During the first 24 hours following your extraction, you should notice that …

  • A blood clot has filled the tooth’s vacant socket. (The creation of a clot initiates the healing process.)
  • And the bleeding from your wound has stopped.

APPLY BITING PRESSURE for 30 minutes to 1 hour to gauze to help stop bleeding and allow a blood clot to form. Mild bleeding/oozing following an extraction is normal for up to 24 hours.

Steps to bring post-extraction bleeding under control.

  1. Put a clean piece of moistened gauze on the empty tooth socket.
    Roll or fold the gauze into a tiny square before placing it. Get the gauze wet so it doesn’t pull out the blood clot. If you don’t have any gauze, you may use a clean cloth instead.
  2. Bite firmly onto the gauze for 30 minutes to an hour.
    Make sure the piece of gauze is big enough and positioned to ensure that when you bite down on it, pressure is sent directly to the extraction site. (If your teeth come completely together when you close, the gauze may not be getting enough pressure.)
  3. Repeat cycles of the above, a few may be needed, to finally bring the bleeding fully under control.

Note: Applying pressure over an extended period is the key.

It’s both creating firm pressure and maintaining it continuously over a prolonged period (30 to 60 minutes of application time) that are important factors in getting this technique to work.

WET GAUZE BEFORE REPLACING when changing gauze be sure to moisten the gauze with water prior to placing as dry gauze will stick to the extraction site. Do not sleep or eat with gauze in your mouth.

At the point 24 hours after your surgery and beyond, any bleeding you notice should be just minor. As examples:

  • Minor low-level blood oozing is not unusual. Saliva combined with a little blood, appears to contain a lot of blood. If it is pale red or pink, it is saliva.
  • You may notice a minor degree of bloody leaking or seepage from your extraction region.
  • Physical trauma (such as eating, brushing, or touching your wound) WILL result in small, temporary bleeding.

REST. During this initial 24-hour period following your extraction, you may start to wonder how much total time you should take off for rest and recovery.

What’s needed.
As anyone would probably anticipate, the specific circumstances associated with your procedure will be one determining factor.

• With routine extractions (“simple” extractions) … it’s normal for a patient to take the rest of the day and the next day off. (2 days)

• For tough or complicated extractions (such as impacted wisdom teeth or “surgical” extractions)… you may need to take a few days off again, depending on the details of your treatment. PAIN WILL BE PRESENT FOR 7-21 DAYS. THIS IS MAJOR SURGERY.

Of course, a patient’s personal characteristics (such as age or overall health state) must also be considered. Limit your physical activity for the initial 24 hours.

DO NOT SMOKE OR USE TOBACCO for 72 hours following procedure. Smoking significantly increases the risk of dry socket, which can be very painful.

DO NOT SPIT, SUCK ON CANDY OR LOZENGES or SUCK THROUGH A STRAW. Doing so could dislodge the clot and increase your risk of infection or dry socket.

MEDICATION as instructed by the doctor. IF YOU HAVE BEEN PRESCRIBED ANTIBIOTICS CONTINUE TAKING THEM UNTIL THEY ARE ALL GONE!

FOR PAIN RELIEF:

ADULTS AND CHILDREN OVER 12: take 400mg ibuprofen (2 Advil) with 1,000 mg acetaminophen (2 Extra-Strength Tylenol) immediately, then repeat every 8 hours as needed. *Do not take more than 3000mg in 24 hours. *Advil Dual Action with acetaminophen is the above already combined. Take 2 tablets every 8 hours.

This is the most scientifically proven effective medication regimen to reduce pain and swelling. This can be taken unless you are allergic or have otherwise been instructed not to take it.

BE CAREFUL WHILE BRUSHING. Do not brush at or near the extraction site for the first 24 hours. When rinsing out toothpaste, DO NOT swish water vigorously or spit. Simply tilt your head from side to side to allow water to flow from one side of the mouth to the other and then lean over the sink and allow the water to fall out of your mouth.

SWELLING. Swelling (more technically known as “edema”) is a typical postoperative tissue reaction in response to surgery, such as having a tooth extracted. And while the amount that forms will vary with each patient and the type of procedure they’ve had, there is a standard set of remedies used to minimize and manage this complication. Experiencing swelling following an extraction is common.

Cycles of Cold (ice) applications on your face in the area of your surgery.

Treatment time frame for cycles of cold application.

• With standard extractions, when edema formation is predicted to be limited, application cycles conducted within 4 to 6 hours of your surgery are generally sufficient.

• With surgeries where a higher level of swelling is anticipated or noticed, it’s common that cycles are continued to a point 18 to 24 hours post-op (waking hours only). The purpose of using on/off application cycles is that it creates the beneficial effect of this treatment while minimizing the potential for damage to the tissues in the region from the effects of cold. Keep in mind that on the day of your extraction you may still be numb. So, you must be careful not to create a temperature extreme that you might not be aware of. Cold application should be done only during awake hours to maintain the treatment’s cyclical on/off nature.

Positioning your head so its blood pressure is slightly reduced can help to minimize the amount of swelling that forms.

  • The general idea is to keep your “head above your heart.”
  • As opposed to lying down, sit (or recline) upright.
  • When lying down, elevate your head using 2 or 3 pillows.

*PAIN AND SWELLING WILL BE WORSE IN THE MORNING*

IF POSSIBLE, DO NOT EAT UNTIL ANESTHETIC HAS WORN OFF AND BE CAREFUL ABOUT WHAT YOU EAT. For the first 24 hours, do not drink anything hot, carbonated, or alcoholic and do not eat anything spicy or hot. Soft foods are best during this time and if possible, chew on the opposite side. After the first 24 hours, you may eat whatever is comfortable for you unless otherwise instructed by the doctor.

AFTER THE FIRST 24 HOURS, YOU CAN RINSE WITH WARM SALT WATER, especially after meals to help reduce swelling even further and prevent food particles from contaminating the site. Use 1 teaspoon of salt per 1 cup of water and gently rinse.

Healing Time

Healing from a tooth extraction takes about 7-21 days. The gum area should be fully healed in three to four weeks. Full healing may take up to six months.

Please call our office (806) 776-4299 if:

  • If persistent bleeding occurs such that your mouth is filling up with blood and you are unable to stop it by biting on gauze.
  • If your pain or swelling continues beyond 7 days or it is more intense after 5 days.
  • If you have an allergic reaction to any medication you have taken.
  • If you detect a bad taste or odor in the mouth and it does not go away after gently rinsing with salt water.