The following are general recommendations after wisdom tooth removal. Please follow any specific instructions given by your surgeon, as these recommendations may be modified for your individual situation. If you have any questions, please call our office.
Instructions After Wisdom Tooth Removal
Proper care after wisdom tooth removal is important for healing. Some bleeding, swelling, soreness, and jaw stiffness are expected during the first several days after surgery.
Immediately Following Surgery
- Keep the gauze placed over the surgical areas in position with firm pressure for approximately 30 minutes. After this time, remove and discard the gauze.
- Avoid vigorous rinsing, spitting, or touching the surgical areas on the day of surgery. These activities may disturb the blood clots that have formed.
- Begin your recommended pain medication before the local anesthetic has completely worn off.
- Rest on the day of surgery and avoid strenuous physical activity.
- Apply ice packs to the sides of your face as described below.
Bleeding
Some bleeding or blood-tinged saliva is normal after wisdom tooth removal. If bleeding is more significant, place a gauze pad directly over the surgical area and bite with firm, continuous pressure for 30 minutes. Repeat if necessary.
A moistened tea bag may also be placed over the surgical area and held with firm pressure if bleeding continues.
If bleeding remains heavy or your mouth is rapidly filling with blood despite firm pressure, please call our office for further instructions.
Swelling
Swelling is normal after wisdom tooth surgery and often increases during the first two to three days before beginning to improve.
Apply ice packs to the sides of your face for approximately 20 minutes on and 20 minutes off, as often as comfortable, during the first 24 to 36 hours. After the first few days, moist heat may be helpful if swelling or jaw stiffness persists.
Pain
Some discomfort is normal following wisdom tooth removal. If you are able to take nonsteroidal anti-inflammatory drugs (NSAIDs), good options include one of the following:
- Aleve (naproxen): 1-2 over-the-counter tablets every 12 hours
- Advil (ibuprofen 200 mg): up to 3 tablets every 6 hours
Choose either ibuprofen or naproxen. Do not take both together.
If you are able to take NSAIDs, use one of the above options on a scheduled basis for the first 3 days following surgery, even if discomfort is mild. Staying ahead of postoperative discomfort often provides better pain control.
If ibuprofen or naproxen alone is inadequate, you may add 1-2 Regular Strength Tylenol (acetaminophen 325 mg each) every 6 hours.
If you are unable to take NSAIDs, 1 Extra Strength Tylenol (acetaminophen 500 mg), or 1-2 Regular Strength Tylenol (325 mg each), every 6 hours is often sufficient when started before the local anesthetic wears off.
Be aware that acetaminophen is also contained in many prescription pain medications and over-the-counter cold and flu products. Do not take additional acetaminophen without considering the total amount you are taking from all medications. If your surgeon has prescribed or recommended a different pain medication regimen, follow those instructions.
Diet & Hydration
Drink plenty of fluids after surgery. Do not use straws during the early healing period, as suction may disturb the blood clot.
Begin with soft foods that require little chewing. Examples include yogurt, applesauce, eggs, mashed potatoes, smoothies eaten with a spoon, and other soft foods. Avoid very hot, hard, crunchy, or sharp foods that may irritate the surgical areas.
Gradually advance your diet as you feel comfortable, chewing away from the surgical sites when possible. Maintaining adequate fluid and nutritional intake is important during recovery.
Oral Hygiene
Do not rinse your mouth on the day of surgery. You may gently brush your teeth, taking care to avoid the surgical sites.
Beginning the day after surgery, gently rinse with warm salt water several times each day, especially after eating. Mix approximately one teaspoon of salt into a cup of warm water. Avoid vigorous swishing or spitting.
Continue brushing your teeth normally as you recover, but remain gentle around the surgical areas.
Using the Monoject Syringe
If you were given a Monoject irrigation syringe, begin using it 7 days after surgery. Fill the syringe with warm salt water, gently place the tip near the lower wisdom tooth extraction sites, and flush the sockets to remove food and debris.
Use the syringe after meals and as needed to keep the extraction sites clean. Do not begin irrigating the sockets before 7 days after surgery unless your surgeon specifically instructs you to do so.
Using the Monoject Syringe
If you were given a Monoject irrigation syringe, begin using it 7 days after surgery. Fill the syringe with warm salt water, gently place the tip near the lower wisdom tooth extraction sites, and flush the sockets to remove food and debris.
Use the syringe after meals and as needed to keep the extraction sites clean. Do not begin irrigating the sockets before 7 days after surgery unless your surgeon specifically instructs you to do so.
Smoking, Vaping & Tobacco
Avoid smoking, vaping, and other tobacco products during the healing period. These can interfere with healing and increase the risk of complications, including dry socket. The longer you are able to avoid tobacco after surgery, the better.
Nausea & Vomiting
Nausea can occasionally occur after anesthesia or after taking medications. If you become nauseated, allow your stomach to settle and then begin with small, frequent sips of clear liquids. Once liquids are tolerated, gradually return to soft foods.
If nausea or vomiting is persistent, prevents you from keeping fluids down, or prevents you from taking necessary medications, please contact our office.
Antibiotics
If you were prescribed an antibiotic, take it according to the instructions provided with your prescription and by your surgeon.
If you were specifically instructed to take a dose before surgery, follow the preoperative medication instructions provided by our office.
Please contact our office if you develop a rash or another suspected reaction to an antibiotic. Seek immediate medical attention for difficulty breathing, facial or throat swelling, or other symptoms of a severe allergic reaction.
Jaw Stiffness, Bruising & Other Expected Symptoms
Jaw stiffness and difficulty opening your mouth are common for several days after wisdom tooth surgery. Gentle jaw movement generally becomes easier as swelling improves.
Bruising or discoloration of the skin may occasionally develop several days after surgery and usually resolves gradually.
A sore throat or discomfort with swallowing can also occur temporarily after surgery.
Numbness of the lip, chin, or tongue may persist after the local anesthetic should otherwise have worn off. Be careful not to bite a numb lip or tongue. If numbness persists or you have concerns, please contact our office.
Sutures
Sutures may be placed at the surgical sites. Some sutures dissolve or become loose during healing. If a dissolvable suture comes out on its own, this is usually not a cause for concern. Please contact our office if you have questions about your sutures or if the surgical area begins bleeding significantly.
Dry Socket
A dry socket can occur when the blood clot within an extraction site breaks down or becomes dislodged before healing has progressed sufficiently. Pain from a dry socket typically becomes more noticeable several days after surgery and may radiate toward the ear or other areas of the face. An unpleasant taste or odor may also occur.
If pain begins to increase after initially improving, becomes severe, or seems unusual for your recovery, please contact our office so that we can evaluate the surgical site.
Activity
Rest on the day of surgery and limit strenuous activity during the early recovery period. Exercise can increase throbbing, swelling, or bleeding. Gradually return to your normal activities as you feel able.
If you become lightheaded when getting up, sit down and allow the sensation to pass. Rise slowly from a lying or seated position, particularly during the first day after anesthesia.
When to Call Our Office
Pain and swelling should generally begin to improve as healing progresses. Please contact our office if you experience heavy bleeding that does not respond to pressure, pain or swelling that is worsening rather than improving, persistent vomiting or inability to drink fluids, a suspected medication reaction, or any other symptoms that concern you.
Your surgery and recovery are individual. If the instructions provided specifically by your surgeon differ from these general recommendations, please follow your surgeon’s instructions.