How to Clean Your Teeth After Wisdom Teeth Removal

Having your wisdom teeth removed by a dentist or oral surgeon requires thorough post-operative care to ensure a full and speedy recovery. If you don't clean your teeth and mouth properly, you could end up with an infection or painful inflammation known as "dry socket" (alveolar osteitis).^[1] Dry socket occurs in about 20% of lower wisdom teeth extractions, so you will want to make sure you take extra precautions after your surgery. You’ll need to care for your mouth for at least a week after your wisdom teeth removal using a few simple processes that don’t require much time or effort.

EditSteps

EditCleaning Your Teeth

1. Change gauze as instructed by your doctor. After your surgery, your doctor will pack your mouth with gauze over the surgery site. You can generally replace these after an hour or so, if you need to. If you continue to bleed, change your gauze packs every 30-45 minutes and apply gentle pressure.^[2] You should not bleed for more than a few hours after surgery. If the bleeding continues for much longer than that, contact your doctor or dental surgeon.^[3]
   
   • It's normal to see a little blood oozing from the site for 24-48 hours after surgery. This oozing should be mostly saliva with just a few traces of blood. If you see significantly more than that, this is excessive bleeding and you should call your doctor.^[4]
2. Avoid brushing your teeth for the first day after surgery. Do not brush your teeth, spit, or rinse with a mouthwash for the first day after surgery. This can disrupt the healing process and lead to conditions such as dry socket or infection.^[5]
   
   • The first 24 hours after surgery are very important for the healing process. Brushing your teeth or other cleaning measures may disturb the stitches or interfere with blood clotting, which can prolong healing or cause infection.^[6]
3. Avoid brushing the surgical site for 3 days. Avoid brushing the area where you had your wisdom teeth removed for three days after surgery. Instead, you can rinse out your mouth with ½ cup warm water and a pinch of salt beginning the day after your surgery.^[7]
   
   • Do not spit the saline rinse out. Instead, gently tilt your head from side to side to allow the water to wash the area, and then tilt your head to the side to allow it to drain.
4. Brush your other teeth very slowly and carefully. On the day of your surgery, resume brushing your teeth very gently. Be sure to avoid the surgery site so that you don’t irritate it or disrupt the blood clots that protect the surgery site.^[8]
   
   • Use a soft-bristled toothbrush and gently and slowly brush your teeth using small circular motions.^[9]
   • Do not spit out toothpaste for the first few days after your surgery. Spitting could disturb the blood clot that needs to form over the wounded gums. Instead, use a saltwater rinse or antiseptic mouthwash to gently rinse your mouth, and then allow the rinse to drain by tilting your head to the side.
5. Resume your usual brushing and flossing routine the third day after surgery. Once you've reached the third day post-op, you can resume your regular brushing and flossing routine. Continue to be gentle with the site of your surgery so that you don’t irritate it.^[10]
   
   • When brushing your teeth, remember to also brush your tongue in order to remove food particles and bacteria, which could enter the wounded gums and cause an infection.
6. Watch for infection. If you follow your doctor’s order and keep your mouth and teeth clean, this will minimize the risk of infection. It’s important to look for the signs of infection, though, and contact your doctor if you see any of them to avoid post-operative complications.
   
   • See your doctor immediately if you experience problems swallowing or breathing, have a fever, see pus near the surgery site or in your nose, or have swelling that worsens.^[11]

EditCleaning Your Mouth

1. Rinse your mouth with salt water. The day following your surgery, start using a simple solution of salt water to help keep your teeth and mouth clean in between brushing. This will not only help keep your mouth clean, but also help reduce inflammation.^[12]
   
   • Make a salt solution by dissolving 1/2 teaspoon of salt in an 8 oz glass of warm water.
   • Gently swish around a mouthful of the saline solution for 30 seconds. Don't spit it out: tilt your head to the side and allow the water to drain. This will avoid disturbing the empty tooth socket.
   • Rinse with the salt water after every meal to help clear out debris in your mouth.^[13]
   • You can also use a mouthwash to rinse your mouth if it doesn't contain alcohol, which can irritate your surgery site.
2. Use an irrigator to rinse your mouth. Your doctor may provide you with an irrigator, or a small plastic syringe, to rinse out your mouth. Use this after meals and at bedtime if your doctor advises this treatment.^[14]
   
   • Your doctor may prescribe the irrigator only on the lower extraction sites. Make sure to follow his or her instructions.
   • You can use the simple saline solution to fill the irrigator.
   • Make sure to get the tip of the irrigator close to the surgery site flush it out. You can also use it to flush out your teeth. This may be slightly painful, but keeping your mouth and the surgery area clean will help reduce the chance of infection or dry socket.^[15]
3. Do not use a waterpik or water flosser. The water pressure from these tools is too great to use immediately after surgery and could disturb your tooth socket, delaying healing. Unless your dentist specifically recommends otherwise, don't use a waterpik or water flosser for one week after having your wisdom teeth removed.^[16]
   

EditCaring for Your Mouth after Wisdom Teeth Removal

1. Do not use a straw. For the first few days after surgery, don't use a straw to sip beverages or foods like smoothies. The suction could disturb the healing process.^[17]
   
2. Drink plenty of water. It’s important to make sure that you drink plenty of water after your surgery. This will keep mouth moist and help avoid dry socket and infection.^[18]
   
   • Avoid caffeinated and carbonated beverages during the first day.^[19]
   • Avoid alcohol for at least a week after surgery.^[20]
3. Avoid hot drinks. Hot drinks such as tea, coffee, or cocoa could dislodge the blood clots forming in the empty socket where your wisdom tooth was. These blood clots are necessary to the healing process.^[21]
   
4. Eat soft or liquid food. Don't eat anything that could get caught in the empty sockets or disrupt clotting. Use your other teeth to chew, if you have to chew your food.^[22] This will minimize the amount of food that can get stuck in between your teeth and potentially cause infection.^[23]
   
   • In the first day post-op, eat foods like yogurt and applesauce, which won’t irritate your mouth or get lodged in your teeth, which could cause infection. Soft oatmeal or cream of wheat are other good options.^[24]
   • Avoid, hard, chewy, brittle, very hot or spicy foods that might irritate the surgery site or get lodged in your teeth, making the conditions ripe for infection.^[25]
   • Rinse with warm salt water after every meal for the first week following surgery.^[26]
5. Avoid tobacco. If you smoke or chew tobacco, avoid them for as long as possible. Doing this will help ensure a full and timely recovery and also keep infection and inflammation at bay.^[27]
   
   • Consuming tobacco following oral surgery can delay healing and also increases your risk for complications such as infection.^[28]
   • If you smoke, wait at least 72 hours to have a cigarette.^[29]
   • If you chew tobacco, don't use it for at least a week.^[30]
6. Take pain medication. It’s normal to have pain for a few days following the removal of your wisdom teeth. Use either over the counter pain relievers or a prescription pain medication to help alleviate pain and some swelling.
   
   • Take NSAIDs (nonsteroidal anti-inflammatory drugs) such as ibuprofen or naproxen. These will help alleviate some of the swelling associated with the surgery. You can also use acetaminophen, but this does not manage inflammation.
   • Your doctor may prescribe a pain medication if over the counter pain relief doesn’t work for you.^[31]
7. Use an ice pack for swelling and pain. You’ll likely have some swelling for a few days after surgery. This is normal and applying an ice pack to your cheeks will help reduce swelling and pain, including around your teeth.^[32]
   
   • The swelling usually goes away after 2-3 days.^[33]
   • Patient should relax and avoid strenuous activity or exercise until swelling resolves.

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