Wisdom Teeth Recovery, Day by Day

Most of the questions I get after wisdom teeth surgery are really one question: “Is this normal?” The answer is usually yes. Recovery follows a fairly predictable pattern, and knowing that pattern makes the week much easier for you and for whoever is looking after you.

Here is what the first week typically looks like, day by day, along with the signs that mean you should call us. Your own surgeon will give you written instructions for your case, and those always come first.

Surgery day: rest and gauze

If you had IV sedation, you will feel drowsy for the rest of the day. You need an adult to drive you home and stay with you for the evening. Plan to do nothing more ambitious than lying on the couch with your head raised on two pillows.

Bleeding is expected for the first few hours. Bite gently but firmly on the gauze pads for 30 to 45 minutes at a time, and change them when they are soaked through. Some pink or red tint in your saliva can continue into the next day. That is normal.

• Ice: 20 minutes on, 20 minutes off, on the outside of your cheeks. Ice helps most in the first 24 to 36 hours.
• Medication: take your first dose of pain medication before the numbness wears off, as directed. Staying ahead of discomfort is easier than catching up.
• Food: cool, soft foods once the numbness fades. Think yogurt, applesauce, a smoothie eaten with a spoon.
• No straws, no spitting, no smoking. Suction can loosen the blood clot that protects the socket.

At Molly, your surgeon calls you the evening after surgery. It is a short call. We want to know how the bleeding is, whether the medication is working, and whether you have any questions.

Days 2 and 3: the peak of swelling

This surprises many patients. Swelling usually gets worse before it gets better, and it typically peaks around 48 to 72 hours after surgery. Your cheeks may look round, and your jaw may feel stiff. Some people also notice light bruising along the jawline, which can turn yellow over the next week.

After the first 36 hours, switch from ice to gentle warmth. A warm, damp washcloth helps the swelling settle and the jaw muscles relax.

Starting the day after surgery, rinse gently with warm salt water (half a teaspoon of salt in a cup of water) after meals. Let the water fall out of your mouth over the sink rather than spitting. Brush your other teeth as usual, carefully avoiding the surgical sites.

Discomfort is often strongest on day 2 or 3 as well. Most patients manage well with an alternating schedule of ibuprofen and acetaminophen, if their surgeon has approved it. Take medication only as prescribed, and do not combine products that contain acetaminophen.

Days 4 and 5: turning the corner

By day 4, most people feel noticeably better. Swelling starts to go down, and opening your mouth becomes a little easier each day. Many students return to class and many adults return to desk work around this point, though you should still avoid heavy exercise.

You can slowly add soft foods that need a little chewing: scrambled eggs, pasta, soft fish, well-cooked rice. Chew away from the sockets when you can. If you were given a plastic irrigation syringe, your surgeon will tell you when to start using it, usually around day 4 or 5 for lower sockets.

Days 6 and 7: the sockets are still healing

A week out, you will likely feel close to normal. The sockets themselves are not healed yet. They fill in with soft tissue over the next few weeks and with bone over a few months. Keep them clean, keep rinsing after meals, and keep crunchy or sharp foods like chips and popcorn off the menu for a little longer.

Stiffness in the jaw can last 7 to 10 days. Gentle opening and closing exercises, along with warmth, usually help. If you have dissolving stitches, they often loosen and fall out on their own within one to two weeks.

What is normal, and what is not

These are common and usually not a concern:

• Oozing or pink saliva for the first 24 to 48 hours
• Swelling that peaks on day 2 or 3
• Bruising on the cheeks or neck
• A sore throat or cracked lips at the corners of the mouth
• A small piece of bone or stitch working its way out
• Mild numbness that fades over the first day

Call us if you notice any of the following:

• Bleeding that soaks through gauze steadily after the first several hours, despite firm pressure
• Pain that gets worse after day 3 rather than better, especially a deep ache that spreads toward the ear. This can be a sign of dry socket.
• Fever above 101°F, or swelling that increases after day 4
• Pus, a bad taste that does not go away with rinsing, or trouble swallowing
• Numbness of the lip, chin or tongue that continues after the first day

If you have trouble breathing or swallowing, call 911 first.

Practical tips that help

1. Set up the couch before you leave for surgery. Pillows, a blanket, water, your phone charger and your medication schedule written down.
2. Stock the fridge. Yogurt, pudding, soup you can cool to lukewarm, mashed potatoes and protein shakes.
3. Set alarms for medication. It is easy to lose track of doses on the first night.
4. Stay hydrated. Small sips of water often. Dehydration makes everything feel worse.
5. Plan your week. Most people need 2 to 4 days off school or work. Impacted teeth and longer surgeries may need a little more.

We are with you after

Every recovery is a little different. Age, how deeply the teeth were impacted and your general health all play a part. Younger patients often bounce back faster, which is one reason we like to evaluate wisdom teeth in the late teens.

If something does not feel right, call us. During office hours, call your Molly office. After hours, our 24/7 surgeon line at (949) 555-0911 reaches a surgeon any night of the week. We would much rather hear from you early than have you worry alone. Your follow-up visit, usually about a week after surgery, is included, and it is a good time to ask anything that is still on your mind.