What To Do After Having a Tooth Pulled

If you've just had a tooth pulled, there are next steps you should take to ensure a successful and speedy recovery.

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Day of Surgery

• Do not rinse or spit for 24 hours following surgery. Do not smoke, drink carbonated beverages, or drink through a straw for one week. These things can prevent     the blood clot from forming, delay healing, or cause a dry socket.
• Constant pressure should be kept on the gauze that was placed in your mouth for one hour. If the gauze becomes saturated or the site is still bleeding after 1     hour, replace the gauze with fresh, slightly moistened gauze.
• A small amount of oozing is normal for several days following surgery.
• Take all medications as directed. Do not drink alcohol while taking narcotics. Narcotics can cause drowsiness, dizziness, and altered consciousness. Do not take     more medication than prescribed, as doing so could result in damage to your liver and/or kidneys. If you were given antibiotics take them until they are completely gone (Note that antibiotics may affect the effectiveness of birth control pills).
• Keep physical activity to a minimum for at least 48 hrs. Avoiding strenuous activity helps prevent complications that delay healing.
• Healing is dependent upon nutrition and hydration. Start with softer foods first (soup, oatmeal, eggs, mashed potatoes, etc.) and then move on to foods     that require more chewing when you are comfortable doing so. Avoid spicy foods or foods that can break into sharp pieces such as nuts, chips, or crackers.
• A combination of ibuprofen (Motrin/Advil) and acetaminophen (Tylenol) has been shown to be as effective as opioid medications for post operative pain relief. We     recommend taking 600-800 mg ibuprofen and 325-500 mg acetaminophen every 6-8 hours for at least the first 72 hours after surgery. If you cannot take     NSAIDs such as ibuprofen, aspirin, naproxen, etc., then take only acetaminophen.

Days after Surgery

• 24 hours after surgery, begin rinsing with warm saltwater rinses (1⁄2 tsp table salt in 1⁄2 glass warm water) 3-4 times a day. Take care not to rinse too aggressively as this can cause the blood clot to come out. You may also rinse with chlorhexidine mouthwash if prescribed. Avoid Listerine or alcohol mouthwashes for at least five days.
• Oral hygiene is important, and you should brush and floss your teeth to the best of your abilities as soon as you are able, beginning the day of surgery. Avoid any     vigorous swishing and spitting.
• You will have holes where the teeth were for about three weeks. These will get smaller as the area heals.
• If sutures were placed, they will normally dissolve between 3-5 days.
• Avoid smoking for as long as possible to avoid dry socket and delayed healing (a minimum of 3 days) and avoid chewing tobacco until the holes in your mouth have     healed.

What Else to Expect

• Numbness - the local anesthetic will begin to wear off within 2 to 6 hours following surgery.     If numbness remains longer than two days after surgery, please call Peace Street Dental for a follow-up appointment in Raleigh, North Carolina.
• Bleeding - It is normal for blood to ooze or bleed occasionally for the first 24-48 hours following surgery. It is a good idea to sleep with a towel or something     over your pillow to prevent blood from staining your pillow at night.
• Swelling - If your surgery involved cutting the gums and bone, then you will likely experience swelling. The swelling will increase and remain constant up to 72 hours following surgery, then it will start to decrease. Immediately following surgery, an ice pack may be applied to your face directly over the surgical site. The     ice pack should remain in place for a period of 15 to 20 minutes, and then removed for 15 to 20 minutes. This alternative sequence should continue throughout the first 24 hours after surgery. Heat, preferably moist heat, may be applied as needed after 24 hours. If your level of swelling continues to get worse after 72 hours, please give our office a call at 919.755.3450 as this could be a sign of an infection.
• Pain - When the local anesthetic wears off, you will feel discomfort. Taking your medication prior to the dental anesthetic wearing off will lessen your post-operative discomfort. The pain following surgery will remain constant or may increase through the 72-hour period following surgery. You should then begin to see a decrease in the levels of discomfort. If your level of pain continues to get worse after the first 72 hours, please call our office as this could be a sign of an infection or dry socket.
• Bad breath - your breath may smell bad for about three weeks while the gum closes over the hole. Any use of mouthwash or other mouth rinses should be done very gently to avoid pulling out the blood clot.

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For Further Assistance

You should seek immediate dental or medical care if you experience any of the following:

- Rapid, exaggerated, painful swelling of the neck, face, or throat

- Excessive bleeding that is uncontrolled with biting down on gauze

- Rise in normal body temperature at or above 101 degrees

- Adverse side effects to the prescribed medications (rash, difficulty breathing, etc.)

If you are a patient of Dr. Ryan Griffith in Raleigh, North Carolina, please call our office with any questions regarding your extraction or your dental health needs.