Extraction care | Old Hook Dental

Tooth Extraction : Post-Op care sheet

(A downloadable PDF version of this care sheet can be found by clicking the link here)

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. Brushing & swishing, sucking through a straw and smoking can all dislodge the clot. Keep anything sharp from entering the wound (crunchy food, toothpicks, eating utensils) and do not aggravate the area. 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. DO keep steady pressure on this gauze for at least 30 minutes. Don't change it or remove it during this time; it needs to remain undisturbed while a clot forms in the extraction socket. After 30 minutes you may remove it. If bleeding still occurs, bite on fresh gauze or a tea bag (lipton or other) for another 30 minutes then gently remove, repeat cycle until bleeding stops. Small amounts of blood in the saliva can make your saliva appear quite red. This is considered normal and may be noticed the rest of the day after the procedure.

Smoking: Smoking should be stopped for at least 4 days following surgery. Healing will be substantially reduced by the cigarette smoke chemicals in your body and the suction created when inhaling can dislodge a blood clot vital to healing. Smokers are at greater risk of developing a Dry Socket, an extremely painful infection of the bone that will require further treatment, longer healing time and medications.

Pain : Some discomfort is normal after surgery. To minimize pain, we recommend taking two Tylenol, Ibuprofen, or similar non-aspirin pain reliever before the anesthesia wears off and every 4-6 hours until bedtime to maintain comfort. If prescription pain medication is prescribed, take it as instructed on the label. NEVER exceed the recommended dose. Taking with food or crackers will help reduce upset stomach. If taken on an empty stomach they may have a sedative effect and make you drowsy. Do not drive, drink alcohol, take other sedative medications or operate heavy machinery while taking prescription pain medications. You may alternate the use of Ibuprofen with the prescription pain medications for the best result.

Note : Do not take Ibuprofen or Aspirin products if you are taking prescription blood thinners.

Nausea & Vomiting: Digestive discomfort is most often caused by taking pain medications on an empty stomach. Reduce nausea by preceding each pill with soft food (see diet section below for more info). Take the pill 30 minutes later with a large glass of water (no straw). Carbonated beverages (coke, ginger ale) may also help relieve nausea. Following the initial 48 hr period, foods such as crackers, toast and carbohydrates are recommended.

Swelling : Is considered the body’s normal reaction to any surgery and healing. DO apply an ice pack to the cheek over the procedure area immediately, it will minimize swelling even if none is present yet. Please do not put the ice pack in direct contact with skin, wrap it in a slightly moist hand towel. Apply for 20 minute intervals, then remove for 20 minutes.

Continue use of the ice pack for the first 24 hours only. Swelling, stiffness, bruising and discoloration of the skin, lip and cheek in the area is considered normal, expected, and can worsen over the first 48-72 hours before it begins to get better. While resting, be sure to keep your head elevated.
After 24 hours, switch to applying moist heat, it will help further reduce any symptoms at this point.
Slight fever following a surgical procedure is considered normal.

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 procedural area as well as the rest of your mouth. Sometimes due to the nature of an extraction, it may cause residual numbness or tingling for six weeks or longer. A loss of sensation in the gum and the adjacent teeth feeling slightly loose near the surgical site is normal. The teeth may also be sensitive to temperature changes (hot and cold). These sensations will return to normal after a period of time.

Oral Habits: DO NOT smoke, use straws, sucking candies or anything else that has a suction effect which can dislodge blood clots; in addition smoking can lead to painful dry socket infections.

Brushing & Rinsing: DO NOT brush your teeth for the first 24 hours after surgery. DO NOT rinse or swish for the first 24 hours after surgery. After the initial 24 hours, you can brush your teeth gently, but avoid the area 1 tooth in front and 1 tooth behind the site of the procedure for 3 days, after which you may resume normal brushing being extra gentle in that area - good oral hygiene is vital to your healing. Brushing and rinsing can disturb the very important formation of the first blood clot which is essential to wound closure. Removal of this clot can initiate bleeding and risk of dry socket.

After 24 hours begin gentle rinsing with a saltwater solution (1 teaspoon salt + 8 ounces warm water), do not swish it, rather let it roll around in your mouth, it will aid in healing and help reduce harmful bacteria. Repeat this process throughout the day. Avoid commercial mouth rinses.

Diet: DO please eat, having food will make you feel better, help you regain strength and heal faster. DO eat a diet of only soft foods for the first two days (mashed potatoes, eggs, pudding, jello, pancakes, cottage cheese, room temp soup, soft cooked veggies, baby food or any puree or blended food). Maintain a good, balanced diet, eat on the opposite side of the procedure and drink plenty of water or gatorade. Return to normal regular meals as soon as you are able after the first two days. DO NOT have foods that are hard, crunchy, or have small bits (Nuts, seeds, berries with seeds, rice, popcorn)

Activity: Avoid any activities for the remainder of the day. Keeping blood pressure lower will reduce bleeding and aid healing. You should be able to return to work the following day, however avoid strenuous activity for the next 3 days.

Antibiotics: If you were given an antibiotic prescription, take all of them as directed until they are gone, do not stop taking them because you feel better.

Women: some antibiotics can reduce the effectiveness of birth control pills. Use alternate birth control methods for two months.

Sinus and Sneezing: There is a close relationship between your upper (back) teeth and your sinuses. As a result of extraction of these teeth, it may result in a communication between them. Do not blow your nose for at least two weeks, regardless if you feel congested or runny. Slight bleeding from the nose is not uncommon for a few days. Should you feel the need to sneeze, do so with your mouth open to avoid excess pressure build up in the sinuses.

Appointments: You may need to return to the office to have sutures removed, for a brief follow-up healing check or if any complications occur.