as directed before the local anesthesia wears off completely. Taking pain medication with a small amount of soft food can help prevent nausea. Swelling is a normal inflammatory response and will not peak until two or three days after the surgery.
Apply ice packs to the outside of your face over the surgical areas in twenty-minute intervals during the first twenty-four hours after the procedure. After 36 hours, ice is no longer beneficial; applying moist heat may instead help reduce lingering stiffness and swelling. Keeping your head elevated, even while sleeping during the first few nights, also aids in reducing swelling and bleeding.
Dietary Restrictions and Hydration
Maintaining proper nutrition and hydration is necessary following the extraction. For the first several days, limit your diet to soft foods that require little to no chewing, such as yogurt, applesauce, mashed potatoes, and broth or smooth soup. Avoid crunchy, tough, or chewy foods, like nuts or chips, as these can irritate the wound or leave particles lodged in the socket.
Avoid consuming very hot liquids or foods during the initial 24 hours, as the heat can increase bleeding. Staying well-hydrated is important for recovery, so drink plenty of fluids like water and juices, but drink directly from a cup. The use of a straw is prohibited because the suction pressure created can dislodge the protective blood clot.
Oral Hygiene and Preventing Dry Socket
The primary goal of oral hygiene is to keep the surgical site clean without disturbing the blood clot that forms in the socket, which acts as a natural biological barrier protecting the underlying bone and nerve endings. If this clot is prematurely lost or dissolves, the result is a painful condition known as alveolar osteitis, or dry socket.
Avoid any form of vigorous rinsing or spitting for the first twenty-four hours to prevent the clot from dislodging. Starting the day after surgery, gently rinse your mouth with a warm saltwater solution (a half-teaspoon of salt dissolved in warm water). Instead of swishing aggressively, tilt your head to allow the solution to gently flow over the extraction site, using gravity to let the water fall out of your mouth rather than spitting.
You can resume gentle brushing of your teeth the day after surgery, being careful to avoid the surgical site itself. Any activity that creates suction or pressure in the mouth, such as smoking, vaping, or forcefully spitting, must be avoided for at least a week, as this is the primary mechanism that causes dry socket. Smoking is damaging because the chemicals in tobacco impair the healing process and restrict blood flow.
Understanding the Recovery Timeline
The recovery process follows a predictable timeline, though individual experiences may vary based on the complexity of the extraction. The first 24 to 72 hours are when pain and swelling are most noticeable, with swelling reaching its maximum around the third day before it begins to subside. Significant soreness decreases markedly by the third or fourth day, allowing many patients to transition off prescription pain medication.
Soft tissue healing takes about seven to ten days, but the socket will continue to fill in with new tissue over the following weeks. Return to your normal routine and diet gradually, avoiding strenuous activity for about a week to prevent a spike in blood pressure that could cause renewed bleeding. Contact your oral surgeon if you experience persistent, severe pain that does not improve after three to four days or if the pain radiates to your ear. Other signs of potential complications include a fever, difficulty swallowing, or a bad taste and odor suggesting a possible infection or dry socket.