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After Tooth Extractions

There are a number of reasons that your dentist might recommend a tooth extraction. Some dental patients suffer from severe tooth decay or fracture; others need to remove teeth hindering orthodontic treatment, whereas various patients simply need wisdom teeth removal. While a tooth extraction can be a serious dental procedure, aftercare is just as critical as the procedure itself. As the dental patient, it is important to understand that pain and the risk of infection can be lessened with proper care.

Care immediately following surgery:

  • Keep pressure on the gauze pad that your doctor placed over the surgical area by gently biting down. Thoroughly dampen the gauze sponge with water if it begins to dry out. Try to maintain constant pressure in intervals of 45-60 minutes, repeating as often as needed, or until bleeding lessens.  Change the gauze as needed, remember to wet gauze first.
  • Keep your head elevated and try to lower your activity level as much as possible.
  • 24 hours after surgery, very gently rinse mouth with  salt water every 1-2 hours (think of soaking extraction site for 30-60 sec. rather than rinsing).  Avoid using any mouthwash.  Most mouthwashes contain alcohol and  can irritate the wound.
  • Keep your mouth clean by brushing areas around the surgical site, but be sure to avoid sutures. Touching the wounded area in any fashion should be prevented especially within the first 5-7 days.
  • Use ice packs to control swelling by placing them on facial areas near extraction.
  • Take all prescribed medications accordingly. If any itching or swelling occurs ( as in a case of drug allergy) contact the practice immediately, or go to the nearest emergency room.
  • Try to eat softer foods which are easy to chew.   Generally, the less chewing the better for the first two days.  Eat food that is mild in temperature.
  • Keep your body hydrated by drinking plenty of water but do not "swish". Do not drink through a straw for the next 5-7 days. Drinking with a straw and smoking cigarettes/cigars creates vacuum in the mouth which can dislodge the clot - thereby causing a dry socket.
  • If you are a regular tobacco user refrain from smoking for the next 3-4 days as smoking increases your chances of getting an infection. (commonly known as a DRY SOCKET infection, very painful).
  • Generally the less a patient does regarding "helping" an area heal, the better.  Leave the area alone.

After your tooth has been extracted, healing will take some time. Within 7 to 14 days, your sutures should fall out or be removed depending on the type used. For sutures that are non-resorbable, your doctor will schedule a follow-up appointment to remove the stitches for you. Resorbable sutures break up over several days and usually work themselves out.  Your socket will gradually fill in with bone over time and smooth over with adjacent tissues.

Possible complications after a tooth extraction

Bleeding – Some bleeding after a tooth extraction is entirely normal. A pinkish tinted saliva and subtle oozing is  common during the first 36 hours. If bleeding gets excessive, control it by using dampened gauze pads and biting down to keep pressure on the area. As an alternative to gauze pads, a moistened tea bag can be used, as the tannic acid helps blood vessels contract. Apply pressure to the gauze or tea bag by gently biting down for 30 minutes. Please remember that raised tempers, sitting upright, and exercise can all increase blood flow to the head, which can cause excess bleeding. Try to avoid these as much as possible. If your bleeding does not reduce after 24 hours, please call the practice.

Bone sequestra (bone fragments) – Some patients have small sharp bone fragments that were unable to be completely removed during surgery. During the recovery period, these dead bone fragments, or bone sequestra, slowly work themselves through the gums as a natural healing process. This can be a little irritating until the sequestra are removed so please call our practice immediately if you notice any sharp fragments poking through the surgery site.

Dry socket – In the days that follow your tooth extraction, pain should gradually subside. Rarely, patients report that pain increases to a throbbing unbearable pain that shoots up towards the ear. Often this is a case of dry socket. Dry socket occurs when the blood clot becomes irritated and dislodged before healing is complete. Food and debris can then get into the socket causing irritation. Tobacco users and women taking oral contraceptives are at a higher risk of getting dry socket.  If you think you may be suffering from dry socket, please contact the practice immediately.

Lightheadedness - Because you may have been fasting prior to surgery, your blood sugar levels may be lower than normal. Until your body has had the chance to catch up and process some sugars, you should remember to stand up slowly when getting up from a relaxed position. For somewhat immediate relief, try eating something soft and sugary, stay in a relaxed position, and reduce the elevation of your head.

Numbness – Extended numbness (4-8hrs.) after a procedure may be due to a long lasting anesthetic.  Numbness which persists for days or weeks may be due to unusual hypersensitivity to anesthetics, nerve contact during injection, or nerve insult during extraction.  All of which are very rare and usually transient.

Swelling – Swelling should subside almost entirely within 10 days after surgery. Immediately following any difficult tooth extraction, apply an ice pack to the facial areas near the extraction. Continue using the ice in 15 minute intervals for the first 36 hours. After 36 hours, ice will no longer be beneficial in reducing swelling and moist heat should be used instead. To decrease swelling, apply a warm damp cloth to the sides of your face.

Trismus (difficulty opening and closing mouth) – If you experience a sore jaw and difficulty chewing or swallowing, do not be alarmed. Occasionally patients’ chewing muscles and jaw joints remain stiff 3-5 days after surgery. This soreness can also make it difficult to open and close your mouth. Soreness should eventually subside.

If you have any worries, or are experiencing any complications not mentioned, please contact our practice immediately so that we may address your concerns.