The removal of wisdom teeth, or third molars, is a common surgical procedure performed to prevent future complications like impaction, crowding, or infection. These teeth are the last to develop, typically emerging between the ages of 17 and 25, and often require extraction because the jaw lacks sufficient space for them to erupt properly. Following the necessary steps for preparation and recovery can significantly reduce the risk of complications and ensure a smoother healing process.
Preparing for the Procedure
Preparation for wisdom teeth removal begins well before the surgery date with a pre-operative consultation. This appointment is the time to review your full medical history, including all prescription medications, over-the-counter drugs, and herbal supplements you are taking. Your surgeon may instruct you to temporarily stop specific medications, such as blood thinners like aspirin or ibuprofen, which can increase bleeding during the procedure.
For patients receiving intravenous (IV) sedation or general anesthesia, strict fasting guidelines are in place. You will be instructed to have nothing to eat or drink—including water, gum, or mints—for a period of six to eight hours before the scheduled surgery time. If you need to take necessary daily medications, your surgeon will likely approve taking them with only a very small sip of water.
Logistical planning must include arranging for a responsible adult to drive you home after the procedure. Due to the lingering effects of sedation or anesthesia, you will not be permitted to drive or operate machinery for at least 24 hours following the surgery. It is also wise to clear your schedule and plan for at least one to three days off from work, school, or other major obligations to allow for initial recovery.
You can proactively set up your home recovery space to maximize comfort and convenience after the surgery. This involves stocking your kitchen with approved soft foods and liquids, as well as placing necessary supplies like ice packs and extra pillows near your resting area. Keeping your head slightly elevated with these pillows during rest can help minimize post-operative swelling once you return home.
Managing the First 48 Hours
You will leave the office with gauze packed firmly over the extraction sites, and maintaining continuous, firm pressure on this gauze helps control initial bleeding. Replace the gauze every 30 to 60 minutes as needed. If heavy bleeding persists for more than a few hours, you should contact your oral surgeon.
Pain management should begin promptly, often before the local anesthesia completely wears off. It is important to take prescribed pain medication with a small amount of food to prevent nausea, and your surgeon may recommend alternating between the prescription medication and over-the-counter anti-inflammatory drugs like ibuprofen. Swelling is a natural inflammatory response, and you can minimize it by applying ice packs to the outside of your cheeks for cycles of 20 minutes on and 20 minutes off for the entire first 24 to 48 hours.
Protecting the blood clot that forms in the empty socket is the single most important action during this period to prevent a painful condition called alveolar osteitis, or dry socket. This means avoiding any activity that creates suction or pressure in the mouth, including using a straw, spitting, smoking, or vigorously rinsing. You must also avoid strenuous physical activity for the first 48 hours, as this can increase blood pressure and lead to renewed bleeding.
Initial hydration and nutrition rely strictly on liquids and very soft, cool foods that require no chewing. Acceptable options include mashed potatoes, yogurt, applesauce, smooth soups, and ice cream. Avoiding hot liquids and temperatures is necessary, as heat can disrupt the clotting process and increase swelling.
Navigating the Extended Recovery Period
You can begin gentle salt water rinses 24 to 48 hours after surgery, using a solution of one-half teaspoon of salt dissolved in eight ounces of warm water. Gently let the solution flow over the surgical sites and passively drain into the sink. Continue to avoid any forceful spitting or swishing.
You should continue to brush your teeth gently, taking care to avoid the surgical sites for the first few days. If your surgeon provided a plastic syringe, you will be instructed to begin using it to gently flush food debris from the sockets after meals, usually starting around five to seven days post-surgery. Maintaining a clean mouth is important for preventing bacterial buildup and infection.
Dietary progression can begin on day three, moving from a liquid-only menu to semi-soft foods like scrambled eggs, soft pasta, and oatmeal. For the first week, you must continue to avoid foods that are hard, crunchy, chewy, or contain small seeds or grains, as these can easily become lodged in the extraction sites. Only progress to harder foods when chewing does not cause pain or strain.
The most common complication is dry socket, which is characterized by a throbbing, severe pain that usually begins three to five days after surgery, often radiating toward the ear. Signs of infection, such as fever, persistent swelling, or yellow or white discharge from the site, warrant an immediate call to your oral surgeon. Most patients can resume light exercise after five to seven days, but you should wait for your surgeon’s approval before returning to full-intensity workouts.