What to do and expect after:
Learn About Extractions
Watch our following videos to learn how extractions work, about the process, and common questions:
After Extractions & Oral Surgery Procedures
DO NOT DISTURB THE AREA. For the next few days, and especially the first 24 hours, it is very important to allow your body to form a good clot and start the natural healing process. Swishing or rinsing your mouth vigorously, sucking through a straw, and smoking can all dislodge the clot. Keep anything sharp from entering the wound (crunchy food, toothpicks, eating utensils). Be sure to chew on the opposite side for 24 hours.
BLEEDING. When you leave the office, you might be biting on a gauze pad to control bleeding. Keep slight pressure on this gauze for at least 30 minutes. Don’t change it during this time; it needs to remain undisturbed while a clot forms in the extraction socket. After 30 minutes you may remove it. You may bite on gauze or a tea bag for another 30 minutes if you feel it is still bleeding. (The tannic acid in the tea helps the blood to clot.) Small amounts of blood in the saliva can make your saliva appear quite red. This is normal and may be noticed the rest of the day after the procedure.
SMOKING. Smoking should be stopped following surgery. Healing and success of the surgery will be substantially reduced by the cigarette smoke chemicals in your body. Also the suction created when inhaling cigarettes can dislodge the clot. Smokers are at greater risk of developing a painful dry socket.
PAIN. Some discomfort is normal after surgery. To minimize pain, take two Tylenol, Nuprin, Advil, or similar non-aspirin pain reliever every 3 to 4 hours until bedtime to maintain comfort. Take it before the anesthesia wears off. If prescription pain medication is prescribed, take it as instructed on the label. Don’t exceed the dose on the label. Taking with food or milk will help reduce upset stomach. Avoid driving or operating heavy machinery when taking pain prescriptions. Do not drink alcohol while taking prescription pain medications.
NAUSEA and VOMITING. This is most often caused by taking pain medications on an empty stomach. Reduce nausea by preceding each pain pill with soft food, and taking the pill with a large glass of water. In the event of nausea and/or vomiting following surgery, do not take anything by mouth for at least an hour, including the prescribed medication. You should then sip on water, tea, or juice. Sip slowly over a 15-minute period. When the nausea subsides, you can begin taking solid foods and the prescribed medication.
SWELLING. The amount of swelling that is normally expected after an extraction depends on the type of surgery. Swelling around the mouth, cheeks, eyes, and side of the face is not uncommon. Applying an ice bag to the face over the operated area will minimize your discomfort. Apply for 15 minutes, and then remove for 15 minutes. Continue this for the first day; the swelling usually starts to go down after 48 hours. If swelling or jaw stiffness has persisted for several days, there is no cause for alarm. On the third or fourth day, if the swelling is still significant, you may use a moist heat compress to help suppress it.
BRUISING. It is not unusual to develop bruising in the area of an extraction. Facial bruising may persist for up to 10-14 days. Local heat, a heating pad set on “low”, or a hot water bottle will help things return to normal more quickly.
NUMBNESS. The local anesthetic will cause you to be numb for several hours after you leave the office. Be very careful not to bite, chew, pinch, or scratch the numb area. Sometimes the extraction causes residual numbness or tingling for six weeks or longer.
BRUSHING. Do not brush your teeth for the first 8 hours after surgery. After this, you may brush your teeth gently, but avoid the area of surgery for 3 days.
RINSING. Avoid all rinsing or swishing for 24 hours after extraction. Rinsing can disturb the formation of a healing blood clot which is essential to proper healing. This could cause bleeding and risk of dry socket. After 24 hours you may begin gentle rinsing with a saltwater solution (1 teaspoon salt + 8 ounces warm water). Avoid commercial mouth rinses.
DIET. Eat soft foods for the first two days. Maintain a good, balanced diet. Return to normal regular meals as soon as you are able after the first two days. Avoid hot and spicy foods. Drink plenty of water. Avoid alcohol for 48 hours.
ACTIVITY. After leaving the office, rest and avoid strenuous activities for the remainder of the day. Keeping blood pressure lower will reduce bleeding and aid healing.
ANTIBIOTICS. If you were given an antibiotic prescription, take all of them as directed until they are gone. Of course, discontinue its use in the event of a rash or other unfavorable reaction. **Women: some antibiotics can reduce the effectiveness of birth control pills. Use alternate birth control methods for two months.**
SINUS. If your sinus was involved in the procedure, you should avoid blowing your nose or playing a wind musical instrument for one week. Use of decongestant medications might be recommended.
SPECIAL CONSIDERATIONS. Trismus (stiffness) in the face muscles may cause difficulty in opening your mouth for a period of days. Moist heat compresses can minimize this condition. You may experience aching from other teeth. This discomfort is caused by referred pain and is a temporary condition. It is not unusual to develop bruising in the area of the extraction. There may be a slight elevation in temperature for 24-48 hours. If the fever persists, please call a dental office for advice.
DRY SOCKET. A “dry socket” is the loss of the blood clot in the socket. This condition creates a delayed healing at the extraction site and presents symptoms such as pain in the ear, chin, adjacent teeth, and jaw. The discomfort usually begins about the third or fourth day after the surgery and can last as long as two weeks or more. The cause of a dry socket is unknown, but it can be attributed to the difficulty of the surgery, increased age, medications (such as birth control pills), and smoking.
SUTURES. If any sutures were required, they may dissolve or fall out on their own in 7-10 days. If not, you may need to return to the office to have sutures removed.
Please call a dental office or emergency department for advice if you have any of the following:
- Uncontrollable pain
- Excessive or severe bleeding
- Marked fever
- Excessive warm swelling occurring a few days after the procedure
- Reactions to medications, especially rash, itching, or breathing problems
Following these instructions very closely will greatly help your comfort, and promote uneventful healing of the area. If any of the instructions are not followed, you might have significantly more discomfort, and the success of the procedure may be affected.
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