Wisdom tooth extraction is a common procedure, and the 72 hours immediately following surgery represent the most intensive period of initial recovery. During this time, the body works quickly to form and maintain blood clots in the empty sockets, which serve as the foundation for new tissue growth. This guide details the progression of care and symptoms you can anticipate as you navigate the first three days of recovery.
Immediate Post-Op Care (The First 12 Hours)
The first hours after surgery focus on managing residual effects of anesthesia and controlling initial bleeding at the surgical sites. Your mouth will likely feel numb for several hours, but it is important to take prescribed pain medication shortly after arriving home, before the anesthesia completely wears off.
Bleeding control is achieved by gently biting down on the gauze pads placed by the surgeon, applying consistent, firm pressure to the area. Gauze should be changed every 30 to 45 minutes, or when it becomes saturated, but slight oozing is normal for the first 12 hours. Avoid creating negative pressure in the mouth, which means refraining from spitting, rinsing vigorously, or using straws for drinking. Such actions can easily dislodge the protective blood clot.
Managing Peak Discomfort and Swelling (Day 2)
Discomfort and swelling typically intensify as the initial trauma response peaks, with the most pronounced symptoms often occurring around 48 hours post-surgery. Swelling usually begins within the first 12 hours and continues to increase before reaching its maximum size. This is a normal inflammatory response as the body initiates the healing process.
To manage the swelling, cold therapy is most effective during the first 24 hours, as the cold temperature constricts blood vessels and minimizes fluid accumulation. Apply an ice pack or cold compress to the outside of the face, using a cycle of 20 minutes on and 20 minutes off. After the first 24 to 48 hours, you may be advised to switch to gentle, moist heat, which promotes circulation and helps the remaining swelling subside more quickly. Maintain a consistent schedule with pain medication to keep the discomfort manageable, but expect some soreness and tightness in the jaw.
Diet, Hygiene, and Activity (Reaching the 72-Hour Mark)
By the third day, care transitions from initial control to sustained maintenance of the surgical site. Gentle oral hygiene can now be introduced, which is important for preventing bacterial buildup. Starting 24 hours after surgery, begin gently rinsing your mouth with a warm saltwater solution, using a half teaspoon of salt dissolved in eight ounces of warm water.
When brushing your teeth, use caution and avoid the surgical site itself for several days to prevent irritation of the healing tissue. Diet should progress gradually, moving from clear liquids and purees on Day 1 to very soft foods, such as mashed potatoes, soft pasta, or scrambled eggs, by the 72-hour mark. Physical activity must remain restricted; avoid strenuous exercise, heavy lifting, or anything that significantly increases your heart rate for the first three to five days. Increased blood pressure from exertion can restart bleeding or interfere with clot formation.
Identifying Complications and When to Seek Help
While some discomfort is normal, certain signs indicate the healing process is being disrupted and require immediate attention from your oral surgeon. Persistent, heavy bleeding that continues to soak through gauze pads after several hours of continuous pressure is a red flag. A slight pinkish tinge to your saliva is normal, but active, uncontrolled bleeding is not.
Signs of a developing infection include a fever, the presence of pus at the surgical site, or swelling that increases dramatically and does not respond to cold therapy after 48 hours. Another serious complication is alveolar osteitis, commonly known as dry socket, which causes severe, throbbing pain that radiates to the ear and neck. This intense pain usually begins three to four days post-procedure, long after the initial surgical discomfort should have started to improve.