After ExtrACTIONS/Removal of Teeth

The extraction of teeth are typically easily managed in the outpatient setting.

Immediately Following Surgery

  • The gauze pad placed over the surgical area should be kept in place for a half hour. After this time, the gauze pad should be removed and discarded.
  • Vigorous mouth rinsing or touching the wound area following surgery should be avoided. This may initiate bleeding by causing the blood clot that has formed to become dislodged.
  • Take pain medications as soon as you begin to feel discomfort. This will usually coincide with the local anesthetic becoming diminished. Start with over the counter medications and then use prescribed medications if prescribed/needed.
  • Restrict your activities the day of surgery and resume normal activity when you feel comfortable.
  • Place ice packs to the sides of your face where surgery was performed. Refer to the section on swelling for explanation.

Bleeding:  A small amount of bleeding is to be expected following the operation. If bleeding occurs, place a gauze pad directly over the bleeding socket and apply biting pressure for 30 minutes. If bleeding continues, a moist tea bag can be used for 30 minutes. If bleeding occurs, avoid hot liquids, exercise, and elevate the head. If bleeding persists, call our office immediately. If immediate dentures were inserted, do not remove immediate dentures unless the bleeding is severe. Expect some oozing around the sides of the dentures.

Swelling:  Use ice packs (externally) on the sides of the face where teeth were removed to help reduce swelling. Apply ice as much as possible for the first 36 hours.

Pain:  For mild to moderate discomfort use Ibuprofen/Motrin/Advil.  If you cannot take these medications you may use Tylenol (Acetaminophen).  Ibuprofen, Motrin or Advil: Take 2 to 4 tablets every 6 hours as needed.  Tylenol:  Take 1 or 2 tablets every 6 hours as needed. 

For severe pain use the prescription pain medication if one was given to you. Add the prescription pain medication to the Ibuprofen, Motrin or Advil.  If you are taking Tylenol, remember that most prescription pain medications contain Tylenol and you should stop taking the Tylenol when you start the prescription pain medications. If the pain does not begin to subside in 2 to 3 days, please call our office.

If an antibiotic has been prescribed, finish your antibiotic prescription.  If you are having trouble taking the antibiotics, please call the office for instructions.

Diet:  After surgery drink plenty of liquids.  Do not use straws. Drink from a glass. The sucking motion can cause more bleeding by dislodging the blood clot. Diet:  Initially restrict your diet to liquids and soft foods, which are comfortable for you to eat. As the wounds heal, you can advance your diet as tolerated.

Keep the mouth clean:  Do not rinse your mouth for the first post-operative day, or while there is bleeding. You can brush your teeth gently as tolerated. After the first day, use a warm salt water rinse several times a day and after meals to keep the extraction sites clean. (1/4 teaspoon of salt in a glass of lukewarm water). If you were given a curved tip syringe, do not start using it before the 7th day after your surgery.  This syringe is used to gently rinse the lower wisdom tooth sockets after meals and before bedtime.  Rinse gently from ½ inch away from the wound.  Do not jab it directly into the extraction site.

Activity:  Limit vigorous physical activity for 24 hours.  This may increase blood pressure and cause more bleeding.  After a day or two, you will feel fine and can resume your normal activities. If you have heavy bleeding, severe pain, continued swelling for 2-3 days, or a reaction to the medication, call our office immediately.

After multiple extractions:  The removal of many teeth at one time is quite different from the extraction of one or two teeth. Because the bone sometimes must be shaped and smoothed prior to the insertion of a denture, the following conditions may occur, all of which are considered normal:

  • There may be more bleeding and swelling and this is to be expected.
  • The area operated on will reach maximum swelling in two days. Swelling and discoloration around the eyes and cheeks may occur.
  • If the corners of the mouth are stretched, they may dry out and crack. Your lips should be kept moist with an ointment like Vaseline or ChapStick.
  • You may have a slight temperature for a day or two. A low grade temperature is normal after surgery.

If immediate dentures have been inserted, sore spots may develop. In most cases, your dentist or denturist will see you within 24-48 hours after surgery and make the necessary adjustments to relieve those sore spots. Failure to do so may result in severe denture sores, which may prolong the healing process.

Your Oral Surgeon will instruct you on when to wear your new dentures.  Generally, patients should leave the dentures in after surgery until they see their dentist or denturist.

If you have any questions or concerns, please call us at Portland Oral and Maxillofacial Surgery Phone Number (207) 387-2055.  After hours, you will reach our answering service and they will page the doctor and have him call you back.