After Wisdom Tooth Removal

Bleeding

Bleeding is to be expected after wisdom teeth extractions. Gauze pad(s) should be placed directly over the extraction site(s) and held in place with firm biting pressure; proper placement will help you not swallow blood, which can make you nauseated. Replace the gauze pad(s) every 30–45 minutes. When the gauze pads have little or no blood on them, they are no longer necessary. The amount of bleeding will vary from person to person. Most of your bleeding will slow within 3–4 hours, but a small amount of bleeding is common for up to 24 hours.

Swelling/Discomfort

Discomfort is normal after the extraction of wisdom teeth. If you are not allergic or intolerant to non-steroidal anti-inflammatory drugs, start taking ibuprofen (also known as Advil^® or Motrin^®) as instructed by your surgeon at the time of your surgery. If you are asthmatic, do not take ibuprofen unless you have tolerated it in the past. If your pain is not controlled by the ibuprofen alone, take your prescribed narcotic as instructed. Ibuprofen and your prescribed narcotic can be taken together. Be certain to take your pain medicines with food; this will help prevent nausea. Remember, narcotic pain medicine will impair your judgment and reflexes, and you cannot drive or operate machinery while taking it.

Swelling is normal after surgery and is a major cause of post-extraction discomfort. Swelling typically peaks by the third day and then starts to resolve; it can be reduced by the use of an ice pack. Apply the ice pack to the side of your face for 10 minutes; transfer it to the opposite side for another 10 minutes. Continue icing the face for the first 24 hours. Do not freeze the skin. Ice packs are most useful in the first 24 hours. When sleeping or resting, keep your head elevated for 3–4 days. These measures will not eliminate swelling, but they will help to reduce its severity.

To help avoid dry socket, do not smoke or use a straw for 1 week. Smoking can increase your bleeding. The nicotine and tar in tobacco impair healing and may cause a dry socket.

Diet

To allow blood clots to form undisturbed, do not eat for 2 hours after surgery. Start with clear liquids, such as apple juice, tea, or broth. Eat soft, cold food for the first 24 hours, then carefully ramp up your diet as tolerated. Always cool down any hot foods or liquids during the first 24 hours. Avoid hard, crunchy foods that can cause bleeding or injury until you are healed.

Hygiene

Do not rinse on the day of surgery; it may prolong your bleeding. Begin saltwater rinses the day after surgery and continue for 1 week. Rinse with warm salt as 3–4 times each day. To make the saltwater solution, dissolve a ½ teaspoon of salt in a small glass of warm tap water. If you were given a prescription mouth rinse (such as PerioGard^®), use it as directed in addition to the salt water.

Begin brushing your teeth the day after surgery. It is important to brush all of your teeth, even if the teeth and gums are sensitive. Bacterial plaque and food accumulation near the extraction site will delay healing.

Do not smoke or use tobacco products for at least a week.

When you return for your follow-up appointment, we will flush out the sockets and give you an irrigating syringe and instructions on how to use it. Premature flushing or manipulation of the surgical sites can increase the chance of a dry socket or other complications.

Activity

Unless told otherwise, do no vigorous physical activity for 3 days following your surgery. Physical activity increases your blood pressure, which will cause an increase in your swelling, pain, and bleeding. You may gradually increase your activity after the third post-operative day.