Post-Op Instructions

There are a number of reasons that your dentist might recommend a tooth extraction. Some dental patients suffer from tooth decay; others need to remove teeth hindering orthodontic treatment, and some may be loose due to periodontal disease. While a tooth extraction can be a serious dental procedure, aftercare is just as critical as the procedure itself. As the dental patient, it is important to understand that pain and the risk of infection can be lessened with proper care.

CARE OF SURGERY SITE 

• Biting on a moist gauze with firm pressure helps to limit bleeding.
• Most areas stop bleeding within 30 minutes to 3 hours.
• Change the gauze as needed when it becomes saturated.
• It is normal to have blood-tinged saliva for up to 24 hours.
• Numbness can last for a few hours after surgery. Be careful not to bite your lip/cheek.

SWELLING

• You may have some swelling that should not be cause for concern. 
• The greatest swelling would peak 36-72 hours after surgery and then should gradually subside.
• If you wish to use ice, apply to the outside of your face for the first 12-24 hours. (20 minutes on- 20 minutes off). 

DIET 

• Avoid food and drinks with hot temperatures until the numbness has worn off.
• Eat soft foods (ice cream, applesauce, noodles, egg dishes, warm soups, etc.) for the day and chew to the opposite side if possible. Advance your diet as you tolerate over the next few days.
• Avoid items such as popcorn, nuts, and seeds that may get lodged in the sites.

PAIN MANAGEMENT 

• You will find better pain control by taking your first pain medication before the local anesthetic wears off. 
• Take Ibuprofen(Advil) or Acetaminophen(Tylenol) as directed by your Doctor.
• If a prescription for pain medicine has been given, take as directed on the bottle. 

ACTIVITY 

• Light activity is permissible the day of your surgery. Advance your activity as you tolerate.
• Limit activities that require you to bend over; keep your head elevated as much as possible.

ORAL HYGIENE 

• Keeping your mouth clean after surgery is very important. This will reduce the risk of post-operative infection.
• You may brush your teeth starting the day AFTER surgery with a soft toothbrush.
• You may brush your teeth the night of surgery, avoiding the quadrant where the tooth was removed.
• You may rinse with 1/2 teaspoon of salt in 8 ounces of water and rinse 2-3 times daily starting the day AFTER surgery.
• Do not vigorously spit liquids or toothpaste out while healing. This could delay healing.

ANTIBIOTICS 

• Antibiotics are not routinely prescribed, however, if you are provided with one please take as directed.

SUTURES

• If sutures were placed, in most cases they will dissolve on their own.
• Sutures are placed to help the extraction site close and heal properly.
• The sutures can feel like floss-please try to avoid playing with them with your tongue as that can delay healing.

SMOKING

• Please try to avoid smoking for 3-4 days after surgery.
• Smoking delays healing and can cause bleeding and may also increase the risk of a dry socket.

BONE/TOOTH FRAGMENTS

• The dentist makes every attempt to completely remove the tooth. In some cases, there may be a small tooth fragment that was unable to be removed during surgery.
• During the healing process, these fragments can slowly work themselves through the gums as a natural healing process.
• This can cause discomfort, so please call our office if you notice any sharp fragments poking through the extraction site.

DRY SOCKET

• A dry socket occurs when the tooth socket either fails to form a blood clot or the clot disintegrates which can result in delayed healing. It is not a serious condition or an infection, but it can be quite painful. 
• Dry socket presents with a distinct severe throbbing/aching pain in the jaw that often radiates toward the ear and forward along the jaw.
• This typically starts between 3 to 5 days after the procedure.
• Dry socket will resolve on its own regardless of any treatment provided, but if pain relievers are inadequate, please contact our office, as an in-office treatment may help to decrease the pain.

TROUBLESHOOTING 

• If you experience bleeding lasting longer than 3 hours, bite on a moistened tea bag directly over the surgery site for 30-60 minutes. The tannins in black tea are most effective, green tea is somewhat effective, and herbal tea is ineffective. If bleeding is severe or lasts into the next day, notify our office.
• Sutures typically take 3-14 days to fall out. They may fall out sooner-even the day of the procedure. This should not be cause for concern, as they are mainly used as an aid to limit bleeding immediately following the procedure.
• Jaw soreness can be expected for a few days after surgery. Taking over the counter pain relief medication can alleviate the soreness, and most discomfort will subside in 3-5 days. 
• Food particles will get into the surgical sites. This should not be cause for concern, as the saliva will break it down over time.
• The socket may appear to have a white material in it or may appear as a deep hole in the tissue. This is normal. In general, we discourage closely inspecting the site and relying more on how the area feels to judge your progress.

UNUSUAL CONDITIONS 
If any of the following conditions should occur during the post-operative period, please call our office:

• Fever over 101 degrees.
• Severe, hard swelling after the third post-operative day.
• Severe, bright red bleeding that you cannot control with the use of gauze or tea bags.
• Rash, difficulty breathing, or severe vomiting.
• Prolonged severe pain that is not relieved after several doses of pain medication.
• Continued numbness of lip, chin, or tongue, persisting the day after surgery.