Post-Operative Instructions: Wisdom Teeth Removal

The following will cover important information regarding proper post-surgical care for wisdom teeth extraction.

Discomfort is normal after the extraction of 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 doctor at the time of your surgery. If you are asthmatic, do not take ibuprofen unless you have tolerated it in the past. If the ibuprofen alone doesn’t control your pain, take your prescribed narcotic in addition. 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.

Gauze pads should be placed directly over the extraction sites and held in place with firm biting pressure; proper placement will help you not swallow blood, which can make you nauseated. Replace the gauze pads every 30–45 minutes. When the gauze pads have little or no blood on them, they are no longer necessary. Most of your bleeding will slow within 3–4 hours, but a small amount of bleeding is common for up to 24 hours. Gradual improvement with each change is what is important.

Do not rinse on the day of surgery; it may prolong your bleeding. Begin salt water rinses the day after surgery and continue for 1 week. To make the salt water solution, dissolve a ½ teaspoon of salt in a small glass of warm tap water.

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 20 minutes on, and 20 minutes off. Continue icing the face for the first 2–3 days.

Start with clear liquids, such as apple juice, tea, or broth. Always cool down any hot foods or liquids during the first 24 hours. If you were sedated for surgery, do not eat fatty, creamy, or oily foods; these foods may cause nausea. You should start with soft foods: for example, soups, eggs, mashed potatoes, and meatloaf are fine. Do not eat hard, crunchy, or very chewy foods, such as European breads, pizza crust, steak or jerky, nuts, or popcorn. You can advance your diet as you tolerate unless advised otherwise by your doctor.

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 for at least a week. Smoking will increase your bleeding; the nicotine and tar in tobacco impair healing and may cause a dry socket.

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.

Sinus precautions: If advised, please follow the following for at least 2 weeks after surgery. Do NOT blow your nose; if you have to sneeze, sneeze with your mouth open. No smoking. Use decongestants like SUDAFED^®, Afrin^®, or Flonase^® to aid with your comfort.