Do's And Don'ts After Tooth Extraction

Tooth extraction refers to painless removal of tooth or tooth roots with minimum trauma to the surrounding tissues so that the extraction socket wound heals uneventfully without any post-operative complications. Whenever any surgery  or Tooth extraction takes place the first thing we want is to let it heal properly ,quickly and smoothly. As a common practice, most of the dental surgeons have standard post surgery instructions printed which are handed over to the patient. One must follow these instructions given by the dentist. Apart from those instructions there are few things which need to be taken care post tooth extraction. Following all the post-operative instructions after tooth extraction reduces the incidence of infection and chances of dry socket after tooth extraction. If aftercare instructions are not followed after tooth extraction, then it can cause dry socket which can further lead to delayed healing of the tooth extraction socket. So patient is advised to follow certain do's and don'ts after tooth extarction procedure.  

Try to take some rest after Tooth Extraction. You may feel great but don’t exercise at least for a day after tooth extraction.When taking rest,keep your head lifted on a pillow.

Let the clot be formed on the tooth extraction site , which covers it and allow it to heal. Bite on the gauze piece after tooth extraction, which the dentist has put on the extraction socket,  minimum for an hour. Don’t chew on that gauze piece but put a steady pressure. This will help in stopping the bleeding and formation of clot  which acts like a cork on the bottle. Change gauze after every half an hour depending on the amount of bleeding. If clot is dislodged,the nerve endings are exposed,nerves and capillaries spasm and constrict,limiting essential blood supply which causes delay in healing. If the bleeding doesn't stop one should try putting a wet tea bag in the site, as tannic acid present in black tea helps  stop bleeding.

 
 

Ice PacksApply ice pack on the side where surgery was performed. All this is done to reduce swelling. Though on simple extractions, swelling isn’t accompanied but in cases requiring severe cheek retractions, swelling can occur after operation. Though the swelling will not occur immediately but will reach maximum at 2nd or 3rd day. So, to minimize this swelling immediately apply ice packs. Various methods of applying ice packs are:

  • Sealed plastic bags filled with ice or

  • A bag of frozen peas or

  • Corn wrapped in a washcloth

Application of ice pack is most effective during the day of extraction as after 24 hours there is no significant beneficial effect. Ice packs should be applied 15 minutes on and 15 minutes off for 1-2 hours.

Blowing and sneezing: Make sure not to blow or sneeze after extraction as it creates a negative pressure thereby dislodging the clot and making the conditions favorable for dry socket.

Don’t spit minimum for 24 hours after tooth extraction because it can dislodge the clot. If the clot is dislodged you can have very painful condition known as dry socket. In case of dry socket, physiologic clot is lose both in quantity and quality. Afterwards one should spit 3-4 times in a day so that no food is lodged near the area where the tooth is removed. Dentist may advice CHLOROHEXIDINE mouth rinses as they kill bacteria.

 
Anesthetic feeling: It shouldn’t be a matter of worry if you feel numb even after surgery, as the period of numbness depends upon the area and dosage where anesthesia was given. So, it may vary for 6 hours to as long as a day. Make sure not to chew or bite something from that area.

Nausea: Feeling of nausea is also common after extraction. There are situations when anything you eat goes out. To get rid of nausea, take a teaspoon of Jell-O mix and 4 ounces of water, every minute until the feeling is gone. Two tablespoons every hour for 4 hours of coca cola syrup can also be taken. These methods will give you necessary sugar and fluids. After this soup can be taken.

Don’t smoke for 48 hours after tooth extraction as the chemicals in the smoke can effect the clot and hence the chances of developing dry socket 3-4 days after tooth extraction increases.
 

Don’t take solids immediately after Tooth Extraction till the numbness is there. When you start feeling your jaws you can start taking solids. After tooth extraction, take soft and liquid foods like soups, mashed potatoes, yogurts, milkshakes, smoothies etc.

Warm saline rinses: The main aim of rinsing is to clean the area of extraction as it is not possible to brush the socket. We mix salt to make the solution isotonic and similar to natural tissue fluid and thus it is less irritating than water. Rinsing is usually advised 12 hours after extraction. So, warm saline rinses help in cleaning and maintaining the hygiene of that area.

Take your medicines as prescribed by your dentist. Don’t skip the medicines. If antibiotics are given they should be taken regularly. Pain killers and anti-inflammatory drugs are to be taken after tooth extraction. It help in reducing the pain and swelling. If the pain continues even after two days of tooth extraction and bleeding starts then you should call your dentist.

Avoid Aspirin: Don’t ever take aspirin (Can take ibuprofen). Aspiring being a blood thinner will delay in clot formation thereby will prevent healing. Take the medications as prescribed by the physician and consult your dentist before taking any medicine.

Avoid Sucking of any type -  SMOKING, SIPPING, EATING HARD VEGETABLES are to be avoided after tooth extraction. Try taking soft and liquid food options such as soups, mashed potatoes, yogurts, milkshakes, smoothies etc. after tooth extraction. Avoid hot drinks, spicy foods, sodas, etc.

If you are daring enough to avoid these instructions, you may be a strong contender for some complications.

Don’t poke into the gap created: Though for initial few days, it will feel a bit awkward to have a gap but don’t poke that area with any toothpick or tongue as it may delay healing, may provoke bleeding and can also lead to dry socket. 

WHAT COMPLICATIONS CAN BE THERE AFTER TOOTH EXTRACTION?

  1. Bleeding
  2. Infection
  3. Dry socket
  4. Jaw fracture
  5. Sinus perforation
  6. Broken Bone Fragments (Sequestrii)
  7. Part of the Tooth Left (Retained Roots)
  8. Osteonecrosis

Bleeding After Tooth Extraction: If one follows the instructions of the dentist after Tooth extraction to take rest and to keep the gauze piece for 1 to 2 hours after extraction then the problem of bleeding is not there. The patients who are taking anticoagulants like Heparin or Coumadin or the patients who have bleeding disorders like hemophilia should give the history to the dentist. The patients who are taking aspirin or nonsteroidal analgesics have increased bleeding time.

Infection after Tooth Extraction:  Infection is the most common complication after tooth extraction. Our mouth Is full of bacteria. One cannot sterilize it. Dentist decides whether to give antibiotics after the tooth extraction or not. Normally for the simple tooth extractions antibiotics are not required but if patient has pain and swelling or pus then it is better to go for preventive antibiotics.  Bleeding continuing after 48 hours after tooth extraction, acute pain and swelling are very common signs  of infection after the tooth extraction and the patient must visit the dentist in such circumstances to avoid further complications after tooth extraction.

 

Dry Socket:  It is the most dreaded and painful condition which can happen after tooth extraction. For a day or two after dental extraction the patient is fine, and then he has acute pain and becomes very restless. Patient complains of bad taste in the mouth. It is more common after the dental extraction of lower teeth than the upper teeth. It can happen even after the simplest tooth extraction.

 
Healing of Extraction socket after Tooth Extraction

Jaw Fracture during Tooth Extraction: It can happen but very rarely and that too in lower jaw. The dentist who is doing the tooth extractions knows that how much pressure has to be put to pull out the tooth. But sometimes dentist before doing the extraction see the x-ray and tell the patient that the bone structure around the tooth has become fragile and chances of fracture are there. In such cases patient and the dentist are prepared beforehand to manage the situation.

Sinus Perforation during Tooth Extraction: The back teeth are in close proximation with the sinus. Sometimes if you see the x-ray it looks as if the roots of the back teeth are virtually in the sinus. It never happens. There is always a thin bone separating the sinus from the roots of the teeth. But sometimes during tooth extraction the piece of the bone comes along with the sinus. This normally happens when the tooth is close to the bone because of infection. In that case perforation occurs. If perforation occurs you cannot suck because in that case the air will rush from the nose to the sinus and through perforation to the mouth. If the perforation is small the patient complains of bleeding from nose. If the perforation occurs then the patient should follow certain instruction like:

  1. Do not suck anything till the tooth extraction socket heals.
  2. Do not do anything which will dislodge the clot. If the clot is not disturbed then no complication arises.
  3. Do not smoke at least for a week after tooth extraction because the chemicals in the smoke either dissolve the clot or dislodge it.
  4. Do not blow up the balloons or anything else, it will disturb the clot..
  5. Avoid aerated drinks instead you can take fruit juices.
  6. Don’t sneeze, it sneezing will surely dislodge the clot.
If the perforation is big and it does not heal by itself then another surgical procedure is carried out in which tissue graft is put to close the perforation.
 
Osteonecrosis: It is a rare dental condition which mostly occurs after dental extraction, implant surgery or other invasive dental procedure.
 
 
There is no sign of healing even after 8 weeks of dental treatment in case of osteonecrosis of jaw. The gums are worn away and the underlying bone is visible in this condition. It is mostly seen in cancer patients.
 
 

 User Comments on -  Do's And Don'ts After Tooth Extraction


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Posted By : Brylee on 18-Dec-2013 01:27 AM
Hi. 7 days ago I got put to sleep to get my two bottom wisdom teeth out. They were very deep and know where near showing. I have been in a heap of pain and still am it comes and goes. Today's pain us worse than yesterday. Is that normal? The pain shoots all the way up to my ear. I got my stiches out on day 5. Also I still don't have any feeling in my back top and bottom teeth us that normal? Thanks
 


Posted By : Shelly on 03-Dec-2013 03:24 PM
I had two teeth surgical removed on 11-29-13. Everything is fine except I went back to the dentist today due to the top of my mouth inside right at the extraction site is very sore and looks like raw meat, my dentist told me it is a fungus, yes I have been very careful about keeping the site and my mouth clean. The two teeth I had removed were very infected. The dentist told me to stop antibotics. Why did this happen, didn't have a chance to ask my dentist. Thanks for any information on this.
 


Posted By : dave on 30-Oct-2013 09:39 PM
I had a bottom tooth and a bicuspid tooth (both on the same side) removed from the bottom left side of my mouth on Monday. I did very little for a couple days. Then today, I notice I bump in to doorways when I pass through them....not every time, but enough that it is bothering me. Is this from the extractions? I am not taking any pain meds except the occasional ibuprofen. Can anyone help?
 


Posted By : Patricia on 26-Oct-2013 09:51 AM
I had a tooth extracted on the bottom right side the one just in front of the 1st molar as it had had a root canal in the past and a crown and the whole thing broke off at the gum line so it had to be removed.My problem is I had it removed on Oct18th 2013 today is the 26th of Oct.Everything is fine with the extraction the stitches are out the site looks healthy my problem is my jaw at the joint I can only open my mouth about 2 inches or if I bite down on something I have horrific pain in my jaw.I know it's normal to have jaw pain I've had a lot of dental work in the past and had jaw pain but nothing like this I am wondering if I should just carry on for awhile longer or call the dental surgeon as this was done in a hospital.
 


Posted By : Alison on 30-Aug-2013 11:12 AM
Hi for over a week I had excruciating nerve pain which travelled all along ny teeth in the left side oglf ny mouth (upper and lower teeth) the dentist could see a lot of blood so gave me antibiotics for the infection however the pain did not go. This afternoon As a last resort he removed a tooth which was where the infection had been as that seemed to be the most painful area. As the anaesthetic is wearing off I can still feel the same travelling nerve pain on my left side of my mouth, does this take time to settle? Or should the extraction of put an end to the horrible pain that remains?
 


Posted By : Laura on 24-Aug-2013 08:11 AM
Hi I had upper front tooth removal and one next to it removed almost 3 weeks ago the sockets are heibg but not completely closed I woke up this morning and one started to bleed very little in the night I wear partial denture which I take out at night could this be grinding y teeth or food stuck in area I carnt get over to my dentist till at least Tuesday I am so worried
 


Posted By : Dr. Ritz on 22-Aug-2013 08:22 PM
Kimberly, you have to wait for another 2-3 days as it takes almost a week for extraction socket to heal. Till then maintain good oral hygiene and keep doing warm saline rinses. If the condition worsens then you have to go to your oral surgeon.
 


Posted By : Kimberly on 22-Aug-2013 07:46 PM
I had a molar(#14)removed 3 days ago. I am having pain & something tastes really bad all the time. I am taking 600mg of Advil every 6 hrs & doing frequent salt rinses. I called the dentist & she said nothings wrong. I think she is wrong. I feel worse everday.
 


Posted By : Alante on 27-Jul-2013 11:03 PM
Its the ninth day can i now drink soda if not i wont do that
 


Posted By : merin on 25-Jul-2013 06:46 AM
i had my tooth removed on 16 th of july and swallowed lot of blood and now last days i am having black stool .please advice.
 


Posted By : Dee on 10-Jul-2013 09:48 AM
Had upper molar (14) extracted 2 days ago; no pain or swelling & appears to be healing OK. The gum area looks OK, but the actual site of the extractions looks kind of like a white spot. Is that normal? Thanks
 


Posted By : Dr. Ritz on 05-Jul-2013 05:52 AM
Little pain is normal and the hole is not filled with anything as the blood in the socket coagulates and form the clot which helps in healing. You are not supposed to irritate the clot which is forrmed . If this clot dislodges it can lead to dry socket which is a painful condition.
 


Posted By : tracy on 19-Jun-2013 10:31 AM
hi,i just had a tooth extracted yesterday 6/18/13. i have a little pain which i assume is normal. but i took a look at the whole and it looks like black/reddish dried blood. were they suppose to pack the hole with something or just remove the tooth and let it help a lone?? do they always pack the hole with something
 


Posted By : Dr. Ritz on 09-Jun-2013 05:26 AM
Alex, it is perfectly normal to have these symptoms. Keep doing warm saline rinses and take semi solid food so that food impaction is not there. Maintain good oral hygiene. Do not try to irritate the surgical area too much. The symptoms will go away in another 2-3 days and then you will be able to eat normally and open the mouth completely.
 


Posted By : Alex on 08-Jun-2013 08:11 AM
I had all four of my wisdom teeth removed yesterday at 10:00 am. Am I allowed to use Listerine today? I have been doing salt water rinses. I've attempted to brush near the surgical area but my jaw is so tense I'm having difficulty opening my mouth more than a quarter of an inch. Also, my the left part of my lower lip and chin are still numb. Are these symptoms normal?
 


Posted By : Dr. Ritz on 07-Jun-2013 08:03 PM
Lisa, it seems that due to food impaction you have infection in the socket. Do warm saline rinses and try to keep the area clean. If the pain and swelling increases then you have to go to dentist. May be he will put you on antibiotics for this. The difficulty in opening of mouth is also due to infection.
 


Posted By : Lisa on 06-Jun-2013 06:32 PM
I had an infection where my wisdom tooth was I had the tooth out #32 it's been 5 days I was feeling good until I ate a piece of steak an now it's throbbing an feels like a piece is stuck in there somewhere but my site was stitched up so is it possible??? An also feels like my jaw is fractured I I open it too much or the wrong way it sends s shooting pain behind my ear. Is this normal to be feeling??
 


Posted By : Dr. Rtiz on 02-Jun-2013 03:39 AM
You should not be smoking at least for 48 hours after tooth extraction but first 24 hours are very crucial. In smoking within 24 hours, the chances of clot dislodgement from tooth extraction site are more. Now what ever is done is done. Take good care of oral hygiene and do warm saline rinses. Take all the precaution told by your dentist and take all the meds on time.
 


Posted By : Kellie on 31-May-2013 07:24 PM
yesterday at 8am i had 2 teeth pulled. #4 (upper right) and i believe #19 (lower left) origionally they thought they thought they were going to have to surgically remove them cuz of how broken they were but the dentist thankfully was able to remove them without having to cut my gums. its now a little after 9pm and #4 feels great, i have no pain aside from tender gums, ive been very careful brushing today and started warm salt rinses today as well. however the lower left is throbbing a bit, my husband checked and the clot is still there (but this tooth was harder to get out, the dentist made a comment that i had a curved root) i will admit that i did go out and have a smoke, i was very very careful not to take to hard of a drag and upon coming back in immediately carefully brushed my teeth,did a salt water rinse and just now took some ibuprofin. was just wondering if this was normal or should i be worried that im forming dry socket?? i know i shouldnt have went out to smoke but i thought if i was careful it would be okay. its only been about 36 hours since my extraction.
 


Posted By : Dr. Rtiz on 11-May-2013 10:59 AM
Elizabeth Hicks, Bleeding after 6 hours of tooth extraction is normal. To stop the bleeding you can put pressure pack or can use iced tea bags. But as the tooth was badly infected you have to be really careful. Tell your husband to maintain good oral hygiene and follow all the instructions given by your dentist.
 


Posted By : Elizabeth Hicks on 06-May-2013 09:28 PM
My husband had a tooth removed yesterday. It was infected to the point that the dentist injected collagen into the hole to shore up the bone. He's telling me that he has an acidic taste in his mouth, and the bleeding hasn't quite stopped, and it's been about six hours since it was removed. What can we do?
 


Posted By : Dr. Rtiz on 18-Apr-2013 09:58 AM
As on right side the procedure took long so may be the tooth cutting was more or the tooth was deep in to the bone and that is why the healing is taking long. Keep taking your meds on time and follow all the instructions given by your dentist. Normally it takes around 7 to 10 days for the ulcers to heal . if the pain is still there then you can consult your dentist.
 


Posted By : Jennifer on 15-Apr-2013 12:44 AM
Hi. I had 2 of my wisdom teeth removed last week (lower left and lower right) since both were impacted. The left was removed on last week, april 8 while the right was removed the following day. For both operations, the dentist had to cut portions of the adjacent teeth to be able to pull out the wisdom teeth since they were blocking the way but no bone was cut. The left took 2hrs to take out while the right took 4hrs. The left side is healing fine, no more pain after a couple of days. However, the right side hurts bad. I have this pain in my jaw and the back of my ear until now. I have numerous ulcers on the sites where the dentist injected anesthesia and my tongue hurts when i move it. The dentist prescribed me with coamoxiclav, prednisone, and periodent ointment and gargling chlorhexidine mouthwash. I have difficulty in talking and eating because of the pain when i move my tongue and jaw. Please help. Also, how long for the pain to go away?
 


Posted By : Dr. Rtiz on 31-Mar-2013 08:21 AM

You have not written whether the rear tooth which was cracked and crowned was root canal treated or not. If it was not root canal treated then get the root canal treatment done if possible and get it re crowned. If it is already root canal treated and still giving you problem then it is better to get it pulled out. If it is the wisdom tooth you are taking about then there is no need to replace it but if it is 2nd molar then you have to get it replaced after pulling out and best option is dental implant.

 


Posted By : pj on 29-Mar-2013 03:08 PM
i have been having dental work done in mexico because of expense. i have 5 new crowns and had a nasty wisdom tooth cut out. all has gone fairly well but a upper rear tooth that was crowned because it was cracked has been a problem for 5 weeks now i'm considering having it taken out and forget it since it is in the very back.also it's time for me to go back to oregon where any problems will cost 4 times as much. any advise?
 

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