After Wisdom Tooth Removal in Billerica, Westford & Worcester, MA

Immediately After Surgery

• Keep the gauze pad over the surgical site in place for 30 minutes, then remove and discard it.
  
• Do not rinse vigorously, touch the wound, or spit during the first day.
  
• Begin over-the-counter pain management as soon as possible using Ibuprofen and Acetaminophen.
  
• Limit activity for the rest of the day and rest in an elevated position.
  
• Apply ice packs to the sides of your face to reduce swelling (see swelling section below).
  
• Avoid alcohol, smoking, and straws.
  

Bleeding

Slight bleeding or blood-tinged saliva is common for the first 24–48 hours. If bleeding becomes more pronounced:

1. Gently wipe away any old clots
   
2. Place clean gauze over the site and bite firmly for 30 minutes
   
3. If needed, use a moistened tea bag and bite for 30 minutes (the tannins help with clotting)
   
4. Stay calm, sit upright, and avoid exertion
   

If bleeding persists, contact our office or visit the nearest emergency room.

Pain Management

Pain often peaks 24–48 hours after surgery and gradually improves thereafter.

Suggested routine:

• Take 400–600 mg of Ibuprofen (Advil or Motrin) every 4–6 hours
  
• In between doses, take 325–500 mg of Tylenol (Acetaminophen)
  
• Alternate doses every few hours for consistent relief
  
• Avoid narcotic medications if possible due to side effects and potential for dependency
  
• If needed, take prescribed narcotic medications cautiously and only if OTC medication is ineffective
  

Do not drive or operate machinery while using prescription painkillers.

Unused narcotics should be safely discarded — your local police department may offer secure disposal boxes.

Swelling

Swelling is normal and usually peaks 2–3 days after surgery.

• Apply ice packs to both sides of the face immediately following surgery
  
• Use for 20-minute intervals during waking hours for the first 36 hours
  
• After 36 hours, switch to moist heat to help reduce lingering swelling and improve comfort
  

Swelling may be accompanied by stiffness of the jaw (trismus). This is temporary and will improve with time.

Diet

• Start with liquids after surgery
  
• Transition to soft foods that do not require chewing near the surgical sites
  
• High-calorie, high-protein foods aid recovery
  
• Drink at least 5–6 glasses of fluid daily
  
• You may use a straw unless otherwise instructed
  

Eat regularly to support healing and maintain strength. Visit our blog for ideas on post-surgery meals.

Oral Hygiene

• Begin gentle brushing the night of surgery
  
• Start warm salt water rinses (1 tsp salt in 1 cup warm water) the day after surgery, 5–6 times daily — especially after eating
  
• If you were given an irrigation syringe, use it to clean the lower sockets once the bleeding subsides
  

Good hygiene is key to preventing infection.

Discoloration

Bruising around the jaw, cheeks, or under the eyes may develop. This typically appears 2–3 days after surgery and is a normal result of bleeding under the tissues. Moist heat can help resolve this discoloration more quickly.

Antibiotics

If prescribed, take antibiotics as directed. If you develop a rash or experience discomfort, discontinue use and contact the office.

Nausea or Vomiting

Nausea is often caused by narcotic medications. To manage nausea:

• Discontinue narcotics
  
• Drink clear fluids with electrolytes (Gatorade, Pedialyte, ginger ale)
  
• Eat small, bland meals as tolerated
  

If vomiting continues, contact our office.

Additional Considerations

Numbness

Temporary numbness in the lip, chin, or tongue may occur and typically resolves over time. Be cautious to avoid biting these areas during recovery.

Jaw Stiffness

Difficulty opening your mouth is common and usually resolves on its own. Gentle jaw movement and warm compresses can help.

Sore Throat

Mild sore throat or discomfort while swallowing may occur due to inflammation. This should improve within 2–3 days.

Dry or Cracked Lips

Keep lips moisturized with petroleum jelly if they become dry during healing.

Bone Fragments

You may feel small hard projections in your mouth. These are not tooth fragments, but normal bony edges. They usually smooth out or dissolve over time. If they persist, our team can assist.

Dry Socket

Dry socket is a painful condition caused by loss of the blood clot from the extraction site, typically developing several days after surgery. Symptoms may include:

• Throbbing pain not relieved by medication
  
• Pain radiating to the ear
  
• Foul odor or taste
  

If you suspect a dry socket, contact our office for treatment.

Learn more about our services on the Wisdom Teeth Removal page.

Sutures

Stitches help reduce bleeding and promote healing. They may loosen or dissolve on their own. If they fall out early, it's usually not a concern. Sutures are typically removed within 7 days and the process is quick and painless.

Returning to Activity

You may resume light activities when you feel up to it. Avoid intense exercise for several days, especially if your calorie and fluid intake is low. Listen to your body and return to your normal routine gradually.

When to Call Us

Contact our office immediately if you experience:

• Persistent or severe bleeding
  
• Unrelieved pain or signs of infection
  
• Vomiting that does not stop
  
• Fever that lasts more than 24 hours
  
• Concerns about healing or unusual symptoms
  

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