Wisdom Teeth Care Tips After Surgery

So you just had your wisdom teeth extracted (or are caring for someone who did) and you need some tips for care after surgery?  Look no further! Here is a list of detailed instructions from our team of dental professionals providing answers for any questions/concerns you may have regarding your recent wisdom teeth removal surgery.  

First Hour

Bite firmly on the gauze that has been placed in your mouth for at least one solid hour following surgery.  This helps to stop the bleeding and begins to form a nice blood clot (like a scab) over your surgical incisions.  If the gauze becomes too soaked, you may roll up a few more pieces, place them way back in your mouth over the surgical sites and firmly bite down again.  If active bleeding persists past one hour, change the gauze and bite down firmly for 30 minute increments until it stops.    

Activity

The rest of the day after your surgery should be spent on the couch or bed for the first day.  Any bending, lifting, strenuous activity or exercise will increase bleeding, swelling and pain.  Strenuous exercise should be avoided for 3-4 days after surgery.  

Oral Hygiene

Even though your mouth is healing, it needs to be kept clean.  Our office sends patients with an antibiotic mouth rinse which should be slightly rolled in the mouth and left to dribble out gently twice daily.  We recommend rinsing the mouth in this manner with salt water after eating as well. To make salt water you can mix ¼ teaspoon of salt dissolved in 8oz of warm water.  The other teeth can and should be brushed in the days following surgery taking care to avoid the surgical sites.  It is important to not rinse vigorously or probe the sites with any objects.  

 

Smoking

We strongly recommend to avoid smoking for at least one week following surgery.  Nicotine in the body’s system delays its ability to heal and by smoking on a cigarette, it may lead to the blood clot dislodging too soon.  

Dry Socket

After a tooth is extracted, a hole, or socket, is left in the mouth.  Typically this hole has a blood clot that forms in it after a tooth is extracted.  The clot temporarily shields the underlying nerve from exposure to air and food.  A dry socket, also known as alveolar osteitis, happens when this blood clot is removed too soon before healing can be completed under it and tissue can permanently cover the nerve. As stated, we tell patients to avoid vigorous mouth rinsing or spitting, or sucking anything thick through a straw in order to prevent this clot from coming out too soon.  This is also why we recommend not smoking for 1 week after surgery.  Pain from getting a dry socket can be incredibly painful and is sometimes remedied by your medical team placing synthetic clot material in the socket.  Fortunately, a dry socket is almost completely avoidable if you follow the advice above!  

Bleeding

Bleeding will happen after surgery and it is not unusual for the sites to ooze blood for 24-48 hours after surgery.  Bleeding is comprised of a lot of saliva and just a little blood, so it often appears as more blood than is actually being lost.  The bleeding should never be severe and most frequently happens when the patient is biting on the gauze using their teeth and not putting pressure on the surgical sites.  It is sometimes helpful to bite on a tea bag over the surgical sites which because it contains tannic acid to promote blood clotting.

 

Swelling

This is the body’s normal reaction to surgery.  Swelling peaks around days 3, 4 and 5 after surgery so it is not uncommon to feel okay for a few days and then begin to feel worse.  It can be best managed by applying ice packs to the face as well as taking ibuprofen regularly (if you are able to) as well as take any medications that your doctor provides.  Ice should be applied in 20 minute intervals (20 minutes on, 20 minutes off) for the first 24 hours after surgery.  

 

Pain

Pain is an unfortunate side effect of nearly every surgery.  As with swelling, it peaks at days 3, 4, and 5.  Typically patients are given prescriptions for pain medicine.  We always recommend using ibuprofen as a base pain and swelling medication (800mg every 8 hours if you are able) and then taking the narcotic medication on top of that, if needed. Some patients find that narcotic pain medication causes them to be nauseated.  This can be best avoided by taking the medicine with some bites of food.  Pain also varies widely among individuals.  

 

Nausea

Having an upset stomach can occur as a result of discomfort, swallowing blood, pain medication or anesthesia medicines.  Often sipping on ginger ale or eating saltine crackers can help ease nausea post-operatively.  Always take narcotic pain medicine with a small amount of food.  

Diet

It is important not to skip meals after having surgery.  We recommend soft foods (anything you can cut with the back of a fork- fish or soft pasta consistency) for one week after surgery.  Milk shakes and protein drinks are great sources of nourishment, just remember to eat them with a spoon and not a straw.  Avoid hot, spicy, or crunchy foods until the numbness has worn off, as you can burn your mouth or bite your tongue without knowing.  Foods like sunflowers seeds, popcorn, rice and nuts can get dislodged in the sockets so we recommend holding off on those for a few weeks after.  

 

Healing Process

Generally the first day or two after surgery are not so bad.  Pain and swelling peak around days 3, 4, and 5 and generally are the days that are most uncomfortable.  After those 4-5 days although there usually is some swelling, patients are able to eat a more substantial diet.  From the fifth day, pain and swelling should diminish day by day with gradual steady improvement.  

Bruising

Blue, Black, green and yellow discoloration of the jaw is normal for the following 1-2 weeks after surgery.  This is the body’s normal response to surgery and may be resolved more quickly if moist heat is applied to the area starting 2 days after surgery.  

Sore Jaw

You may feel a limitation or stiffness in your jaw for a few days following surgery.  It commonly resolves in the week after surgery.  Note that wisdom teeth surgery can temporarily exacerbate temporomandibular joint (TMJ) pain. Every patient can experience wisdom tooth surgery differently, as no two cases are exactly alike.  We suggest not taking well-intended advice from family and friends, but to call our office or your surgeon with further questions so we can best assist you!