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What To Expect: Removal Of Impacted Teeth

Surgical Post-Op Instructions For Patients Receiving Impacted Teeth Removals

The removal of impacted wisdom teeth is quite different from the extraction of erupted teeth.

The Following Conditions May Occur, All of Which are Considered Normal
  • The operated area may develop significant swelling.
  • It is not unusual to have difficulty opening your mouth completely after surgery for a period of seven to ten days.
  • You may develop a slight earache or sore throat.
  • Your other teeth may ache. This is referred to as sympathetic pain and is a temporary condition.
  • If the corners of the mouth are stretched, they may dry out and crack. Your lips should be kept moist with a cream or ointment.
  • There will be a hole at the site where the tooth was removed. This area should be rinsed after meals and at bedtime beginning on the second postoperative day with warm salt water. The area will gradually fill in over a period of several months with new bone and soft tissue.
  • There may be a slight elevation of temperature for 24 to 48 hours. If temperature remains elevated, notify us.
  • If you were put to sleep with an injection in your arm and a bruise appears around the injection site, do not be concerned as this is not abnormal and will disappear.
  • Small but tender oral ulcers may appear after your surgery. These will resolve spontaneously.
What to Do After Surgery

Extraction sites usually heal quickly and without complications if simple precautions are taken. Reduce your activities for 24 hours after surgery. This helps reduce bleeding and permits the formation of a clot at the site of surgery which is necessary for uncomplicated healing.


Maintain the gauze pads over the extraction sites for two to three hours with firm biting pressure. When the gauze pads are removed, the extraction sites will continue to ooze slightly for several days, coloring the saliva pink to light red depending on the number and difficulty of the extractions. This oozing of blood is normal and can be expected with all third molar extractions. However, if heavy bright red bleeding resumes after removal of the initial gauze pads, the following procedures should be used.

  • Take a clean gauze and gently wipe the blood from the mouth.
  • Fold another clean gauze into a compact pad and moisten it with tap water.
  • Place the pad directly over the bleeding area behind the last visible tooth and bite firmly. The gauze pad must apply pressure to the extraction site. Merely placing the gauze between the teeth and biting on the pad will not stop the bleeding.
  • Maintain the pressure for about 30 minutes. Repeat if necessary.
  • If bleeding continues, take a moistened tea bag and substitute it for the gauze pad. Tea contains tannic acid which is a strong astringent and frequently will stop active bleeding when gauze alone is ineffective.
  • Do not spit. Spitting disrupts the clotting of the blood at the extraction site and prolongs bleeding. If necessary rinse your mouth lightly with cold water to remove any saliva or blood.
  • Do not use straws for the first week.
  • If bleeding persists or other unusual conditions appear, call our office promptly.
What to Eat

To help the healing process, try not to miss a meal after surgery. A cool to warm liquid diet is ideal for the day of surgery. Be sure to drink plenty of liquids (water, milk, coffee, tea or juice). On the second and third postoperative day your diet should consist of soft foods which will not irritate the surgical sites or cause bleeding. On the third day solid foods can be added to the menu.

Suggested foods include:

  • Yogurt
  • Eggs
  • Soups (broth)
  • Custards
  • Mashed potatoes
  • Cooked cereals
  • Jello

Swelling is to be expected. Place an ice bag on the affected area immediately upon your return home, 15 minutes on and 5 minutes off. Do this for the remainder of the day. Swelling usually reaches its maximum within the first 48 hours and then slowly decreases. The application of warm moist compresses after 48 hours will promote rapid reduction of the swelling.

PRECAUTION: The use of moist heat prior to the third day may result in bleeding and excessive swelling.


One ounce of carbonated water for every hour for four to five hours will usually ease nausea. When hunger returns, mild tea or clear soup are better tolerated than heavy or coarse foods.

Antibiotics and Pain Medications

Have the enclosed prescriptions filled promptly and take as directed. Nonnarcotic medications (Motrin, Advil, Ibuprofen, Tylenol) should be taken as soon as possible and repeated as prescribed for the first several days. Narcotic pain medication can be taken in addition if pain relief is not adequate. However, when narcotic pain medications (Percocet, Vicodin, Tylenol #3) are taken you should not operate automobiles or other power equipment.

Antibiotics, when prescribed, should be taken as indicated until gone. If a rash or swelling develops discontinue the antibiotic immediately and call the office to inform your doctor.

Oral Hygiene and Smoking

The extraction sites should not be disturbed allowing adequate time for clotting to occur. The mouth should not be rinsed on the day of surgery. The day following surgery, and for one week after the mouth should be rinsed gently with warm salt water after each meal and at bedtime (one teaspoon of salt in a large glass of warm water). The teeth should be brushed as usual, but the surgery site should be avoided. It is helpful to soften the bristles of the brush prior to use by placing the brush in a cup of hot tap water for several minutes. It is important to maintain oral hygiene so that the wound will heal properly and not become infected. Smokers are advised not to smoke for at least 72 hours after surgery. Drawing on a cigarette may disturb the blood clot and thus interfere with the healing process.

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