Procedure Instructions

Wisdom Tooth Extractions – Proper Care After Surgery


  • Bleeding is normal following wisdom tooth extractions. It may last two hours or several hours, either way is normal. Gauze should be folded into a tight square and placed directly on top of the extraction sites. Then bite firmly on the gauze for 45 minutes. The gauze should be sufficiently thick so that pressure is placed on the sockets when biting. Remove the gauze and repeat until there is just pink left on the gauze. If this doesn’t completely control the bleeding after several attempts, a moistened tea bag can be used in place of the gauze.
  • Do Not Rinse while still bleeding. Rinsing will keep the blood clot from forming and prolong bleeding.
  • Do Not Spit while still bleeding. Spitting will keep the blood clot from forming.
  • It is normal to have small amounts of bleeding for up to 24 hours.


  • Do not rinse during the first 24 hours following wisdom tooth extractions.
  • Perioguard Antimicrobial Mouth rinse: If this prescription mouth rinse was provided, rinse twice a day for one week. If this is used for longer than two weeks it can begin to lightly stain the teeth. If staining occurs it can be polished with a dental cleaning.
  • Salt Water: Rinse gently with salt water up to 4 times a day for the first week as well. One teaspoon of salt in a cup of warm water should be sufficient.
  • Irrigation Syringes: An irrigating syringe will be provided and should not be used during the first week. Fill the syringe with warm salt water and irrigate directly into the extraction site several times a day to keep debris and bacteria out of the socket. The sockets should be irrigated until they no longer collect food and debris. This is different for each patient but may be necessary for several weeks following surgery.


  • Facial swelling is normal following wisdom tooth extraction. It is variable depending on the difficulty of the surgery as well as the individual patient’s response. Swelling typically peaks on the third day following surgery. It is normal to have one side be slightly worse than the other. The swelling can take over a week to completely resolve.
  • Ice packs: Ice packs should be used for the first two days following surgery. Place the ice on one side for 10 minutes and then transfer to the other side and repeat throughout the day. Ice will not prevent the swelling but will help reduce it.
  • Elevate head: Keeping your head elevated during the first 2-3 days after surgery will help reduce the swelling in the face. Sleeping with multiple pillows is a good way to do this.

Pain Control

  • Discomfort is normal following any surgery and is dependent on the difficulty of surgery and the patient’s individual response.
  • Start your pain medication before the numbing wears off. This will keep you ahead of the pain. It is easier to stay ahead of the pain than to try to catch up to it.
  • NSAIDS: Non-steroidal anti-inflammatory drugs (NSAIDS) are a good way to control post-operative pain and swelling if you are not allergic or intolerant. Start taking Motrin (Ibuprofen) as prescribed immediately after surgery and as often as allowed during the first two days after surgery. It can be taken at the same time as prescribed narcotics and will often work better when combined with either the narcotic or Tylenol. Since Ibuprofen can also help prevent swelling it is recommended to continue this for mild discomfort after narcotic use has ended.
  • Prescribed Narcotic Pain Medicine: If the Motrin does not control the discomfort alone, take the prescribed narcotic as well. The two drugs can be taken together. You should not drive or make important decisions while taking the narcotic pain medicine. Common side effects of narcotic pain medicine include nausea and vomiting, constipation and dizziness.


  • Nausea can be a side effect of both general anesthesia as well as narcotic use. If you have a history of nausea following surgery please let Dr. Loveless know and we will provide preventative medication.
  • Nausea caused by prescription narcotic use can often be prevented by taking your medications with food or eating a light meal prior to taking medication. If vomiting occurs immediately rinse with salt water or antibiotic rinse. Vomiting can cause dry sockets and infections. If it persists please call Dr. Loveless and a prescription will be called in.


  • Start with clear liquids and gradually increase you diet as you are able to based on your comfort. We recommend eating as soon as possible following surgery to help prevent nausea.
  • It is important to drink lots of fluids to replenish your body after fasting.
  • Soft foods will be more comfortable while you are healing during the first few days: eggs, soups, soft pasta, meatloaf, mashed potatoes, ice cream, shakes, etc.
  • Do not use a straw for one week as this can dislodge the blood clots.


  • Do not smoke for one week following extractions. The nicotine and tar in the cigarette smoke can contribute to dry sockets and can delay healing and increase bleeding.
  • Do not use e-cigarettes for one week as well. These still contain nicotine that will contribute to dry sockets, delay healing, and increase bleeding.


  • Do not do any vigorous activity for three days following surgery. This includes sports, exercise, or heavy lifting. Vigorous activity can increase bleeding, slow healing, and predispose to dry sockets. Gradually increase your activity as you feel comfortable, returning to normal activity about one week after surgery.


  • Begin brushing your teeth on the day following surgery. It is important to brush all of your teeth including the teeth and gums near the extraction sites, even though they will be sensitive. Keeping nearby teeth clean will help prevent bacteria and plaque from delaying the healing of the extraction sites.

Other Post-Operative Issues:

  • Bruising: Discoloration, or mild bruising, can occur following surgery. This will be a light yellow, green, or bluish discoloration of the cheeks 2-3 days after surgery. Warm heat packs or a warm wet towel can help this resolve.
  • Jaw Stiffness can occur due to inflammation of the chewing muscles. If this happens it usually takes 2-3 weeks to fully resolve. Moist heat to the sides of the jaw and exercising and stretching the jaw muscles can help.
  • A sore throat can develop. This will usually resolve a few days after surgery
  • A mild fever may occur. This will be treated with your prescribed Motrin and Tylenol based narcotic. If a fever persists after three days contact the doctor.
  • Adjacent teeth may be sensitive for several days following surgery. This is called sympathetic pain and will resolve.
  • Corners of the mouth may become dry and cracked. Applying Vaseline or chapstick will keep your lips moist after surgery.
  • Numbness of the lower lip, chin or tongue may occur. If this happens it is usually only temporary. It may last from several days to several months. Be sure to speak to your doctor and evaluate this at your post operative visit.

Oral surgical care in a safe, warm, and caring environment!

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5 of 5 stars of 167

My father had gone for a root canal the night before and a root fracture was discovered so the tooth could not be saved. We called the next morning to set up an oral surgery appointment and Dr. Loveless was able to accommodate him the same day. The staff explained everything in great detail regarding finances and post operative instructions. Dr. Loveless also discovered another area of concern and removed an additional tooth. This was extremely helpful since my dad is on blood thinners and we really wanted to avoid having to make two trips. Very clean office as well. Will recommend everyone we know to the practice.

5 of 5 stars of 167

Dr. Loveless is amazing. I will continue to use and refer people to him.

5 of 5 stars of 167

What can I say? No one likes to visit the dentist…especially for anything other than having their teeth cleaned. I am no different. Hated that I had to have a tooth taken out but it was necessary. I was referred here by my dentist to see Dr. Loveless. If I ever have to have anything else done from an oral surgeon, I would never wish to see anyone else. Dr. Loveless and his staff not only made me feel less anxious but they were super nice and made sure that I knew everything that was being done. I would refer them to anyone with complete confidence! If I could give them more than 5 stars, I would. I want to tell them all thank you for making this process much easier on me. Just an amazing staff and surgeon!!

5 of 5 stars of 167

This surgeon is great. ALL his staff is outstanding. Had implant done, basically painless, very interesting procedure. Assistant /hygienist (practically doctor) Emily was great. Highly recommend this office.

Larry C.
Happy Patient

5 of 5 stars of 167

I went to have my wisdom teeth removed and it was the most pleasant experience. The staff and physician were very friendly and immediately put me at ease. The office was beautiful and exceptionally clean and I would definitely recommend their services to anyone and everyone!

Holly P.
Happy Patient

5 of 5 stars of 167

I went to get my wisdom teeth removed a few days ago & i could not wait to leave a review. My experience was absolutely PHENOMENAL. I wish i could give them more stars. Everyone at the facility was nice, accommodating and very professional. The procedure was done very quickly and they even gave me Ted Drew’s afterwards! My recovery has been unbelievably easy & fast. I had all 4 wisdom teeth extracted and there was very little swelling. I’ve barely had to take any pain medication and i was even able to eat the next day! I’m convinced they are magicians because the entire experience was just so great it seemed unreal! I never leave reviews but I just had to after receiving such amazing treatment. They definitely live up to the reviews!

Keyonna H.
Happy Patient

5 of 5 stars of 167

Best oral surgery place! Everyone is so friendly & caring! They did a great job of making sure I was comfortable & the surgeon did an excellent job-they even gave me some Ted Drewes to bring home!

Deb M.
Happy Patient

5 of 5 stars of 167

Dr. Loveless did an amazing job. I needed a wisdom tooth extracted that had a large cavity. He got it out whole in less than 1 minute. He is great. His staff is wonderful too. My whole experience was great. I will refer anyone that needs an oral surgeon!

Pamela W.
Happy Patient

5 of 5 stars of 167

“For the gentle care on my three extractions–you’re the best!”

5 of 5 stars of 167

My experience with the ladies and Doctor Loveless was great. I had never been put under by anesthesia before and they made me comfortable and very relaxed. They took care of me from the beginning consultation to leaving minus 4 teeth. Thankfully Dr. Loveless is a younger man so he will hopefully be around to treat my children with the same care, someday.

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St. Louis Office

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Washington, MO 63090


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