Vomiting after a wisdom tooth extraction is a stressful experience that requires specific, careful management to protect the surgical site. The primary concern is the potential for the physical strain of vomiting to dislodge the protective blood clot that forms in the socket. This can lead to a painful complication known as alveolar osteitis, or dry socket. Understanding the cause of the nausea and knowing the immediate, gentle steps to take afterward are necessary for a smooth recovery.
Why Post-Extraction Vomiting Occurs
The causes of nausea and subsequent vomiting following oral surgery are generally related to the medical procedures and medications involved. General anesthesia or intravenous sedation agents commonly cause temporary stomach upset, which typically resolves within four to six hours after the procedure. Nausea can also develop later, often one to four days post-surgery, usually due to the prescribed narcotic pain medications. Opioids are well-known for causing gastrointestinal distress, especially when taken on an empty stomach. Swallowing a significant amount of blood and saliva mixture from the surgical site can also irritate the stomach lining, leading to nausea or vomiting.
Immediate Steps During the Event
If nausea progresses to vomiting, the first priority is to prevent aspiration, the inhalation of stomach contents into the lungs. Position yourself sitting upright or leaning over a basin to use gravity to your advantage, minimizing the risk of fluid entering the airways. The physical act of vomiting creates significant pressure within the mouth, which is the main threat to the surgical site. During the episode, avoid any vigorous mouth movements, including trying to spit. Allow the stomach contents to exit passively, as the suction created by forceful spitting can easily remove the fragile blood clot.
Protecting the Surgical Site Afterward
The most critical step after vomiting is protecting the blood clot, which acts as the body’s natural bandage over the exposed bone. The force exerted during the episode may have compromised the clot, significantly increasing the risk of dry socket. To clean the mouth, perform an extremely gentle saline rinse instead of forcefully spitting or swishing. Dissolve about a half teaspoon of salt into a cup of warm water. Take a sip of this solution, let it rest over the surgical area for a few seconds, and allow it to dribble out of the mouth without any muscular effort or suction.
Signs That Require a Call to Your Dentist
While a single episode of vomiting can often be managed at home, certain symptoms indicate that professional intervention is needed. Repeated vomiting (three to four episodes) is a sign that the body is not stabilizing. The inability to keep fluids down for several hours creates a high risk of dehydration, which can complicate the healing process. Worsening pain not alleviated by prescribed medication may signal the loss of the protective blood clot, the primary symptom of dry socket. A fever above 102°F, or the presence of pus or a foul odor, suggests a post-operative infection may be developing.