Extraction of Impacted Wisdom Teeth

Read this entire information sheet or use the index below to navigate directly to the information you need. 

This site is intended as general information only and should not replace regular consultation with your dental hygienist and dentist.


Preoperative Instructions for Intravenous Anesthesia Sedation (asleep)

  1. You may not have anything to eat or drink (including water) for eight (8) hours prior to the appointment.
  2. A trusted adult must accompany the patient to the office, remain in the office during the procedure, and be able to drive the patient home.
  3. The patient should not drive a vehicle or operate any machinery for 24 hours following the anesthesia experience. Activity Level---A certain amount of bleeding, pain, and swelling is normal. Reduce your activity as much as possible for several hours minimum. Plan to be foggy-headed for up to 24 hours after extractions if you've had surgery in which you were "asleep". Pain medication may make you drowsy and unable to drive or operate machinery or do heavy studying.
  4. Wear loose fitting clothing with sleeves which can be rolled up past the elbow, and low heeled shoes. Contact lenses, jewelry, and dentures must be removed at the time of surgery.

The removal of impacted wisdom teeth and surgical extraction of teeth is quite different from the extraction of erupted teeth. Removal of impacted teeth is a surgical procedure. Postoperative problems are not unusual, and extra care must be taken to avoid complications. Severity of postoperative pain will depend on the procedure and your physical condition. Take medication for pain precisely as directed.

The following conditions may occur--all of which are considered normal:

  • Discomfort may include trismus (stiffness) of the muscles which open your mouth, and discomfort in swallowing.
  • Swelling of the surgical area peaks on the 2nd or 3rd post -operative day. It is not unusual to develop bruising in the area of an extraction. Apply ice bags as directed below.
  • Healing of the surgical site is variable.
  • There will be a space where the tooth was removed. This cavity will gradually (over weeks or months) fill in with new tissue.
  • Your other teeth may ache. This is referred pain and is a temporary condition.
  • Numbness of lips and/or tongue on the affected side may be experienced for a variable period of time.
  • Other symptoms may include a slight earache or a sore throat may develop.There may be a slight elevation of your body temperature for 24 to 48 hours. If temperature continues, notify this Clinic or the dentist who performed the extractions.
  • Please take all prescriptions as directed. [Women: Some antibiotics may interfere with the effectiveness of your birth control pills. Please check with your pharmacist.]
  • Do not be alarmed if your vision is blurred for a time following anesthesia or if a "black and blue" bruise should appear at the site of an injection. The arm also may be bruised, swollen, or tender to touch due to the sedation used for "sleep".

Get ready for the procedure

  • Activity Level--- Plan to be foggy-headed for up to 24 hours after extractions if you've had surgery in which you were "asleep". Pain medication may make you drowsy and unable to drive or operate machinery or do heavy studying. A certain amount of bleeding, pain, and swelling is normal. Reduce your activity as much as possible for several hours minimum.
  • You may expect swelling for 10 days to two weeks and a low grade fever (99 - 100 degrees F).
  • Supplies to have ready---Bags of frozen peas (two to three) and some way to keep them frozen; a soft cloth (such as a wash cloth); semi-soft food (two to three day supply); ointment for your lips; a water bottle with clear fluid (no straw!); a few plastic bags without holes or a hot water bottle; a friend you can call on; light entertainment such as a novel or relaxing music; a willingness to follow directions; and a good attitude.
  • No smoking for at least 5 days after surgery. Nicotine may break down the blood clot, cause a "Dry-Socket", increase pain, and cause delayed healing.

Rules for a successful extraction procedure

  • Get a good night sleep. Be rested and hydrated.
  • Bring your insurance information, checkbook, or credit card. If you have documents and x-rays, in your possession, make sure that you take them to your appointment.
  • Know your appointment time and be there a few minutes early.

Immediately following procedure

  • Encourage clotting by keeping a steady biting pressure on the gauze placed at the bleeding site by your doctor. Pressure helps reduce bleeding and permits formation of a clot in the tooth socket. Gently remove the gauze after the local anesthesia has worn off and normal feeling has returned (one to two hours is common).
  • Reduce your activity level for several hours minimum-relax. Be careful not to bite or burn your mouth or lips. Avoid eating and unnecessary talking for a few hours---relax.
  • Your lips should be kept moist with cream or ointment. If the corners of the mouth were stretched they may dry and crack.
  • Keep fingers and tongue away from socket or surgical area.
  • Do not rinse your mouth or brush your teeth for 24 hours. These activities may hinder formation of a blood clot which is necessary for proper healing.

Control Pain and Swelling

  • Immediately following procedure begin taking medication as directed by your doctor to minimize discomfort when the numbness wears off and feeling is back to normal. Take it before the local anesthetic wears off and the feeling returns to normal. Continue to take medication if pain persists.
  • For mild discomfort take Tylenol or Ibuprofen (600-800 mg with soft food) every four hours. For severe pain take the pharmaceutical drug as instructed---be sure to read the directions carefully.
  • Use ice packs on surgical area (side of face) for 24 - 48 hours: apply ice 20 minutes on - 10 minutes off. Bags of frozen peas work well. Be sure to place a soft cloth (such as a wash cloth) between your face and the cold pack to avoid skin irritation. A prone position, with the head turned to one side, will allow you to lay the ice pack on to the sore muscle. Flip your body over and apply the ice pack to the other side of your face if needed for reduction of swelling and pain.
  • Some oozing of blood may persist after 24 hours. If necessary, apply a moist tea bag to the area and bite firmly for one hour. If bleeding does not slow, call the Clinic or the dentist who performed the extraction.

Nutrition and Hydration

  • Drink plenty of fluids. (Do not use a straw!)
  • Diet may consist of soft foods which can be easily chewed and swallowed. No seeds, nuts, rice, popcorn, etc. Have your meals at the usual time. Eat what you wish, but be careful not to disturb the blood clot. Add solid foods to your diet as soon as they are comfortable to chew.

24 Hours after surgery--Oral Care begins

  • After bleeding has stopped, cautiously begin your daily mouth cleaning routine, but avoid disturbing the surgical site so as not to loosen or remove the blood clot Rinsing is important to prevent infection and promote healing because it removes food particles and debris from the extraction site. Keeping your mouth very clean will help avoid infections, complications and delayed healing.
  • Use a warm salt-water rinse (1/2 teaspoon salt per 8 oz) to clean the surgical area. Mouthwash can be added for better taste. Repeat after every meal or snack for seven days minimum or as long as you need to keep the area free of debris. If the extraction site seems deeper than rinsing is able to clean, please stop by the Clinic for more information.
  • Brush your teeth twice per day and floss once per day. Brush the tongue with a wet toothbrush to keep bacteria growth down..

48 Hours after surgery

  • If the muscles of the jaw are stiff 48 hours after surgery, chewing gum (for a few minutes only) or the use of warm, moist heat may help relax the sore muscles. Use warm packs on the outside of your face: apply heat 20 minutes on - 10 minutes off. Items such as a hot water bottle or a plastic bag with warm water work well. Be sure to place a soft cloth (such as a wash cloth) between your face and the warm pack to avoid skin irritation. Apply the warm packs as need to the sore face muscle/jaw areas.

This site is intended as general information only and should not replace regular consultation with your dental hygienist and dentist.