Post-Surgical Instructions – Tooth Extraction

Tooth Extraction

The following information contained within our “Guide to Good Healing” will provide an idea of what to expect after your surgery.

Guide To Good Healing Following Your Surgery

Gauze Packs

We have placed gauze packs over the surgery sites and have asked you to bite on them. Pressure on the gauze will help slow the bleeding down. The gauze will need to be changed out about every 30-45 minutes. Some patients may be taking medication to thin their blood, therefore they may bleed a little more and require the gauze to be changed out more frequently. If you are comfortable biting on the gauze packs after the feeling returns to the area, continue to do so. Please remove the gauze when you eat or drink something (So you don’t swallow the gauze). We have seen some really good healing when the gauze packs are used until bedtime the night of surgery. Just take them out before bedtime. They act as a protective bandage, controlling both swelling and bleeding. For that reason we ask you to “take it easy” the first day.

If bleeding seems excessive, remove any blood clots that may have formed outside the tooth sockets, then bite on a dampened tea bag placed directly over the bleeding site. (The tannic acid in the tea helps blood clot.) If bleeding continues an hour after the tea bag is used, then moisten gauze and place in freezer for 20 minutes, then bite on the gauze for 30 minutes. This should stop the bleeding.

Medication To Reduce Discomfort

We have either written a prescription for a medication to reduce discomfort and inflammation or suggested one for you to get at the pharmacy. We may have also written a prescription for a narcotic pain medicine. If necessary take the prescription medication as directed to control the discomfort. Please take the other (non-narcotic) medication for 7 days as directed. We suggest taking the non-narcotic first and then the narcotic pain medication 30 minutes later or as needed for severe discomfort. Please take your pain medication before your numbness wears off. Remember that postoperative numbness may last up to 24 hours depending upon the anesthetic used. This will control discomfort and actually help the healing by reducing inflammation. Remember not to drive or operate machinery or tools while taking narcotics. Also, mixing alcohol and narcotics can be very dangerous!

Cool It!

Using an ice pack (ice cubes in a small zip-lock bag wrapped in a damp cloth) against your face next to the area of surgery helps prevent swelling and discomfort. This is useful for the first 24 hours after surgery. Be sure to alternate sides, if surgery was done on both sides, every 20-30 minutes. The day following surgery the swelling may or may not be significant. If the swelling is significant you may use warm moist heat to help reduce it. Use cold ice packs to prevent swelling; use heat to help treat swelling once it has occurred. The less swelling, the less pain.

Mouth Care

It is very helpful to rinse and soak the areas of surgery with warm saline. Stir ½ teaspoon of salt into 8 ounces of very warm water, use it all to clean and soak the area of surgery. Begin doing this the day following surgery. Do not use mouthwash or hydrogen peroxide for 1 week following surgery. Please brush all of your other teeth only avoiding the area near surgery for two days. Then gently include those areas beginning the third day after surgery. You can expect some bleeding and if you have sutures, they may come loose or come out while brushing. This is normal.

If you’ve had wisdom teeth removed, you’ll be more comfortable if you keep your mouth fairly still. Refraining from opening widely will usually result in better healing of the incision. If you’ve had upper molars or wisdom teeth removed, please don’t blow your nose for at least a week. Air pressure can seriously disrupt healing because the sinuses are very close to the roots of these teeth.


Balanced nutrition is essential to good healing. Chewing is difficult and not desirable for the first few days following surgery. You should increase your fluid intake the first few hours after surgery to prevent dehydration. Do not use a straw, alcohol, alcoholic products or carbonated beverages for 7 days. The following things are recommended: Day of Surgery: All cool or luke warm things that don’t need to be chewed such as yogurt, ice cream, pudding, jello, milk shakes, sherbet, Instant Breakfast milkshakes, applesauce, low-fat milk, fruit juices. Drink at least 8 ounces (1 cup) of liquid every hour that you are awake. Next Day: eggs, grits, mashed potatoes, warm cream or broth soups, pasta such as macaroni and cheese, spaghetti with tomato sauce (no meat). Day Three: begin to add soft foods to the diet following this rule: “If it hurts, don’t eat it!”

What’s Happening?

Various consequences to oral surgery can be expected and are usually more inconvenient than truly troublesome. Pain and swelling “peaks” 72 hours after surgery. A slight elevation in temperature (usually less than 100°), bruising, unpleasant tastes and odors are all common. Less commonly, you may have numbness or a change in feeling in adjacent teeth, tongue, gums or lip and chin. These will be evaluated at your post-operative visit. Sutures used during surgery usually dissolve in 3-10 days. They can easily be removed if they are worrying you. Occasionally bone fragments work out of the area. If after they do, everything feels normal to you, there’s no need to be concerned. If it doesn’t seem to be “right”, please let us check you. After an intravenous anesthetic you may be drowsy or groggy for quite a while. Don’t drive or operate any particularly dangerous equipment until you are fully alert. Sleep with your head elevated and we suggest placing an old pillowcase on your pillow. For those of you who may have had a bone graft, postoperative swelling may take much longer to subside and sutures will remain in place up to three weeks.

We Are Concerned About You!

If there are questions or concerns about your healing or about your recovery from anesthesia or surgery at any time, please call us! Please make every effort to keep your post-operative check-up.