After Wisdom Tooth Removal

Home Instructions After Wisdom Teeth Removal With IV sedation

The removal of impacted wisdom teeth is a serious surgical procedure. Care of the mouth after oral surgery has an important effect on healing. Swelling, discomfort, restricted jaw function, and cheek discoloration is expected, and need not cause alarm. These may be minimized by the following instructions. Please read them carefully. It is strongly encouraged that they be followed. 

Bleeding Control

  • Place a damp gauze pack over the extraction site and gently bite for 30 minutes. 
  • Bleeding should be evaluated by looking directly at the extraction site, not the gauze. 
  • If bleeding continues, place another gauze pack or a moistened black tea bag over the extraction site and bite firmly for an additional 30 minutes with constant pressure.
  • Slight bleeding or oozing is common for up to 2-3 days following surgery.
  • Do not rinse vigorously, spit, or brush near the extraction site for 24 hours after the procedure. These activities may dislodge the blood clot and cause further bleeding. Resume brushing after 24 hours. 
  • If sutures were placed, they will begin to dissolve and fall out after 3-7 days.

Pain Control

  • Please refer to the separate pain control sheet for wisdom tooth surgery.

Swelling Control

  • Apply ice packs (a bag of frozen peas works well) to the face for 20 minutes on, 20 minutes off for the first 24 hours.
  • After 48 hours, apply moist heat to the face to reduce the swelling more quickly. Swelling will usually reach its peak during the first 48-72 hours. Occassionally, facial bruising will develop and could last 7-10 days. 
  • Assume a semi-upright bed position when sleeping using 2 pillows for the first 48 hours. Expect more facial swelling on the side of your face that you sleep on.

  • 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. 


  • After a general anesthetic/IV sedation, start with drinking only cold liquids. While numb, avoid hot liquids or foods.
  • Patients may start with applesauce, pudding or Jell-O. Once the numbness wears off, you can advance to soft, solid foods. 
  • Avoid using straws for 5 days after surgery as this will disrupt healing and can cause a dry socket. 
  • Narcotic pain medication (hydrocodone) can cause constipation. This can be alleviated with fiber supplements/stool softeners.
  • Liquids to drink while numb: water, Gatorade, juice, ice chips, popsicles
  • Food to eat while numb: Applesauce, Jell-O, pudding, yogurt, milkshake (with a spoon)
  • Examples of soft foods to eat after numbness wears resolves: mashed potatoes, pasta, eggs, creamed cereals, soups. 


  • Take the pills as directed until they are gone.
  • Irregularity of bowel habits can be caused by antibiotics. If you develop diarrhea stop the antibiotics and call the office. 

Nausea and vomiting

  • If you experience nausea, stop taking pain medications and food and wait one hour. Then slowly restart clear fluids and soft foods. Advance your diet to more solid foods (yogurt, bananas) and restart the pain medications. 
  • If you vomit, wait one hour before eating or taking pain medication.
  • If you cannot control your nausea/vomiting, please call our office for additional instructions. 

Oral Hygiene

  • Resume brushing your teeth the day after surgery. You may gently brush the areas near the extraction site.
  • Avoid aggressive spitting and any alcohol-based mouthwashes for 1 week after surgery.
  • Rinse your mouth with warm salt-water (1/2 teaspoon of salt in a large glass of water) after each meal and at bedtime. Begin this the day after surgery and continue for one week.

physical exercise

  • Avoid physical activity the day of surgery and for the next 2 post-operative days. You can begin working out 3 days after surgery, but do not expect to perform optimally until 7 days after surgery.
  • When you are physically active, you may experience an increase in pain or soreness. If this occurs, discontinue that activity.


  • It is advised that you do not travel until your 1-week, post-operative appointment
  • A change of pressure (elevators, elevation, or airplanes) may be uncomfortable and cause oral or nasal bleeding, but this should not cause a surgical complication.


Do not to smoke or vape for at least 24 hours after surgery. It is best to avoid smoking for 1 week as this will help to insure a rapid and uneventful recovery.

allergic reaction

If you develop hives or a rash, discontinue all medication and immediately contact our office.

Other Complications

  • If numbness of the lip, chin, or tongue occurs there is no cause for alarm. As reviewed in your consultation, 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. Call Dr. Esmail 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. You could get light headed from low blood sugar or medications. Before standing up, you should sit for one minute before getting 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 removed by Dr. Esmail.
  • If the corners of your mouth are stretched, they may dry out and crack. Your lips should be kept moist with an ointment such as vaseline.
  • 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 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. 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 usually no discomfort associated with this procedure.
  • 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 near the ear may occur 2-3 days following surgery. Call the office if this occurs.
  • Your case is unique, no two mouths are alike. Discuss any problems with the trained experts best able to effectively help you: Dr. Esmail or your family dentist.

telephone support 24/7: 360-671-4859

  • Please call our office with any questions. Surgical assistants are available to answer your questions Monday through Friday.
  • For after-hours support, we utilize a third-party answering service. If they do not answer, leave your name and telephone number. The doctor will return your call immediately. If the doctor does not call back in 20 minutes, please call again.