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After Wisdom Tooth Removal

Following 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.

Immediately Following Surgery

The gauze pad placed over the surgical area should be kept in place for a half hour. After this time, the gauze pad should be removed and discarded.

Vigorous mouth rinsing or touching the wound area following surgery should be avoided. This may initiate bleeding by causing the blood clot that has formed to become dislodged.

Take the prescribed pain medications as soon as you begin to feel discomfort. This will usually coincide with the local anesthetic becoming diminished.

Restrict your activities the day of surgery and resume normal activity when you feel comfortable.

Place ice packs to the sides of your face where surgery was performed. Refer to the section on swelling for explanation.


Some bleeding for 24-48 hours is expected. If bleeding continues or is excessive, place a tight ball of gauze DIRECTLY over the bleeding site and bite teeth together for 15 minutes. If the gauze is placed correctly, it may be uncomfortable, but must be done. If after repeating this procedure three times the bleeding continues, try biting on a moistened tea bag for 15 minutes. If bleeding still continues, please call us. Do not use straws or create negative pressure in your mouth because this may disrupt the clot. Elevating your head with a couple of pillows may help to prevent excessive bleeding.


The swelling that is normally expected is usually proportional to the surgery involved. Swelling around the mouth, cheeks, eyes and sides of the face is not uncommon. This is the body’s normal reaction to surgery and eventual repair. The swelling will not become apparent until the day following surgery and will not reach its maximum until 2-3 days post-operatively and may last 5-7 days. However, the swelling may be minimized by the immediate use of ice packs. Two baggies filled with ice, or ice packs should be applied to the sides of the face where surgery was performed. The ice packs should be left on continuously while you are awake. After 36 hours, ice has no beneficial effect. If swelling or jaw stiffness has persisted for several days, there is no cause for alarm. This is a normal reaction to surgery. Thirty-six hours following surgery, the application of moist heat to the sides of the face is beneficial in reducing the size of the swelling.


For moderate pain, one or two tablets of Tylenol or Extra Strength Tylenol may be taken every 6 hours or Ibuprofen, (Motrin or Advil) two-four 200 mg tablets may be taken every 6 hours.

For severe pain, take the tablets prescribed as directed. The prescribed pain medicine will make you groggy and will slow down your reflexes. Do not drive an automobile or work around machinery. Avoid alcoholic beverages. Pain or discomfort following surgery should subside more and more every day. If pain persists, it may require attention and you should call the office.

If you experience stomach upset after taking your pain medication, you should not take it again until you are able to take it with food. If your pain increases after 72 hours, please call us.


Following anesthesia, patients should be restricted to clear liquids only, until their numbness wears off and their stomach is tolerating clear liquids well. Patients may progress to soft foods for the balance of the day of surgery, and resume a normal diet the following day. Patients may avoid difficult to chew solids and spicy meals for the first two days. Do not drink alcoholic beverages for 48 hours. Do not use straws for 48 hours. You will feel better, have less discomfort and heal faster if you maintain adequate food and liquid intake.

Mouth Care

Immediately after surgery, do not rinse for this will disturb your blood clot. 24 hours after surgery, you may begin GENTLY rinsing with warm salt water (1/2 tsp. Table salt in coffee cup of warm water) every 4-6 hours and continue this for 2 weeks after your surgery. Rinsing and brushing your teeth will decrease the amount of bacteria in your mouth as well as flushing food debris from the sockets and therefore, promote healing. If you are given a plastic syringe to rinse the surgery sites, do not use until one week after surgery.


In some cases, discoloration of the skin follows swelling. The development of black, blue, green, or yellow discoloration is due to blood spreading beneath the tissues. This is a normal post-operative occurrence, which may occur 2-3 days post-operatively and may last 7-14 days. Moist heat applied to the area may speed up the removal of the discoloration.

Muscle Soreness

If you were given a muscle relaxant as a part of your anesthetic, sore neck, shoulder, and chest muscles is common.


If you have been placed on antibiotics, take the tablets or liquid as directed. Antibiotics will be given to help prevent infection. Discontinue antibiotic use in the event of a rash or other unfavorable reaction. Call the office if you have any questions.

Nausea and Vomiting

In the event of nausea and/or vomiting following surgery, do not take anything by mouth for at least an hour including the prescribed medicine. You should then sip on coke, tea or ginger ale. You should sip slowly over a fifteen-minute period. When the nausea subsides you can begin taking solid foods and the prescribed medicine.

Other Complications


Sutures are placed the area of surgery to minimize post-operative bleeding and to help healing. Sometimes they become dislodged, this is no cause for alarm. Just remove the suture form your mouth and discard it. The sutures will be removed approximately one week after surgery. The removal of sutures requires no anesthesia or needles. It takes only a minute or so, and there is no discomfort associated with this procedure. So it’s really nothing to worry about.

The pain and swelling should subside more and more each day following surgery. If your post-operative pain or swelling worsens or unusual symptoms occur call my office for instructions.

There will be a cavity where the tooth was removed. The cavity will gradually over the next month fill in with the new tissue. In the mean time, the area should be kept clean especially after meals with salt water rinses or a toothbrush.

Your case is individual, no two mouths are alike. Do not accept well intended advice from friends. Discuss your problem with the persons best able to effectively help you: Dr. Fangman or your family dentist.

Brushing your teeth is okay – just be gentle at the surgical sites.

A dry socket is when the blood clot gets dislodged prematurely from the tooth socket. Symptoms of pain at the surgical site and even pain to the ear may occur 2-3 days following surgery. Call the office if this occurs.

If you are involved in regular exercise, be aware that your normal nourishment intake is reduced. Exercise may weaken you. If you get light headed, stop exercising.

Emergency Care

If you need us for any reason, please call us at (720) 328-4990. We have a 24-hour answering service that can reach us ASAP.