Post-Op Extraction Instructions

Following these instructions after your tooth extraction will help you heal faster and more comfortably. If you have questions or concerns at any time, please call our office.

Day of Surgery

First hour

Bite down gently but firmly on the gauze packs that have been placed over the surgical areas, making sure they remain in place. Do not change them for the first hour unless the bleeding is not controlled. The packs may be gently removed after one hour. If active bleeding persists, place enough new gauze to obtain pressure over the surgical site for another 30 minutes. The gauze may then be changed as necessary (typically every 30 to 45 minutes). It is best to moisten the gauze with tap water and loosely fluff it for more comfortable positioning.

Exercise care

Do not disturb the surgical area today. Do not rinse vigorously or probe the area with any objects. You may brush your teeth gently. Smoking will slow healing, causing increased discomfort and an increased chance of dry sockets. We strongly discourage smoking during the healing phase.

Oral hygiene

It is important to keep the mouth clean. You should brush your teeth the night of surgery, but be gentle around the surgical sites. If there is minimal bleeding, saltwater rinses may begin 24 hours after surgery (mix [CONFIRM SALT AMOUNT: 1 tablespoon here vs. 1/4 teaspoon below] of salt with 8 ounces of water). Swish gently and allow the water to drip into the sink. Rinses should be done 2 to 3 times a day, especially after eating.

Activities

Activities after surgery should be limited to couch or bed rest for the first day. Bending, lifting, or strenuous activity will result in increased bleeding, swelling, and pain. Be careful going from lying down to standing, as you could get lightheaded when you stand up suddenly. If you exercise regularly, be aware that your normal fluid and caloric intake is reduced. Exercise in the post-operative period may also result in increased bleeding, swelling, and discomfort. Exercise should be avoided for 3 to 4 days following surgery.

Oozing

Bleeding will occur after surgery, and it is not uncommon to ooze blood for 24 to 48 hours after surgery. Keep in mind that oral bleeding represents a little blood and a lot of saliva. Placing a gauze pack over the area and biting firmly will control bleeding. If oozing is still active, replace the gauze as needed every 30 to 45 minutes.

Persistent bleeding

Bleeding should never be severe. If it is, it usually means that the packs are being clenched between the teeth only and are not exerting pressure on the surgical areas. Try repositioning the packs. If bleeding persists or begins again, sit upright or in a recliner, avoid physical activity, use ice packs, and bite on gauze for 1 hour or on a moistened tea bag for 30 minutes. The tannic acid in the tea leaves helps to promote blood clotting. If bleeding remains uncontrolled, please call our office.

Swelling

Swelling is a normal occurrence after surgery and will not reach its maximum until 2 to 3 days after surgery. It can be minimized by using a cold pack, ice bag, or a bag of frozen peas wrapped in a towel and applied firmly to the cheek next to the surgical area. Apply it twenty minutes on and twenty minutes off during the first 24 hours after surgery. If you have been prescribed medicine to control swelling, be sure to take it as directed.

Suggested way to apply ice

Fill two zipper lock bags with crushed ice. Cut a pair of pantyhose at the thigh and slide both ice bags halfway down the leg (to the knee area). Tie the ends of the pantyhose on top of the patient’s head and adjust the ice to the sides of the face over the surgical sites.

Pain

Unfortunately, most oral surgery is accompanied by some degree of discomfort. You will usually have a prescription for pain medication. If you take the first pill before the anesthetic has worn off, you should be able to manage any discomfort better. Some patients find that stronger pain medicine causes nausea, but if you precede each pain pill with a small amount of food, the chances of nausea will be reduced. The effects of pain medications vary widely among individuals. If you do not achieve adequate relief at first, you may supplement each pain pill with an analgesic such as aspirin or ibuprofen. Some patients may even require two of the pain pills at one time. Remember that the most severe pain is usually within six hours after the local anesthetic wears off; after that, your need for medicine should lessen. If you find you are taking large amounts of pain medicine at frequent intervals, please call our office. If you expect to need more prescription medication over the weekend, you must call for a refill during weekday business hours.

Diet

Eat any nourishing food that can be taken with comfort. Avoid extremely hot foods. Do not use a straw for the first few days after surgery. It is sometimes advisable, but not absolutely required, to limit the first day’s intake to liquids or pureed foods (soups, puddings, yogurt, milkshakes, etc.). Avoid chewing food until tongue sensation has returned. It is best to avoid foods like rice, nuts, sunflower seeds, and popcorn, which may get lodged in the surgical areas. Over the next several days, you may gradually progress to solid foods. It is important not to skip meals! If you eat regularly, you will feel better, gain strength, have less discomfort, and heal faster. If you are diabetic, maintain your normal eating habits or follow the instructions given by your doctor.

Nausea

Nausea and vomiting can occur as a result of swallowed blood, discomfort, anesthesia, or pain medicines. Post-operative nausea usually goes away on its own, and sipping flat cola or ginger ale often helps. Soda crackers may also be used. If nausea persists, stop taking the pain medicine and substitute an over-the-counter pain medicine for the next dose. If nausea still persists, call our office.

Instructions for the Second and Third Days

Mouth rinses

Keeping your mouth clean after surgery is essential. Use [CONFIRM SALT AMOUNT: 1/4 teaspoon here vs. 1 tablespoon above] of salt dissolved in an 8-ounce glass of warm water and gently rinse with portions of the solution, taking five minutes to use the entire glassful. Repeat as often as you like, but at least two or three times daily.

Brushing

Begin your normal oral hygiene routine as soon as possible after surgery. Soreness and swelling may not permit vigorous brushing, but it is extremely important to clean your teeth within the bounds of comfort. Keeping the area around the healing surgical sites clean is required for optimal and speedy healing.

Healing

Normal healing after a tooth extraction should be as follows: The first two days after surgery are generally the most uncomfortable, and there is usually some swelling. On the third day, you should be more comfortable and, although still swollen, can usually begin a more substantial diet. The rest of your recovery should be a gradual, steady improvement. If you don’t see continued improvement, please call our office.

Discoloration or bruising

Black, blue, green, or yellow discoloration is caused by bruising beneath the tissues. This is a normal post-operative occurrence that may appear 2 to 3 days after surgery. Beginning 36 hours after surgery, moist heat applied to the area may speed up resolution of the discoloration.

Sharp edges

If you feel something hard or sharp in the surgical areas, it is likely the bony walls that once supported the extracted teeth. Occasionally, small slivers of bone may work their way out during the following week or so. If they cause concern or discomfort, please call our office.

Dry lips

If the corners of your mouth are stretched, they may dry out and crack. Keep your lips moist with an ointment such as Vaseline.

Sore throat

A sore throat is not uncommon after oral surgery. The muscles get swollen, which may make swallowing painful. This should go away on its own in 2 to 3 days.

Stiff jaw muscles

Stiff jaw muscles may limit how wide you can open your mouth for a few days after surgery. This is a normal post-operative event that usually resolves within a week. Gently stretching these muscles may help speed up recovery.