After Wisdom Tooth Removal

Home Care Instructions for After Removal of Wisdom Teeth

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

  • You should gently bite on the gauze pad placed over the surgical area and change the pad every fifteen to twenty minutes. Typically, bloody oozing will cease after a couple hours. After this time, the gauze pad should be discontinued.
  • 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.
  • We suggest you utilize an OTC non-steroidal medication such as ibuprofen, (Advil, Nuprin) every six to eight hours during the first several post-operative days
  • Take the prescribed pain medications for ‘break through’ pain or pain/discomfort not relieved by the non-steroidal medication. 
  • Restrict your activities the day of surgery and resume normal activity in a couple days once you feel comfortable. If you have been sedated, do not drive for 24 hours.
  • Place ice packs to the sides of your face where surgery was performed. Refer to the section on swelling for explanation.
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A certain amount of bleeding is to be expected following surgery. Slight bleeding, oozing, or redness in the saliva is not uncommon. Excessive bleeding may be controlled by first rinsing or wiping any old clots from your mouth, then placing a gauze pad over the area and biting firmly for thirty minutes. Repeat if necessary. If bleeding continues, bite on a moistened tea bag for thirty minutes. The tannic acid in the tea bag helps to form a clot by contracting bleeding vessels. To minimize further bleeding, do not become excited, sit upright, and avoid exercise. If bleeding does not subside, call for further instructions: Wake Oral & Maxillofacial Surgery Raleigh NC Office Phone Number 919-783-9920.


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. However, the swelling may be minimized by the immediate use of ice packs. Baggies filled with ice, or our custom ice packs should be applied to the sides of the face where surgery was performed. The ice packs should be left on with occasional skin breaks for the first six to eight hours. 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. Three to four days following surgery, the application of moist heat to the sides of the face is beneficial in reducing the size of the swelling.

Pain Management

We recommend utilizing non-steroidal medications such as Motrin, Advil, (Ibuprofen) etc to minimize discomfort. Most discomfort can be minimized by taking 600 mg of Ibuprofen every eight hours, (three times a day on a schedule). For mild discomfort,  two tablets of Tylenol (500mg x 2) may be taken in between your Ibuprofen dosing.

For severe or ‘break through’ pain, take the prescription narcotic analgesic tablets as directed. The prescribed pain medicine may 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: Wake Oral & Maxillofacial Surgery Raleigh NC Office Phone Number 919-783-9920.


After a general anesthestic or IV sedation, liquids should be initially taken. Do not use a straws for the first week. The sucking motion can cause more bleeding by dislodging the blood clot. In a couple days, you may eat most soft foods by chewing away from the surgical sites. High calorie, high protein intake is very important. Refer to the section on suggested diet instructions at the end of the brochure. Nourishment should be taken regularly. You should prevent dehydration by taking fluids regularly. Your food intake will be limited for the first few days. You should compensate for this by increasing your fluid intake. At least 4 – 5 glasses of liquid should be taken daily. Try not to miss a meal. You will feel better, have more strength, less discomfort and heal faster if you continue to eat. Caution: If you suddenly sit up or stand from a lying position you may become dizzy. If you are lying down following surgery, make sure you sit for one minute before standing.

Keep the mouth clean

No rinsing of any kind should be performed until the day following surgery. You can brush the teeth that are away form the surgical sites the night of surgery. The day after surgery you should begin rinsing four to five times a day especially after eating with a cup of warm water mixed with a teaspoon of salt. If a prescription rinse, (Peridex) has been given, use as directed.


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. Moist heat applied to the area may speed up the removal of the discoloration.


If you have been placed on antibiotics, take the antibiotic directed. Antibiotics may be given to treat or 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: Wake Oral & Maxillofacial Surgery Raleigh NC Office Phone Number 919-783-9920.

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 room temperature tea or ginger ale. You should sip slowly over a fifteen-minute period. When the nausea subsides you can begin taking soft, no chew foods and the prescribed medicine.

Call the office if your nausea persists: Wake Oral & Maxillofacial Surgery Raleigh NC Office Phone Number 919-783-9920.

Other Complications

  • If numbness of the lip, chin, or tongue occurs there is no immediate cause for alarm. As stated before surgery, this is usually temporary in nature. You should be aware that if your lip or tongue is numb, you could bite it and not feel the sensation. So be careful. Call Dr. Hum if you have any questions: Wake Oral & Maxillofacial Surgery Raleigh NC Office Phone Number 919-783-9920.
  • Slight elevation of temperature immediately following surgery is not uncommon. If the temperature persists, notify the office: Wake Oral & Maxillofacial Surgery Raleigh NC Office Phone Number 919-783-9920. Tylenol or ibuprofen can be taken to reduce the fever.
  • You should be careful going from the lying down position to standing. You were not able to eat or drink prior to surgery. It was also difficult to take fluids. Taking pain medications can make you dizzy. You could get light headed when you stand up suddenly. Before standing up, you should sit for one minute then get up.
  • Occasionally, patients may feel hard projections in the mouth with their tongue. They are not roots, they are the bony walls which supported the tooth. These projections usually smooth out spontaneously. If not, they can be remodeled by Dr. Hum.
  • If the corners of your mouth are stretched, they may dry out and crack. Your lips may be kept moist with an ointment such as vaseline or Blistex.
  • Sore throats and pain when swallowing are not uncommon. The muscles get swollen. The normal act of swallowing can then become painful. This will subside in 2-3 days.
  • Stiffness (Trismus) of the jaw muscles may cause difficulty in opening your mouth for a few days following surgery. This is a normal post-operative event which will resolve in time.


Sutures are typically placed in 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 from your mouth and discard it. If the sutures need removal, this will occur at approximately one week following 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.

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 Wake Oral & Maxillofacial Surgery for instructions: Wake Oral & Maxillofacial Surgery Raleigh NC Office Phone Number 919-783-9920.

There will be a small cavity or opening where the tooth was removed. The cavity will gradually heal over the next month and fill in with new tissue. In the mean time, the area should be kept clean, especially after meals, with salt water rinses or a syringe, available at our office.

Your case is unique, no two mouths are alike. Do not accept well-intended advice from friends. Discuss your problem with the person best able to effectively help you: Dr. Hum or the staff of Wake Oral & Maxillofacial Surgery.

Brushing your teeth is okay after the first day — just stay away from 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 3 – 4 days following surgery. Call the office if this occurs: Wake Oral & Maxillofacial Surgery Raleigh NC Office Phone Number 919-783-9920.

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.