What to do after a tooth is extracted

What to do after an extraction

Me, after wisdom tooth extraction

Following this discussion of what you should and should not do after an extraction, I will go into the complications that can arise if you do not follow this advice.  If you have any doubt about the need to follow these instructions, skip ahead and read about the complications. 

1.  You are sick, even if you don't know it yet. (Wait until the anesthesia wears off and then you will know it.)  Go home and act sick! I mean go home, put your head down and do not exercise for at least 12 to 24 hours. Do NOT go to work just because you feel great while your mouth is still numb.  The nicer you are to yourself today, the more likely it is that you will be able to resume a normal life tomorrow.  

2. When you leave the office, you should have a piece of gauze over the socket.  Keep biting on the gauze for at least two hours.  Do not chew on the gauze.  Just keep constant, even, gentle pressure on it so that the socket is covered, and the bleeding is stemmed.  There is only one way to stop bleeding, and that is to keep biting on the gauze.  If you go to the emergency room with bleeding, they will sit you down in a chair and make you bite gauze for another two hours.  Be sure that the extraction socket is completely covered by the gauze.  You do not have to change the gauze unless it becomes soaked with blood.  

If you have kept the socket covered firmly for at least two hours, the blood in the socket should have clotted.  The clot then acts like a cork and keeps you from bleeding further. If the clot is kept intact you may fall asleep and wake up with some blood on the pillow, but this is just a bit of blood oozing from the clot while it continues to organize itself. The blood mixes with saliva and can can appear worse than it really is.

3. Do not spit for 24 hours.  The act of spitting always starts with a sucking action, and this will dislodge the clot causing renewed bleeding, or even a dry socket.  You may gently bring blood and saliva  forward with your tongue and wipe it away with a tissue, but avoid forceful spitting at all costs.

4. Do not smoke for 48 hours!  If you smoke, you WILL get a dry socket because the chemicals in the smoke get into the saliva and dissolve the clot.  Even worse, the continued smoking irritates the bone in the socket and the dry socket will be especially painful and persistent.  If you have ever had a dry socket, you will do ANYTHING to avoid another one.  

5. Wait until the anesthesia wears off before eating anything solid, and when you can feel your mouth, you can eat whatever you can tolerate.  

6. Take your medications. If you have been prescribed an antibiotic such as penicillin or erythromycin, take it on schedule until it is all used up.  Dental infections can be not only painful, but quite dangerous.  The pain medications can reduce swelling and speed your recovery.  If you are prescribed a narcotic like codeine, Vicodin or Percocet, do not drive or operate equipment under the influence. 

7. If, after 48 hours, the pain gets worse, or you start bleeding again, call the dentist.  You could be getting a dry socket, or an infection. 

 Next page>>Complications after an extraction