After Tooth Extraction
Immediately Following Surgery
- If you received intravenous sedation or general anesthesia, you may feel drowsy for several hours. Remember do not drive a vehicle, operate any machinery, or undertake important matters for 24 hours following your anesthesia experience and plan to rest for the remainder of the day.
- Keep the gauze pad in place over the surgical site with firm biting pressure for one (1) hour. After this time, the gauze pad should be removed and discarded. A new gauze pad does not need to be placed unless bleeding continues or recurs.
- Take the prescribed pain medications before you begin to feel discomfort. This will usually coincide with the start of the local anesthetic wearing off which typically occurs 4 to 6 hours after surgery.
- Restrict your activities the day of surgery and avoid exercise. Lie down upon returning home with your head elevated on two or three pillows or sit up in a recliner and take it easy.
- Place an ice pack to the side of your face over the site where surgery was performed to help minimize swelling.
- Avoid straws, spitting, cigarette use, and vigorous swishing for 24-48 hours to prevent bleeding. Avoid hot foods and liquids for the first day and avoid the surgical area when chewing for at least a week.
A certain amount of bleeding is to be expected following the extraction of a tooth. Slight oozing or blood-tinged saliva is not uncommon for the first 12-24 hours. Excessive or continued bleeding may be controlled by first rinsing or wiping any old clots from your mouth, then placing a gauze pad over the area and biting firmly for an additional hour. Repeat as necessary. If bleeding continues you may bite on a moistened black tea bag in the same manner. Tannic acid in the black tea helps blood clot by contracting bleeding vessels. To minimize further bleeding, try to remain relaxed, sit in an upright position, and avoid strenuous exercise. If bleeding does not subside, please call our office for further instructions.
You may experience some swelling around the mouth, cheeks, eyes, and sides of the face following an extraction. This is the body’s normal reaction to surgery. Most swelling will not become apparent until the day following the extraction and will not reach its maximum until 2-3 days post-operatively. However, swelling and discomfort may be minimized by the immediate use of ice packs. An ice pack (a bag of frozen peas work great) should be applied to the outside of the face over the area where the tooth was extracted. The ice pack should be applied for 30 minutes on and 30 minutes off for the first 24 to 48 hours while awake. After 48 hours ice has no beneficial effect. Instead, the application of moist heat to the outside of the face may be helpful in reducing the size of the swelling more quickly. On occasion, some residual swelling may last a week or longer.
In some cases discoloration of the skin may follow swelling. The development of black, blue, green, or yellow discoloration is due to blood spreading beneath the tissues of the mouth and face. This is a normal post-operative occurrence that may occur 2-3 days after the extraction and will gradually fade away over the following one to two weeks.
Take the prescribed pain medications before you begin to feel discomfort. This will usually coincide with the start of the local anesthetic wearing off which typically occurs 4 to 6 hours after an extraction. Taking pain medication on an empty stomach may cause nausea, so it is recommended to take the pills with food or drink. Pain medication may make you groggy and slow your reflexes. Do not drive a vehicle, operate any machinery, or undertake important matters while medicated. It is also best to avoid alcoholic beverages. If you do not achieve adequate pain relief you may supplement each pill with an over-the-counter pain medication such as ibuprofen. When appropriate you may transition from the prescribed pain medication to an over-the-counter pain medication such as acetaminophen (Tylenol) or ibuprofen (Advil/Motrin). Discomfort following an extraction may increase on the second or third day following the procedure and should then improve each day thereafter. If pain persists or worsens after four (4) days, please notify the office as it may require attention.
It is best to wait until your local anesthetic has completely worn off before beginning to eat. Drink from a glass and do not use a straw as this encourage more bleeding by displacing the blood clot. Avoid hot foods and liquids the first day after surgery. You may eat anything that is soft and cool the first day by chewing away from the extraction site. Avoid hard, crunchy foods that may disturb the area. It is best to progress to more solid foods and return to your normal diet as soon as possible.
Begin gentle, warm salt water rinses (1 teaspoon of salt in 1 cup of warm water) the morning after your surgery. Rinsing with salt water at least 3-4 times a day, especially after eating, will help to reduce inflammation and will gently flush food particles away. Dr. Conquest may prescribe an antibiotic mouth rinse to use in place of salt water and an irrigating syringe may also be provided for use starting a week after the procedure. Continue to brush your teeth 2-3 times a day as best you can – being careful to avoid your extraction site for several days.
Antibiotics may be prescribed for certain patients after a surgical procedure to help prevent or cure an infection. If you have been placed on antibiotics, take the tablets or liquid as directed until gone. Discontinue antibiotic use in the event of a rash or any other unfavorable reaction and contact our office immediately. If you were prescribed an antibiotic and are currently taking oral contraceptives, you should use an alternate method of birth control for the remainder of this cycle.
Any time a tooth is removed there is always the possibility of developing a dry socket. Please notify our office if severe radiating pain develops between postoperative days 4 and 6 which is not relieved by your pain medication and is accompanied by a foul odor or taste in the mouth. A dry socket can be quickly and easily treated in the office and should not cause undue alarm.
What Else Should I Know?
Keep your lips moist with chap stick or an ointment such as Vaseline. Due to stretching of the mouth during surgery, your lips may dry out and crack – especially at the corners.
Stiffness (Trismus) of the jaw muscles may occur and cause difficulty when opening your mouth and during chewing for several days following your extraction. This is a normal post-operative event which will resolve on its own after several days. Taking an anti-inflammatory medication such as ibuprofen (Advil/Motrin) may help.
You may have sutures in your mouth to minimize bleeding and to help with healing. If one or two of these sutures fall out early, there is no cause for alarm. Just remove the suture from your mouth and discard it. Unless Dr. Conquests informs you otherwise, the sutures we place will dissolve and fall out on their own in 1 to 2 weeks.
There will be a cavity where the tooth was removed. This depression will fill in with new tissue gradually over the next month. Be sure to keep the area clean with salt water or a tooth brush to promote better healing.
You may feel hard projections in your mouth with your tongue near the extraction site. These projections are not forgotten tooth roots but the bony walls of the empty tooth socket. These projections usually smooth out as the extraction site heals. If not, Dr. Conquest will smooth them off.
You should avoid strenuous exercise for 2 to 3 days after your extraction as this can cause the extraction site to start bleeding again. After a few days you should be fine to return to your normal routine.