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.

Sometimes the after-effects of oral surgery are quite minimal, so not all of the instructions may apply in your particular situation.  Common sense will often dictate what you should do.  However, when in doubt follow these guidelines or call our office for clarification.  Our number is (406) 585-1120.


FIRST HOUR: Bite down firmly on the gauze packs that have been placed over the surgical areas, making sure they remain in place. Do not change them for the first hour unless the bleeding is not controlled.  The packs may be gently
removed after one hour.  If active bleeding persists, place enough new gauze to obtain pressure over the surgical
site for another 30 minutes.  The gauze may then be changed as necessary. Only use when active bleeding is present.

BLEEDING:  Intermittent bleeding or oozing overnight is normal.  Bleeding may be controlled by placing fresh gauze over the areas and biting on the gauze for 30-45 minutes at a time.  Severe bleeding is extremely rare.  If bleeding persists, it usually means that the packs are improperly positioned and are not exerting pressure on the surgical areas. Try repositioning the packs directly over surgical sites.  If bleeding persists or becomes heavy you may substitute a tea bag for 30 to 40 minutes.  If bleeding remains uncontrolled, please call our office.

EXERCISE CARE:  Do not disturb the surgical area today.  Do NOT rinse vigorously or probe the area with anything.  PLEASE DO NOT SMOKE for at least 5 days, since this is very detrimental to healing and may cause a dry socket.  Rest and keep your upper body elevated greater than 30 degrees, even when sleeping at night.  Avoid vigorous activity.

SWELLING:  Swelling is often associated with oral surgery and is generally proportional to the amount of surgery that was done.  It can be minimized by using a cold pack, ice bag or a bag of frozen peas wrapped in a towel and applied firmly to the cheek adjacent to the surgical area.  This should be applied twenty minutes on and twenty minutes off during the first 24 to 48 hours after surgery.

PAIN:  Unfortunately most oral surgery is accompanied by some degree of discomfort. You will usually have a prescription for pain medication.  If you take the first pill before the anesthetic has worn off, you should be able to manage any discomfort better.  Take the pain medicines as directed by Dr. Wallis. Precede each pain pill with a small amount of food.  If you anticipate needing more prescription medication for the night or weekend,
you must call for a refill during weekday business hours.

ANTIBIOTICS: Antibiotics are not routinely used after the removal of wisdom teeth. They may however, be used in specific situations. If you have been prescribed antibiotics, take them as directed. Discontinue antibiotic use in the event of a rash or other unfavorable reaction.

NAUSEA:  Nausea is not uncommon after surgery, but generally only lasts a few hours. In the event of nausea and/or vomiting following surgery try sipping regular Coke, or ginger ale from a glass filled with ice. You should sip a small amount (2 – 3 tablespoons) slowly over a fifteen to thirty minute period. If you tolerate this then double the amount over the next fifteen to thirty minutes. When the nausea subsides you can begin taking solid foods and the prescribed medicine. Sometimes pain medications are the cause of nausea.  Nausea can be reduced by preceding each pain pill with a small amount of soft food, and taking the pill with a large volume of water.  Try to keep taking clear fluids and minimize dosing of pain medications, but call us if you do not feel better.

DIET:  Eat any nourishing food that can be taken with comfort.  Avoid extremely hot foods.  Do not use a straw for the first few days after surgery.  It is sometimes advisable, but not absolutely required, to confine the first day’s intake to
liquids or pureed foods (soups, puddings, yogurt, milk shakes, etc.)  It is best to avoid foods like nuts, seeds, popcorn, etc., which may get lodged in the socket areas.  Over the next several days you may gradually progress to solid foods.  If you take nourishment regularly you will feel better, gain strength, have less discomfort and heal faster.  If you are a diabetic, maintain your normal eating habits or follow instructions given by your doctor.


MOUTH RINSES:  Keeping your mouth clean after surgery is essential.  Use 1/4 teaspoon of salt dissolved in an 8 ounce glass of warm water and gently rinse.  Repeat as often as you like, but at least two or three times daily.

BRUSHING:  Begin your normal oral hygiene routine the day after surgery.  Soreness and swelling may not permit vigorous brushing, but please make every effort to clean your teeth within the bounds of comfort.

HOT APPLICATIONS:  You may apply warm compresses to the skin over the areas of swelling (hot water bottle, hot moist towels, heating pad) for 20 minutes on and 20 minutes off to help soothe tender areas.  This will also help decrease swelling and stiffness.

HEALING:  Normal healing after tooth extraction should be as follows: The first two to  three days after surgery are generally the most uncomfortable and there is usually some swelling, bruising and jaw stiffness.  Swelling and jaw stiffness usually peak in 48 to 72 hours after surgery then gradually improve thereafter. Any bruising will gradually fade as well. It is normal to have red spit in your mouth off and on even for several days after the surgery. This is not a problem and does not require treatment. It is very rare to have any significant bleeding problems after wisdom tooth removal.

AFTER THE THIRD DAY: The remainder of the post-operative course should be gradual, steady improvement. You will have holes in the area where the teeth were removed.  If you were given a plastic irrigating syringe to clean these holes, DO NOT use it for the first five days.  Then use it to irrigate the extraction sites after meals and before going to bed until you no longer catch food in the sockets. The holes will completely heal on there own gradually.

SHARP EDGES:  If you feel something hard or sharp edges in the surgical areas, it is likely you are feeling the bony walls which once supported the extracted teeth. Occasionally small slivers of bone may work themselves out during the following week or so.

Other items

  • If numbness of the lip, chin, or tongue occurs there is no 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. We will check on it at your follow up appointment. Call us if you have any questions.
  • Slight elevation of temperature immediately following surgery is not uncommon. If the temperature persists, notify the office. Tylenol or ibuprofen should be taken to reduce the fever.
  • You should be careful going from the lying down position to standing. Because you were not able to eat or drink prior to surgery and it may also difficult to take fluids you may be slightly dehydrated. Taking pain medications may also contribute to making you dizzy. You could get light headed when you stand up suddenly. Before standing up, you should sit for one minute then get up.
  • If the corners of your mouth are stretched, they may dry out and crack. Your lips should be kept moist with the lip balm given to you or an ointment such as Vaseline.
  • Stiffness (Trimus) 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 begin to resolve after the second or third day.

It is our desire that your recovery be as smooth and pleasant as possible. Following these instructions should help your recovery go as comfortably as possible. You are an individual and no two mouths are alike. If you have concerns about your progress, do not accept well intended advice from friends or information you found online. Discuss your problem with the persons best able to effectively help you: please call us at (406) 585-1120.