After Wisdom Tooth Removal

The removal of impacted teeth is a serious surgical procedure. Post-operative care is very important. Unnecessary pain and the complications of infection and swelling can be minimized if the instructions are followed carefully.

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Impacted Tooth Removal: Post-Operative Care Instructions

The removal of impacted teeth is a surgical procedure, and proper after-care plays a major role in healing. Following these instructions closely helps reduce pain, swelling, bleeding, and the risk of infection.

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Immediately After Surgery

  • Keep the gauze pad in place for 30 minutes, then remove and discard it.

  • Avoid rinsing, spitting forcefully, or touching the surgical area. This can disrupt the blood clot and cause bleeding.

  • Begin taking prescribed pain medication before the numbness wears off.

  • Rest for the remainder of the day. Resume normal activities only when you feel comfortable.

  • Apply ice packs to the outside of your face over the surgical areas (see Swelling section below).

Bleeding

Some bleeding or light oozing is normal for the first 24 hours.

  • If bleeding increases, gently wipe away old clots, place fresh gauze over the area, and bite firmly for 30 minutes.

  • If needed, repeat once or bite on a moistened tea bag for 30 minutes.

  • Sit upright, avoid physical activity, and remain calm.

  • If bleeding does not improve, contact the office for further instructions.

Swelling

Swelling is a normal response to surgery and usually peaks 2–3 days after the procedure.

  • Apply ice packs continuously while awake for the first 36 hours.

  • After 36 hours, switch to moist heat to help reduce swelling and jaw stiffness.

  • Swelling, tightness, or jaw stiffness lasting several days is expected and not a cause for concern.

Pain Control

  • For mild to moderate pain:

    • Acetaminophen (Tylenol) every 3–4 hours or

    • Ibuprofen (Advil or Motrin) 400–800 mg every 3–4 hours

  • For severe pain, take the prescribed medication as directed.

  • Do not drive, operate machinery, or drink alcohol while taking prescription pain medication.

  • Pain should gradually improve each day. If it worsens or does not improve, call the office.

Diet and Hydration

  • Start with liquids after anesthesia or IV sedation.

  • Do not use straws, as suction can cause bleeding.

  • Advance to soft foods, chewing away from the surgical sites.

  • Drink plenty of fluids (at least 5–6 glasses daily) to prevent dehydration.

  • Good nutrition helps reduce discomfort and speeds healing.

  • Move slowly from lying down to standing to avoid dizziness.

Oral Hygiene

  • Do not rinse your mouth on the day of surgery.

  • You may gently brush your teeth the night of surgery, avoiding the surgical areas.

  • Starting the next day, rinse 5–6 times daily, especially after meals, with warm salt water (1 teaspoon salt in a cup of water).

Bruising and Discoloration

Bruising of the face or neck may appear 2–3 days after surgery and can change colors as it heals. This is normal. Applying moist heat may help it resolve faster.

Antibiotics

If prescribed, take antibiotics exactly as directed.

  • Stop the medication and call the office if you develop a rash or other reaction.

  • Contact the office with any questions or concerns.

Nausea or Vomiting

  • If nausea occurs, avoid food and medications for one hour.

  • Sip clear liquids such as ginger ale, tea, or cola slowly.

  • Resume food and medications once nausea improves.

Other Normal Healing Responses

  • Temporary numbness of the lip, chin, or tongue can occur and usually resolves on its own. Be careful not to bite numb areas.

  • A mild fever shortly after surgery is common. Use acetaminophen or ibuprofen as directed.

  • Jaw stiffness (trismus), sore throat, or difficulty swallowing may occur and typically improves within a few days.

  • Small hard areas felt with the tongue are often healing bone and usually smooth out on their own.

  • Keep lips moist with petroleum jelly to prevent cracking.

Sutures (Stitches)

  • Sutures are placed to aid healing and reduce bleeding.

  • If a suture loosens or falls out early, this is not an emergency.

  • Sutures are usually removed about one week after surgery. Removal is quick and painless.

Dry Socket

A dry socket occurs when the blood clot is lost too early.

  • Symptoms include increasing pain 2–3 days after surgery, sometimes radiating to the ear.

  • If this happens, call the office promptly for treatment.

Exercise and Activity

  • Limit physical activity for several days.

  • Reduced food intake may cause lightheadedness during exercise.

  • Stop activity immediately if you feel dizzy.

Final Notes

Healing improves steadily each day. If pain, swelling, or other symptoms worsen or seem unusual, contact the office for guidance.

Every patient heals differently. Avoid advice from well-meaning friends or family, and direct any concerns to Dr. Katz or your family dentist, who are best equipped to help you.

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