After Tooth Removal or Exposure of Impacted Teeth

Bleeding

  1. Change gauze every 30-60 minutes as required.  You may also bite on a clean black tea bag instead of gauze.
  2. Blood streaked saliva and minor oozing is normal for the first 2 days.
  3. Semi-sitting position is suggested with rest while attempting to control bleeding.
  4. Avoid touching the wound area, spitting, vigorous mouth rinsing, exercise or heavy lifting for the first 2 days because this may trigger bleeding.
  5. If these measures do not stop the bleeding, please contact our office.

Pain

If the pain is mild you may use over-the-counter Extra Strength Tylenol or Advil/Motrin.  Taking both Tylenol and Advil at the same time or alternating every 2-3 hours may provide greater pain relief than either alone.

For severe pain, the prescribed medication should be taken as directed.  If it is Tylenol #3, it may make you sleepy.  Do not drive an automobile or work around machinery, and avoid alcoholic beverages.

Do not take any of the above medications if you are allergic, or have been instructed by your doctor not to take it.

If the pain gets worse after the third day or if any of the following symptoms appear:  increased pain, earache or headache, please contact our office.  These symptoms may indicate you have a dry socket.

Swelling

This is normal and can increase during the first two days.  Most of the swelling will resolve after one week.  Ice bags wrapped in a towel can help reduce the swelling if applied to the cheeks and jaw.  Apply for 30 minutes, remove for 30 minutes, then repeat as often as possible for the first 48 hours.  If swelling increases in tenderness or firmness after 3 days, please contact our office.  On the third or fourth day after surgery, applying warm compresses to the jaw may help to reduce the swelling more quickly.

Diet

Although a regular diet may not be possible for about a week, nutritious liquids and soft foods should be taken (e.g. juices, soups, shakes).  Do not use a straw for the first 4 days.  Avoid hot fluids or chewing food while your mouth remains numb/frozen.  Avoid chewing over the surgical site for the first week.  You will feel better, have more strength, less discomfort and heal faster if you continue to eat.  Transition back to your regular diet when you are comfortable eating.

Smoking/Alcohol

Smoking for the first 4 -7 days is not advised as the chance of dry socket is increased.  Do not drink alcohol for 48 hours to reduce bleeding complications.

Sutures

Sutures hold the tissue in place; do not attempt to remove them yourself.  Avoid manipulating them with your tongue or fingers.  Unless otherwise directed, they will dissolve in 4-10 days.  If the gum was left open, it will take 2-4 weeks for the gum to close over the surgical site. 

Oral Hygiene

Good oral hygiene is important to aid healing.  Do not rinse the mouth today.  Start gently rinsing tomorrow with the prescribed mouth rinse.  If you have not been prescribed one, gently rinse your mouth with warm salt water (one teaspoon of salt mixed in a glass of warm water) after each meal and at bedtime for 1-2 weeks.  Avoid brushing and flossing beside the surgical site for 2-3 days, or longer if advised.  You may brush and floss your other teeth as normal.

Bruising

Sometimes bruising may occur 2-3 days after surgery.  Warm compresses applied to the area may speed up the removal of the discoloration.  It may take as long as 2-3 weeks for the bruising to completely resolve.

Antibiotics

If you have been placed on antibiotics, take the medication as directed.  Discontinue antibiotic use in the event of a rash or other unfavorable reaction. Call the office if this occurs.

Nausea and Vomiting

In the event of nausea and/or vomiting following surgery, please call our office for assistance. Generally nausea and/or vomiting is due to either the anesthesia medications or the prescribed pain medication or antibiotic. By calling us, we can help you determine the cause of the nausea and vomiting, and can recommend a management strategy that may include anti-nausea medication.

Other

  • If numbness of the lip, chin, or tongue is present the day after surgery, please call our office and we will schedule a follow up appointment. As stated before surgery, this is usually temporary in nature. You should be aware that if your lip or tongue is numb, you could bite it and not feel the sensation.
  • If you have fluids that come enter your nose when drinking, or if blood comes out of your nose, please call our office to notify us.  There is probably a hole connecting the mouth with the sinus cavity above the upper teeth. We will provide instructions on how to take care of your sinus and will schedule you for a one week follow up appointment.
  • Slight elevation of body temperature on the evening of the surgery is not uncommon. If the temperature persists, notify the office. Tylenol or ibuprofen should be taken to reduce the fever.
  • Stiffness of the jaw muscles may cause difficulty in opening your mouth following surgery. This is normal and will resolve in 1-2 weeks as the pain and swelling diminishes.  Applying warm compresses to the jaw starting on the 3rd or 4th day after surgery will help relax the jaw muscles and help you open your mouth wider.
  • There will be a depression in the gum if a tooth was removed. The depression will gradually fill in with new gum and bone over a few months. Eventually it will flatten out, but there may still be a slight depression when healing is complete. In the meantime, the area should be kept clean especially after meals. If you have difficulty cleaning, please contact our office and we can provide you a special plastic cleaning syringe.