Post-Operative Instructions: Tooth Extraction

If you have any questions or concerns after your surgery, you can reach your doctor 24 hours a day by calling our office number. We should always be your first resource if you are having difficulty.

If you are going to receive intravenous (IV) sedation during your procedure, you will leave the office in the care of your escort. It is important that the person be willing and able to look after you and take responsibility for you until you are adequately recovered from your anesthesia to be on your own. How long that will take varies greatly and depends entirely upon the individual. You will likely need someone with you for at least most of the day following your surgery.

When you leave the office, you will have gauze in your mouth packed tightly against the extraction sites. It is important that you bite on the gauze firmly, keeping it undisturbed for 1 hour after you leave. If you move the gauze, talk, or move your mouth around, you will stimulate persistent bleeding. After an hour, remove the gauze. If you are no longer bleeding significantly, you can leave it out from this point forward. If bleeding persists, you need to repeat that process. Wad up a tight little pack of gauze, put it directly on the spot where it's bleeding, and bite down with solid pressure undisturbed for another hour. Repeat this process as needed until the bleeding has stopped. It's important to realize a tiny amount of bleeding off and on however, even for several days, is not unusual or worrisome after oral surgery.

It is very important that you be cautious while you have the gauze pack in your mouth not to swallow or let the gauze pack fall back in your throat. Your mouth may be very numb for an extended period of time, and it can be difficult to know where the gauze pack is located. Be aware that falling asleep with the gauze pack in your mouth could present a choking hazard.

As soon as you are able you should have something very easy to eat, like mashed potatoes or pudding. And then once you have something in your stomach, you should take some of the pain medicine you were prescribed. This way, when the numbness wears off from surgery, you will already have some pain medicine in your system. It is important to note if you take pain medicine on an empty stomach it may make you nauseated or make you vomit.

It is advisable for you to maintain a relatively soft diet for 7–10 days following surgery. It is particularly important that you avoid small things like rice, nuts, or popcorn, as they may get lodged in the surgical site.

We recommend over the several days after surgery that you keep your head elevated as much as possible, and even keeping yourself propped up slightly while you're sleeping is helpful. Also, placing ice packs on your face adjacent where the surgery was performed for several days intermittently following surgery will be helpful to reduce the amount of pain you experience.

You should not start brushing your teeth again on the day of surgery, but you must start brushing your teeth again on the day following your surgery. It is important to resume good oral hygiene as soon as possible, but be careful not to disturb the area where your actual surgery was performed. Many patients also find it soothing to rinse with warm salt water several times a day.

If you have had lower wisdom teeth extracted, you will be provided with a small irrigating syringe. Starting on the fifth day following your surgery, you should use this syringe to gently rinse out the extraction sites of your lower wisdom teeth two times per day. This should be done very gently using either room temperature water or saltwater.

If you have medications prescribed by your physician that you take on a regular basis, you should resume taking these on your normal schedule.

So those are the things primarily you need to do after surgery. It's also important that you know what to expect and what is normal.

It is quite normal after oral surgery to have some pain, swelling of your face, and bruising on your face or neck. Sometimes these things can be quite severe, even from a very small procedure. It is also normal to experience tightness of the muscles around your jaws, which can make it very difficult to open your mouth fully. All of these symptoms will generally increase for 3 –4 days after surgery and then slowly start to improve. Most patients will require some degree of pain medicine for 7 to 10 days after surgery.

Some patients will have sutures in their mouth after surgery. All of the sutures used will dissolve over time. They do not typically need to be removed, but if you notice pieces of suture hanging or starting to come out of your mouth it is OK for you to trim them carefully with a small scissor.

Small amounts of intermittent bleeding may also occur from your extraction sites, even for 2–3 weeks after surgery. If bleeding is significant repeat the gauze packing procedure as described earlier to get it to stop.