Wisdom teeth tend to bleed longer after extraction than other teeth. Whenever a tooth is removed, your body

creates a blood clot. This clot protects the newly exposed bone and sometimes nerves. If that clot is disturbed, it leaves the bones and nerves vulnerable to bacterial contamination and inflammation. Not only does this slow your recovery process, but it can leave you in significant discomfort. To minimize pain and the risk of complications,

please follow your home care instructions. 

Bleeding

• Some oozing and slight bleeding (redness in saliva) is normal after surgery. 

• Leave the gauze pad over the area(s) of surgery for about 30-60 minutes following the procedure. You may then replace with the fresh gauze provided in your postoperative bag. Leave the gauze in place for a minimum of 20-30 minutes after changing. Repeat this process until the bleeding stops or significantly slows. A clot should form within a few hours after surgery, after which you no longer need to use gauze.

  • DO NOT go to sleep with any gauze in your mouth.

• For persistent bleeding, place a gauze pad over the area and apply mild pressure. Repeat if necessary.

  • You may also gently bite on a moistened black or green tea bag for thirty minutes. The tannic acid in the tea helps the formation of a clot by constricting blood vessels.

• Avoid the following as they can prohibit clot formation and increase bleeding:  

  • Drinking through a straw

  • Aggressive rinsing of the mouth

  • Exercise/strenuous activity for three days following surgery

  • Hot/carbonated beverages

  • Smoking for at least 72 hours following surgery. Ideally, stopping any/all tobacco use is always recommended.

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Swelling

Swelling around the mouth, cheeks, eyes, and sides of the face is not uncommon. This is the body’s normal reaction to surgery. The swelling will not become apparent until the day following surgery and will peak around 2-3 days postoperatively.

• Ice packs (or baggies filled with ice) should be used for the first 24-36 hours after surgery to help reduce swelling. 

  • Ice packs can be applied to the cheek, on the exterior of the extraction sites.

  • Use for 20 minutes on, 20 minutes off.

• After 36 hours, ice has no beneficial effect on swelling. If you are still experiencing some swelling and/or jaw stiffness, the application of moist heat to the sides of the face can be helpful. 

• 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 normal postoperative occurrence, which may occur 2-3 days following surgery. Moist heat applied to the area may speed up the removal of the discoloration.

 

Pain Management

Pain is often most intense for eight hours following surgery and should subside more and more every day.

 

For moderate pain: 

• Acetaminophen (Tylenol): 500-1000mg every 6 hours, not to exceed 3000-4000mg daily for an adult. Ask your surgeon about your specific dosing.

• Ibuprofen (Advil or Motrin): 400-600mg every 6 hours, not to exceed 3200mg daily for an adult. Ask your surgeon about patients under 18.

• Acetaminophen and ibuprofen can be taken at the same time, or their dosing can be staggered.

 

Narcotics should be used as a second-line medication.

• If prescribed, fill the prescription immediately and take as directed.

• Be sure to take with food to minimize the risk of nausea.

• Do not drive a car, operate machinery, make important decisions, sign legal documents, or drink alcohol while taking narcotics.

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Antibiotics

If you were prescribed an antibiotic, take for the full course prescribed, even if signs and symptoms of infection are not present. 

• Women, please note: Some antibiotics may interfere with the effectiveness of your birth control pills. Please check with your pharmacist or primary care provider.

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Diet

It is important you continue to take nourishment regularly. You will feel better, have less discomfort, and heal faster if you continue to eat and drink. 

• After IV sedation or general anesthesia, only liquids should initially be consumed for 4-6 hours following the surgery. Drink from a glass and do not use straws.

• You may eat anything soft by chewing away from the extraction site(s).

• Maintain a soft diet for 7-10 days or until your incisions have healed.

• Be sure to drink enough fluids. To prevent dehydration, drink at least 5-6 glasses of liquid daily.

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Other

• You may experience numbness or tingling in the lip, tongue, or cheek following surgery. This is no reason to be alarmed. Be aware that there is a greater chance of biting your lip/tongue/cheek if you are numb. You should notice the numbness/tingling resolving in the days/weeks following surgery; however, if it does not, follow up with your surgeon.  

• A sore throat and pain when swallowing are not uncommon as muscles become swollen following surgery. This should subside in 2-3 days.

• Stiffness of the jaw muscles is normal postoperatively. You may find that stiffness increases in the days following surgery, but then it should start to resolve. If jaw stiffness persists beyond 5-7 days, please follow up with your surgeon. 

• Maintaining oral hygiene is important.

  • You may brush and floss your teeth, avoiding areas where surgery was performed.

  • Gentle mouth rinsing can begin the day after surgery. Do not aggressively rinse or spit.

• If you were provided with a syringe for rinsing your extraction sockets, you can begin using it on the 5th (fifth) day after surgery. To do so, place the tip of the syringe directly above the socket to direct the flow of water into the socket, and gently irrigate. Do not poke the syringe deeply into any socket.

• Sutures (stitches) are sometimes placed in the area of the surgery to minimize bleeding and to help healing. The sutures may dissolve on their own or they may need to be removed. Ask the team if you are unsure.

  • It is not uncommon for sutures to become dislodged. If this happens, simply remove the suture from your mouth and discard.

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When to Call

• If your bleeding worsens (i.e. if you can see blood actively flowing from an extraction socket).

• If you develop a rash, diarrhea, or any other reaction to medication we have prescribed for you, stop taking the medication and call the office immediately.

• Severe pain that is not reduced with the use of acetaminophen, ibuprofen, or narcotics.

• Swelling that is not improving or persists after 5-7 days.