Wisdom tooth removal is a common minor surgery requiring careful attention to post-operative instructions for a smooth recovery. The healing process involves managing bleeding, controlling swelling, maintaining a specific diet, and practicing gentle oral hygiene. Following a structured aftercare routine is the most effective way to minimize discomfort and prevent complications. This guide provides a step-by-step approach for navigating the first few days following the procedure.
Immediate Post-Procedure Care
The first 24 hours focus on promoting clot formation and reducing initial swelling. Upon returning home, rest with the head elevated on pillows to minimize bleeding and manage swelling. Limiting physical activity for the first two to three days avoids increasing blood pressure, which can restart bleeding.
Initial bleeding is managed by biting firmly on the gauze pads placed over the extraction sites. Gauze should be replaced every 30 to 45 minutes as needed, ensuring the new material is placed directly over the wound. Bleeding should become minimal or stop within a few hours, though a slight pinkish tinge in the saliva may continue for up to 48 hours.
Swelling is an expected part of the body’s healing response and is best addressed immediately with cold therapy. Ice packs should be applied to the outside of the face over the surgical areas for 20 minutes on and 20 minutes off. Consistent use of cold compresses during the first full day helps constrict blood vessels and minimize the amount of swelling that develops.
Pain and Swelling Management
Controlling discomfort is a major concern, so pain management should begin before the local anesthesia fully wears off. Non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, are often the first line of defense against both pain and swelling. These medications should be taken as directed, often in a staggered schedule with other prescribed pain relievers, to maintain steady pain control.
For more severe pain, a prescribed narcotic may be used in combination with an NSAID, but never with additional acetaminophen if the narcotic already contains it. Taking all medication with a small amount of food is recommended to prevent stomach upset or nausea. Swelling typically reaches its maximum between 36 and 72 hours after surgery.
After the first 24 to 48 hours, ice therapy becomes less effective, and a transition to moist heat may be beneficial. Applying warm compresses to the sides of the face for 20 minutes at a time, three times a day, can help reduce residual swelling and ease jaw stiffness. Following the full course of any prescribed antibiotics is necessary, even if symptoms improve, to prevent infection.
Eating and Drinking Guidelines
Maintaining proper nutrition and hydration is important for healing, but the diet must be carefully restricted to protect the blood clot. For the first week, only soft foods that require minimal chewing should be consumed, such as yogurt, applesauce, mashed potatoes, and smooth soups. Ensure that any liquids or soft foods are cool or lukewarm, as heat can disrupt the protective blood clot.
The creation of suction in the mouth must be strictly avoided for at least seven days, meaning absolutely no drinking through straws. The negative pressure created by sucking can dislodge the blood clot from the socket, a painful condition known as dry socket. Activities that create suction, like forceful spitting or smoking, pose the same risk and must be avoided.
Avoid crunchy, sticky, or small-seeded foods (like chips, nuts, or rice) because particles can become lodged in the empty sockets. Gradually reintroducing solid foods can happen as comfort allows, but this should be a slow process over the course of the first week.
Oral Hygiene and Recognizing Complications
Proper oral hygiene is necessary to keep the surgical site clean without disturbing healing. Vigorous rinsing or spitting should be avoided on the day of surgery to allow the blood clot to stabilize. Starting 24 hours after the procedure, the mouth should be gently rinsed with a warm salt water solution several times a day.
The solution is typically made by dissolving half a teaspoon of salt in eight ounces of warm tap water. The liquid should be allowed to passively fall out of the mouth rather than being spit out. Brushing the teeth can resume after the first 24 hours, but the extraction sites should be carefully avoided for the first few days. A soft-bristled toothbrush should be used to clean the remaining teeth gently.
Recognizing Complications
It is important to watch for signs that may indicate a complication, such as dry socket or infection. Dry socket is characterized by intense, throbbing pain that typically worsens two to four days after the surgery, often radiating to the ear, temple, or neck.
Warning signs include an unpleasant taste or foul odor, which can signal an exposed socket or infection. Persistent or increasing pain after the third or fourth day, swelling that does not begin to subside, or a fever should prompt a call to the oral surgeon for further guidance.