Wisdom teeth recovery, one day at a time

You'll leave with gauze folded over the sockets. Bite down on it with steady, firm pressure and swap in a fresh piece when it's soaked, usually every 30 to 45 minutes for the first few hours. Pink saliva for a day or so is normal. A mouth that keeps filling with bright red blood is not.

Your lip, tongue and cheek will stay numb for a few hours. Don't chew on them, and skip hot drinks until the feeling is back. If your dentist told you to, take the first dose of pain medicine before the numbness fades. Getting ahead of the pain is much easier than chasing it.

After oral sedation, the pill keeps working for hours: plan on a ride home, an adult with you for the day, and no driving until tomorrow. Nitrous oxide wears off within minutes, so most people can drive after it.

Lower teeth, impacted teeth and all four at once usually mean a slower recovery than one easy upper tooth. Treat this as a rough map, not a schedule.

Watch the direction. Days two and three often feel worse than day one, because swelling builds slowly. That's expected. Pain that eases and then comes back harder around day three to five, or swelling that keeps growing after day three, is not. Both are reasons to call.

The holes outlast the pain. The gum closes over them in a few weeks and the bone keeps filling in for months. Until then, food can tuck into the lower sockets. Annoying, not dangerous: a gentle rinse after meals usually clears it.

Think in stages, let your comfort lead, and chew on the side that had less work done.

• Day 1, cool and smooth: yogurt, applesauce, pudding, lukewarm broth, protein shakes, smoothies eaten with a spoon.
• Days 2 to 3, soft and warm (not hot): mashed potatoes, scrambled eggs, oatmeal, refried beans, blended soups.
• Days 4 to 7, soft with a little chew: pasta, flaky fish, soft tortillas, well cooked vegetables, bananas.
• Week 2 and on: work back toward your normal food as your jaw opens wider. Crispy tacos can wait until the end.

Skip straws, crunchy foods like chips, popcorn, nuts and seeds, spicy food, and very hot food and drinks. Skip alcohol too, and never mix it with prescription pain medicine. Small grains like rice can lodge in the lower sockets, so rinse gently after eating them.

Prop yourself up for the first two or three nights. Extra pillows or a recliner keep your head above your heart, so swelling drains instead of pooling in your cheeks overnight. Sleeping on your back keeps pressure off the sore side.

Take the gauze out before you fall asleep, since sleeping with it in is a choking risk. Put an old towel on the pillow in case of a little oozing, and keep water and your next dose on the nightstand. Waking up stiff on day two is normal.

On day one, leave the sockets alone. No rinsing, no spitting and no brushing right next to the surgery sites. The clot forming in each socket is your bandage, and swishing or spitting can pull it loose.

From the next day, most dentists want you to rinse gently after meals and before bed with warm salt water, about half a teaspoon of salt in a cup. Tilt your head side to side, then lean over the sink and let the water fall out. No hard swishing, no spitting. Brush your other teeth as usual and go slowly near the back.

Some people go home with a curved-tip syringe for flushing the lower sockets. Use one only if your dentist gave it to you, and only when they said to start. Too early can disturb the clot.

Inhaling creates suction, the same pull a straw makes, and that can drag the clot out of the socket. Nicotine also narrows blood vessels, so less blood reaches the area that's trying to heal, and smoke and vapor irritate the fresh wound.

The safest plan is to stop for as long as you can around surgery, and at least for the first few days after. If you don't think you can, tell your dentist beforehand so you can plan for it together.

Dry socket is when the clot comes out or breaks down too early and leaves the bone in the socket bare. It usually shows up a few days after surgery, most often in a lower socket. The signs:

• Pain that was getting better turns into a deep, throbbing ache that keeps getting worse
• The pain spreads toward your ear, temple or neck on that side
• A bad taste or smell that brushing doesn't fix
• The socket looks empty, or you can see whitish bone instead of a dark clot
• Your usual pain medicine barely touches it

If that sounds like you, call. Dry socket hurts, but it's treatable and usually not dangerous. The dentist typically rinses the socket and places a soothing medicated dressing, and many people feel relief the same day. Don't poke at it yourself.

Normal: soreness that's worst around days two and three, cheek swelling, some bruising, a stiff jaw, a little oozing on day one, and a sore throat.

Call for a fever, pus or a foul-tasting discharge, pain that gets worse after day three, swelling that keeps growing after day three, or numbness in your lip, chin or tongue that hasn't worn off by the next day. Our Oak Lawn office is open Tuesday 9 to 3 and Wednesday to Friday 10 to 5 at (214) 304-2112. After hours, leave a message and we'll call back. Had your teeth out elsewhere and can't reach that office? An emergency visit here starts with a $75 exam and an x-ray of the area.

Most people with a desk job or classes take two to four days. If your job is physical, plan a little longer. A Thursday or Friday appointment puts the hardest days on the weekend.

Hold off on hard workouts, running and heavy lifting for at least the first several days. A racing heart can restart bleeding and add to the throbbing. Easy walks are fine. When you go back, start light and stop if the sockets throb or bleed.

A little shopping the day before makes the week easier:

• Soft foods for a week: yogurt, applesauce, broth, eggs, oatmeal, bananas
• Two cold packs, or bags of frozen peas, to rotate
• Extra pillows, or a recliner you don't mind sleeping in
• The pain medicine your dentist recommends, plus lip balm
• A ride home and an adult nearby if you're having oral sedation

At Soleil Dental in Dallas, many wisdom teeth are handled right here in our office, and if a case needs a specialist, we'll tell you and help with the referral. You're numbed with local anesthetic, with nitrous oxide or oral sedation if you'd like to feel calmer. We don't offer IV sedation or general anesthesia, so if you want to be fully asleep, we'll refer you to an oral surgeon. Nervous about it? Read how we handle anxiety-free dentistry, or start with our wisdom teeth page.