Post-Op Care – Extractions

Post Operative Care Tooth Extraction

The following general guidelines will help promote healing, prevent complications, and make you more comfortable during the healing period following the removal of teeth.

The extraction site will be most uncomfortable for the first three days. During the fourth day, the discomfort begins to lessen. After about 7 – 10 days, most patients report feeling minimal to no discomfort.

A blood clot (scab-like covering) will develop in place of the missing tooth and is extremely important to the healing process. A poorly formed clot (or total loss of the clot itself) increases the risk of unmanageable pain, infection, and/or uncontrolled bleeding. Your maintenance of the extraction site determines how well a clot will form!

  1. Maintain constant bite pressure to the gauze placed by the dentist. You will need to maintain pressure for about 2 – 4 hours. Replace the gauze once it feels like the pressure has lessened (about 30 minutes to an hour) with a clean, moistened gauze. DO NOT chew the gauze as it will stimulate MORE bleeding.
  2. Avoid smoking, drinking through a straw, vigorous rinsing, and spitting for the first 72 hours.
  3. Avoid drinks with alcohol and/or carbonation (fizzy) and HOT drinks (warm is ok). This includes sodas, beer, champagne, and any mouth rinses such as Listerine that have an “after-burn” feeling.
  4. Limit strenuous activity for 72 hours. Heavy lifting, cardio exercise, and other strenuous activities can raise your heart rate and blood pressure forcing the clot out of place.

Things you SHOULD do:

  1. Avoid biting your cheeks, lip, or tongue while numb. The numbing may last anywhere from 1 - 4 hours following the procedure.
  2. Apply a cold compress or ice pack to the affected cheeks for the first 24 hours. Avoid placing the pack directly on the skin by using a thin wash cloth or paper towel around the pack. Leave on for 10 - 15 minutes at a time and take off for 10 - 15 minutes. Application directly to the skin or for longer periods can cause FROSTBITE.
  3. Take the medication prescribed to control pain and prevent infection. Refer to medicine bottle for correct dosage. Begin taking the medication before the numbing wears off. If the prescribed medicine does not seem to work for you, DO NOT increase the dosage. Call your dentist.
  4. The site will continue to ooze blood for the first 24 hours staining your saliva (spit) dark red/brown or pink. This is not a true "bleeding" or hemorrhage. Make sure to place an old towel over your pillow when you sleep as the drool may stain pillows and sheets.
  5. Brush and floss your teeth regularly making sure to avoid the areas right next to where the tooth was removed. You can use a moistened Q-tip or soft cloth to gently wipe the area free of debris. When getting rid of your spit, just let it dribble from your mouth. Avoid forceful spitting.
  6. Starting 24 hours after the extraction you can begin rinsing with salt water (NO MOUTH RINSES). Dissolve a large spoonful of salt in warm water and gently swish. When getting rid of the rinse, just let it dribble from your mouth. Avoid forceful spitting.
  7. Begin eating soft foods and attempt more solid foods when you are comfortably able to tolerate chewing them. Chew on the side opposite of the extraction if possible. Foods to avoid: gummy/sticky foods (gum, caramel) that can grab on to the clot and remove it and foods that do not dissolve easily or can get trapped in the socket (popcorn, chips, rice, nuts). Use salt water rinses after eating.
  8. Ensure adequate fluid intake. Drink as much water, juice, and sports drinks as you can tolerate. Meal supplement drinks (such as Ensure) work well to keep nutrition and fluids up.
  9. If sutures (stitches) were placed, they should dissolve within 3 to 7 days. You do not need to return to the clinic to have them removed (unless told otherwise). The stitches do not dissolve at the same rate so you may notice small pieces become free or loose earlier than expected.

Signs and symptoms of an infection that will require immediate attention of the dentist:

Severe pain that is not controlled or pain that seems to be getting worse after 3 days

  • Bright red, heavy bleeding
  • Rapid swelling that develops unexpectedly or extremely rapidly
  • Fever, chills, night sweats
  • Nausea/vomiting
  • Foul odor coming from the extraction site
  • Heavy pus drainage from the extraction site