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Post-Operative Instructions: Extractions


All Extraction Patients

After tooth extraction, it’s important for a blood clot to form to stop the bleeding and begin the healing process. That’s why we ask you to bite on a gauze pad for 30–45 minutes after the appointment. If the bleeding or oozing persists, insert another moist gauze pad and bite firmly for another 30 minutes. You may need to do this several times.

After the blood clot forms, it is important not to disturb or dislodge the clot as it aids healing. Do not rinse vigorously, suck on straws, smoke, or drink alcohol or carbonated beverages for 72 hours. These activities will dislodge or dissolve the clot, retarding the healing process and increasing the risk of dry sockets. Limit vigorous exercise for 4 days, as this will increase blood pressure and may cause more bleeding from the extraction site. You may gradually increase your activity, such as jogging or tennis, 5–7 days after your surgery.

After the tooth is extracted, you may feel some pain and experience some swelling. An ice pack or an unopened bag of frozen peas or corn applied to the area will keep swelling to a minimum. Ice packs are useful for the first 48 hours only. Take pain medications as prescribed. The swelling usually subsides after 72 hours.

Discomfort is normal after the removal of teeth. If you are not allergic or intolerant to non-steroidal anti-inflammatory drugs, start taking ibuprofen (also known as Advil® or Motrin®) as instructed by your doctor at the time of your surgery. If you are asthmatic, do not take ibuprofen unless you have tolerated it in the past. Call the office if the medication doesn’t seem to be working. If antibiotics are prescribed, continue to take them for the indicated length of time, even if signs and symptoms of infection are gone.

It is important to resume your normal dental routine after 24 hours. This should include brushing and flossing your teeth at least twice a day. This will speed healing and help keep your mouth fresh and clean.

If you have heavy bleeding, severe pain, continued swelling, or a reaction to the medication, call the office immediately.

Wisdom Teeth Patients Only

Swelling is normal after surgery and is a major cause of post-extraction discomfort. Swelling typically peaks by the third day and then starts to resolve; it can be reduced by the use of an ice pack. Apply the ice pack to the side of your face for 20 minutes; transfer it to the opposite side for another 20 minutes. Continue icing the face for the first 48 hours. Do not freeze the skin. Also, keep your head elevated on 2 pillows for 3–4 days. These measures will not eliminate swelling, but they will help to reduce its severity.

If your pain is not controlled by ibuprofen alone, take your prescribed narcotic in addition. Ibuprofen and your prescribed narcotic can be taken together. Be certain to take your pain medicines with food; this will help prevent nausea. Remember, narcotic pain medicine will impair your judgment and reflexes.

To allow blood clots to form undisturbed, start with clear liquids, such as apple juice, tea, or broth. Gradually ramp up your diet as tolerated. Always cool down any hot foods or liquids during the first 4 days. If you were sedated for surgery, do not eat fatty, creamy, or oily foods; these foods may cause nausea. You should eat only soft foods for the first 5–7 days: for example, soups, eggs, mashed potatoes, and smoothies are fine. For the first week, do not eat hard, crunchy, or very chewy foods, such as European breads, pizza crust, steak or jerky, nuts, rice, or popcorn. To help prevent dry socket, do not use a straw for the first 4 days after surgery.

Begin saltwater rinses the evening of surgery and continue for 1 week. Rinse with warm salt water 6–8 times each day. To make the saltwater solution, dissolve a ½ teaspoon of salt in a small glass of warm tap water. If you have been given an irrigating syringe, start irrigation on the third day following surgery. Fill the syringe with warm salt water and place the tip of the syringe into the extraction site and irrigate gently. Do this 2 times a day for 2 weeks and lessen as the surgical site heals.

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