Extractions Post-Op Instructions
The initial healing period typically takes from one to two weeks,
gum tissue takes about 3-4 weeks to heal, and complete healing of the bone can take about
6-8 months, depending on the care you give the area.
Some discomfort, bleeding, and swelling should be expected in the next 24 hours as
your mouth heals. Following these simple instructions will normally be all that is needed.
As your mouth heals, you can promote faster healing and avoid complications by
simply following these instructions.
Do Not Disturb the Wound
In doing so you may invite irritation, infection, and/or
bleeding. The healing process begins immediately after surgery as your body sends blood to
nourish the tooth socket. Complete healing will take one to two weeks, and swelling may
last 48 hours. Simple pressure from a piece of gauze is usually all that is needed to
control the bleeding and to help a blood clot to form in the socket. Sutures may need to be
removed in 3-5 days. Keep your fingers and tongue away from this area. No positive or
negative pressure like blowing up balloons. Blowing your nose or sneezing violently can
dislodge the blood clot and impair healing, so if you have an upper respiratory infection
or allergies be sure to take the appropriate medications to treat these conditions.
Do Not Smoke or Use Tobacco Products for 72 Hours
Smoke can interfere with the healing process, promote bleeding, and cause a very painful situation
known as "dry socket." Continuing to smoke during these first few days will slow healing, and soft
tissue will not be able to begin to fill in the socket to form the blood clot needed for healthy
healing. Smoking can also interfere with the bone grow that surrounds the socket, resulting in
slowing its process of filling in the socket.
Brushing
For several days after the extraction, it is important to keep the area as clean as possible to
prevent infection and to promote healing. Do not directly brush the extraction site for the first
3-4 days after surgery to prevent dislodging of the blood clot from the socket. Don't use any
toothpaste. Rinsing toothpaste from your mouth could remove the blood clot. Instead, this area can
be gently and carefully wiped with a clean, wet gauze pad or cloth. After this time you may
carefully brush your teeth around this area and floss gently.
Mouthwash
Avoid all rinsing for 24 hours after extraction. This is to ensure the formation of a blood clot.
Disturbance of this clot can lead to increased bleeding or the loss of the blood clot. After the
first 36 hours you should very gently rinse this area 4 times a day using warm salt water (1
tablespoon salt in 8oz of warm water) or mild antiseptic rinses like Breath RX™. Rinse very
gently after every meal and snack, making sure that the water reaches the extraction site. Rinsing
removes food particles and debris from the socket to help promote healing. Chlorhexadine mouth rinse
twice a day for 10 days after the first 36 hours is very helpful.
Do Not Spit or Suck Through a Straw
This will promote bleeding and may dislodge the blood clot.
Bleeding
When you leave the office, you will be given verbal instructions regarding the control of
postoperative bleeding. A gauze pad will be placed on the extraction site that you are asked to keep
firm pressure on. You will also be asked to change this dressing every hour or so, depending on the
amount of bleeding that is occurring. Do not chew on the pack. Do not suck on the extraction site.
It is normal for some blood to ooze from the area of surgery for 12 hours. We will also give you a
package of gauze to take with you to use at home if the bleeding should continue. Should you need to
use the gauze at home, remember to fold the clean gauze into a pad, thick enough to bite on. Then
moisten it and place it directly on the extraction site. Hold it firmly in place for about 30-60
minutes, either by biting down on the gauze pad or by using your finger to apply pressure. This
pressure helps reduce bleeding and permits a clot to form in the tooth socket. If bleeding still
continues, moisten a tea bag with water, fold it in half, and bite down on it for 30 minutes. Tea
contains tannic acid, which may help to reduce the bleeding. Keep your head elevated with pillows to
control bleeding.
Medications
Some discomfort is normal after surgery. Analgesic tablets (e.g., Tylenol®, Motrin®, or non-aspirin)
can be taken (2 tablets) every four hours as needed or as directed. Don't drive while taking any
pain medication, as they may cause drowsiness. If antibiotics are prescribed, you should carefully
follow the instructions and finish the antibiotics until they are completely gone. Avoid aspirin, as
it may increase bleeding. A side effect of aspirin is that it can increase bleeding by inhibiting
blood clotting, making it unsuitable to take following an extraction. To avoid nausea, do not take
pain medications on an empty stomach.
Swelling
To prevent swelling, apply an ice pack, a bag of frozen peas, or a cold towel to the outside of your
face in the area of the extraction during the first 24 to 48 hours. Apply alternately, 10-20 minutes
on then 10-20 minutes off.
Sore Jaw Joint
Your jaw may be sore from holding your mouth open during surgery. This may last 4-5 days. Massage
the jaw muscles gently. Apply moist heat for 10 minutes on/10 minutes off (after the fist 36 hours).
Eat soft foods. Do not over extend opening your mouth; it can further aggravate this area. Rarely,
there may be some semi-permanent numbing in the area of the extraction. It will decrease in size
within the first 6 to 8 weeks and may continue until 6 months after surgery.
Diet
For the first 24-48 hours, you should maintain a diet of soft foods, such as JELL-O®, pudding,
yogurt, cream of wheat, mashed potatoes, clear soups, etc. Food that crumbles, such as potato chips,
popcorn, crackers, cookies, etc., should be avoided. Hot, spicy foods should also be avoided, in
order to prevent irritation and burns of the extraction site. Also avoid carbonated and hot
beverages for 3-4 days. Avoid sticky foods such as taffy. Eating immediately following the
procedure is not recommended. When the numbness has worn off you may eat, yet be sure to chew on the
opposite side for the first
24 hours in order to keep food
away from the extraction site. Also, keep anything sharp from entering the wound (e.g., eating
utensils, fingers and other objects) It is also important to drink 8 glasses of fluids between meals
and with meals. Try vegetable and/or fruit juices or high-protein drinks. Cut food into small pieces
to ease chewing. Return to a normal diet as tolerated.
Activity
For the first 24 hours, your activity should be limited, because increased activity can lead to
increased bleeding. No bending over or heavy lifting for 2-3 days. Do not play any wind instruments
or blow up balloons for a period of 10-14 days. When lying down, elevate your head slightly.
Non-pressurized flying and deep-water diving are also to be avoided for 2-3 days.
Alcohol
Do not drink alcohol for 48 hours after surgery.
Pain
Pain that lasts for up to a week or so but is gradually improving should be considered typical.
Pain that seems to be getting worse after two days should be considered abnormal and may require an
evaluation by us.
Anesthesia Warning
When a local anesthetic is used, your lip, tongue, and cheek will be numb for several hours after
the procedure. While it is numb, it will feel "funny." During this period you
must be careful not to bite, chew, pinch, and/or scratch this area,
as this can lead to serious soft tissue trauma.
Long-Term Problems
You may have a numb, tingling feeling in the area for 4-6 weeks or longer. Additionally, having a
missing tooth can lead to several problems such as shifting teeth, difficulty chewing, and
malocclusion, which could lead to TMJ problems. Many times the extraction site will need to be
restored with a fixed bridge, implant, a removable partial, or a denture to ensure good long-term
dental health.
