Post-Operative Instructions After Teeth Extractions

Teeth Extractions: Post-Operative Instructions

Your tooth extraction was a success, and the scary part is over. However, before you can fully put the procedure behind you, the gums need to heal. You’ll have to spend a week or two being very cautious of the extraction site because you can develop an infection or suffer from dry socket.

We want you to get back into your normal routine as quickly as possible, and this means that you need to:

Right After the Extraction

Right after you have a tooth removed, you’ll experience some bleeding at the extraction site. The blood can last for 24 hours, but it shouldn’t be intense or severe. During this time, we really want the blood clot in the socket to form, and you can achieve this by:

• Biting down on a damp gauze paid for the first hour. We’ll provide you with gauze when you’re in our office, along with a few extras.
• Replace the gauze every 20 minutes or so as necessary. Most people stop bleeding in an hour or two
• Avoid laying fully flat on your back. Instead, prop your head up with a pillow.

During the first three days, you want to keep your activity minimal. You can engage in most activities, but try not to exercise or do anything too strenuous. If you do, you risk causing excess blood flow from the wound.

For patients who wear a flipper: unless we specifically recommend keeping your flipper in it's best to keep it out if it sits close to the extraction site.

0 - 48 Hour After Your Procedure

The first two days following the extraction are the most important. Your jaw will feel sore and your gums will be swollen. A lot has happened in the last two days, but you must give your gums time to heal properly.

We recommend that you do the following:

1. No straws. Using straws is not recommended. The force when using a straw is often enough to dislodge the blood clot that protects your gums and underlying nerves.
2. No smoking. Refrain from smoking. You can hinder the healing process.
3. No touching. Extracting a tooth leads to a lot of curiosity from the patient. It’s not uncommon to “play” with the extraction site and touch it with your fingers or tongue. Avoid touching the area to the best of your ability to prevent disturbing the site.
4. No rinsing. Vigorously rinsing your mouth or using mouthwash is also not advised. You don’t want to cause the blood clot to dislodge and interrupt the healing process.

If you follow these four tips, you’ll be well on your way to healing and being able to eat all of the foods that you love again. However, there’s still more to do.

If my extraction site is still bleeding later in the day what should I do?

Using a tea bag can be an effective home remedy to help stop bleeding after a tooth extraction. The tannins found in tea can help promote blood clotting and reduce bleeding. Here's how you can use a tea bag for this purpose:

Materials Needed:

• A tea bag (black tea is ideal due to its higher tannin content)
• A cup of hot water
• Gauze or a clean cloth

Steps:

1. Prepare the Tea Bag: Steep a tea bag in a cup or pot of boiling hot water for 2-3 minutes to allow it to soak. Afterward, remove the tea bag from the water and let it cool slightly. Make sure the tea bag is warm, not hot.
2. Fold the Tea Bag: Gently squeeze out excess moisture from the tea bag and fold it into a small square. Be careful not to squeeze it too hard, as you want the tea bag to remain somewhat damp.
3. Place the Tea Bag: Hold the tea bag against the extraction site where bleeding is occurring. Bite down gently but firmly to apply pressure. The tannins in the tea bag can help promote blood clotting and reduce bleeding.
4. Hold for 20-30 Minutes: Keep the tea bag in place by biting down on it for about 20-30 minutes. During this time, try to keep your head elevated and avoid excessive talking or spitting, as these actions can disrupt the blood clot forming in the extraction site.
5. Check for Bleeding: After the recommended time, carefully remove the tea bag and check for any persistent bleeding. If bleeding has significantly reduced or stopped, you can remove the tea bag. If bleeding continues, you can try using a new tea bag following the same steps.
6. If the extraction site is still bleeding please contact our office via text at 604-888-9468

How to Manage Swelling

It’s not uncommon for the extraction site to swell. You may even experience swelling on the side of your cheek where the extraction took place. Your body will naturally swell, but you can control this process by following the routine below:

1. Ice the area for 20 minutes on and 20 off.
2. Keep rotating the icepack for the first day.

It’s important that you avoid putting ice directly on your cheek. Instead, wrap the ice pack in a towel or clean cloth before placing it on your skin. Most patients find that after the first day, they don’t need to use the icepack. At that point using a warm compress at the same interval works best.

Swollen gums and cheeks will start to subside after the first 24 - 72 hours.

If you experience a rapid increase in swelling after this time period and notice that pain increases, be sure to call our office immediately.

How to Avoid Infection

Infection is a major concern following any tooth extraction that you have. If you suffer from an infection, it can derail the entire healing process. Instead, you will want to take any of the prescription antibiotics that may recommend.

Many patients stop taking their antibiotics because they feel fine and don’t see the need to take their pills.

The antibiotics that you’re taking are why you feel fine, so be sure to finish the course. 

What to Do If You Experience Discomfort?

Removing a tooth is painful. You’re removing something that is meant to stay with you for your entire adult life. Teeth may be uncomfortable and cause a wide range of dental problems, but that doesn’t mean that they don’t hurt when they are removed.

It’s 100% normal to experience:

• Discomfort
• Pain
• Throbbing

Prescriptions that we give you may help manage the pain, but they’re unlikely to stop all sensations in the area. Often, patients do not want to feel anything. Unfortunately, you’ll feel throbbing or minor pain for the first few days while the body is healing.

You can call our office and schedule a visit if you notice that the pain remains the same or worsens after a few days.

Pain medication: If you’re prescribed pain medication, be sure to read the warning label and learn about the potential side effects. You should not operate a motor vehicle while taking any narcotic pain medication. Typically we recommend taking Tylenol and Advil together at the following dosages.

How to Brush Your Teeth After the Extraction

Sutures are sometimes placed in the mouth to help speed up healing. We want your mouth to heal as quickly as possible, and it’s important that you allow the sutures to remain uninterrupted. Avoid touching the sutures until they either dissolve on their own or are removed.

Our team will remove the sutures if we cannot use the dissolvable ones. Most dissolvable sutures will come out on their own within a week or so. We’ll discuss this with you before you leave our office.

Now, you may be hesitant to brush your teeth because you don’t want to irritate the sutures or extraction site. We do recommend that you:

• Brush lightly the next day
• Avoid brushing the extraction site
• Avoid spitting 
• Avoid rinsing the mouth too hard

Over the course of the next week or so, you’ll be able to brush closer to the extraction site. Eventually, you’ll be brushing just like you were in the past and won’t need to worry about rinsing too intensely.

Diet Recommendations

Really hot food is a big no-no when your wound is healing in the first few dats because the heat can cause the blood clot to dislodge by increasing blood flow to the area. If the blood clot dislodges, you’re at a much higher risk of developing dry socket. Your food intake will be greatly limited during the first week after the extraction, and you will want to slowly progress to normal foods.

The first day or two, you want to eat very soft foods, such as:

• Applesauce
• Jell-O
• Pudding
• Milkshakes
• Warm soups

Over the course of the first week, you can introduce other soft foods. For example, pasta, mashed potatoes and other foods that are similar in texture are great additions to your diet.

A few foods that we highly recommend that you avoid to prevent any complications include:

• Nuts
• Seeds
• Chips
• Popcorn

You don’t want to risk these small food particles becoming lodged in your extraction site. The first few days may be inconvenient, but you’ll soon find that the healing is over before you know it.

When to Contact Us for an Emergency Visit

The vast majority of wisdom tooth extractions go well. A patient who follows all of our instructions will find that in a week or two, they’re back to their normal diet and daily routine. The small percentage of people that do have problems after an extraction often have warning signs that they didn’t know were red flags and to call the dentist.

We want you to know all the signs that something is amiss with you’re healing and it’s time to schedule a visit.

Signs that warrant a call or visit to our office include:

• Pain that continues to intensify, and the medication we prescribed does not seem to be helping.
• Bleeding remains strong even after our recommendation of biting down on gauze pads.
• Repeated nausea or vomiting occurs, which can also cause the blood clot to dislodge or tear the sutures.
• After 72 hours, swelling is increasing and potentially making it hard to swallow.
• You develop a fever.
• You experience discharge from the extraction site that is foul-smelling and tastes bad.

Is it possible to faint after an extraction?

Yes, it is possible to faint after a wisdom tooth extraction. This can occur for a variety of reasons, including:

• Anxiety and Stress: Dental procedures, especially surgical ones like wisdom tooth extractions, can cause anxiety and stress in some individuals. This emotional response can lead to a drop in blood pressure and potentially result in fainting.
• Vasovagal Response: The vasovagal response is a common cause of fainting. It involves a sudden drop in heart rate and blood pressure, often triggered by certain stimuli like pain, anxiety, or the sight of blood. Dental procedures, including extractions, can trigger this response, leading to fainting.
• Pain and Discomfort: Wisdom tooth extraction can be painful, even with anesthesia. The pain, along with the body's response to it, can sometimes lead to fainting.
• Hyperventilation: Some people tend to hyperventilate (breathe rapidly and shallowly) when they're anxious or in pain. This can lead to a decrease in carbon dioxide levels in the blood, which can cause dizziness, lightheadedness, and potentially fainting.
• Low Blood Sugar: If you haven't eaten before the procedure or have gone a long time without eating, your blood sugar levels might drop, increasing the likelihood of fainting.
• Reaction to Anesthesia: Though not common, some individuals might have adverse reactions to the anesthesia used during the procedure, which could include fainting.

To help prevent fainting after a tooth extraction, it's important to communicate any anxieties or concerns you have with your dentist or oral surgeon. They can take steps to manage your anxiety and make the experience as comfortable as possible. Additionally, following pre-procedure instructions, staying hydrated, eating a balanced meal before the procedure, and taking things slowly afterward can also help reduce the risk of fainting. If you do feel lightheaded or dizzy after the procedure, it's important to sit or lie down and let the healthcare professionals know so they can provide the necessary assistance.

Why do I need a blod clot to form in the extraction site and what is dry socket?

Blood clots protect your gums, fill the void with nutrients and also ensure that the jawbone is protected. If the blood clot comes out, it can lead to something called “dry socket.” Dry socket is a very painful condition that exposes the underlying nerves.

If you do develop dry socket, we’ll need to combat the pain with pain relievers and place a special medicament in the socket so please call us for an appointment if you feel the pain is getting more and more intense.