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.

Immediately Following Surgery

  • Keep the gauze pad placed over the surgical area in place for a half hour. After this time, it should be removed and discarded.
  • Avoid vigorous mouth rinsing or touching the wound area following surgery. Doing so may dislodge the blood clot that has formed and thus, initiate bleeding.
  • As soon as you begin to feel discomfort, take the prescribed pain medications. This will usually coincide as the local anesthetic wears off.
  • 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 an explanation.


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 30 minutes. Repeat if necessary. If bleeding continues, bite on a moistened tea bag for 30 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, or exercise. If bleeding does not subside, call for further instructions.


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.

Swelling may be minimized by the immediate use of ice or cold packs. Two baggies filled with ice or store -bought cold packs should be applied to the sides of the face where the surgery was performed and be left on continuously while you are awake. After 36 hours, ice has no beneficial effect but there is no cause for alarm if swelling or jaw stiffness persists for several days. 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 swelling.


For moderate pain, one or two tablets of Tylenol or Extra Strength Tylenol may be taken every three to four hours or Ibuprofen, (Motrin or Advil) two-four 200 mg tablets every 3-4 hours.

For severe pain, take the prescribed medication as directed. The medication may make you groggy and 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.


After general anesthetic or I.V. sedation, liquids should be initially taken. Prevent dehydration by taking fluids regularly.

Drink from a glass but DO NOT use straws as the sucking motion can cause more bleeding by dislodging the blood clot. Nourishment should be taken regularly. You may eat anything soft by chewing away form the surgical sites. High calorie, high protein intake is very important. Refer to the section at the end of the  brochure on suggested diet instructions.

Your food intake will be limited for the first few days. You should compensate for this by increasing your fluid intake. At least 5-6 glasses of liquid should be taken daily. Try not to miss a single 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 your teeth the night of surgery but rinse gently. The day after surgery you should begin rinsing at least 5-6 times a day, especially after eating, with a cup of warm water mixed with a teaspoon of salt.


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.


Antibiotics may be given to help prevent infection. 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.  Sip slowly over a fifteen-minute period. When the nausea subsides you can begin taking solid foods and the prescribed medicine.

Other Complications

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  • If numbness of the lip, chin or tongue occurs there is no cause for alarm. As stated before surgery, this is usually temporary. You should be aware that if your lip or tongue are numb, you could accidentally bite one and not feel the sensation. So be careful. Call Dr Greco 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 when you shift from lying down to standing up. You were not able to eat or drink fluids prior to surgery and it may be difficult to take fluids after surgery.  Pain medications can make you dizzy and you may get light-headed when you stand up suddenly. Before standing up, sit up 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 that supported the tooth. These projections usually smooth out spontaneously. If they do not, they can be removed by Dr. Greco.
  • Your lips should be kept moist with an ointment such as Vaseline. If the corners of your mouth are stretched, they may dry out and crack.
  • Sore throats and pain when swallowing are not uncommon after surgery. This is because the muscles can get swollen and the normal act of swallowing may become painful. This will subside in 2-3 days.
  • 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 resolve in time.

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.

Final Post Op Notes

Sutures (stitches) are placed in the area of surgery to minimize post-operative bleeding and to help healing. Sometimes sutures become dislodged. If this happens, there 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 the office for instructions.

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

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