After Extractions

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, 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 another gauze or a tea bag for another 30 minutes if you feel it is still bleeding.  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 (see below).


PAIN:  Some discomfort is normal after surgery, and can last for several days.  To minimize pain, take two Acetaminophen (Tylenol), Naproxen (Aleve), Ibuprofen (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:  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.


SWELLING:  Applying an ice pack to the face over the operated area will minimize swelling.  Apply for 15 minutes, then remove for 15 minutes.  Continue alternating this for the first day as needed.  It is common for swelling and some pain to recur 3-4 days after surgery as the secondary healing begins.  Begin using the ice pack and Ibuprofen again to reduce the swelling.


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 of 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.  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:  Antibiotics are not needed following most extractions.  If you were given an antibiotic prescription, take all of them as directed until they are gone.  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. 


HEALING SITE:  As the area continues to heal, sometimes you may notice something “sharp” that feels like a piece of tooth still in the gums.  Most often this is just the edges of the bone socket where the tooth used to be and will smooth itself out over time.  Sometimes a small fragment of bone may come loose while the area is healing as well and become uncomfortable.  The dentist should be notified in this case.


DRY SOCKET:  A dry socket occurs when the blood clot dislodges from the extraction area prematurely, and occurs 3-5 days after the surgery.  They are more common for the lower back teeth and usually result in sudden sharp pain accompanied by a foul taste and odor.  Treatment usually involves placing medicated dressing back in the socket and continuing to treat discomfort with pain medications.  To avoid dry sockets, follow the recommended guidelines listed above.


FOLLOW-UP APPOINTMENTS:  You may need to return to the office to have sutures removed, or just for a brief follow-up healing check.


Our office phone number is (706)738-8070.  If you need to reach your dentist directly after hours for an emergency, call this number and our on call dentist will call you back.  Emergencies include:


  • 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.