I realize that most patients are a little distracted when I review care instructions after they have had a tooth pulled (extracted). Patients always nod as though they are listening but they often have a lot of questions for the poor person working the front desk after I walk away. Therefore, I provide my patients with a written list of dos and don'ts following an extraction. Post operative instructions are very important; following them can help ensure proper healing of the socket. After having a tooth pulled, follow these steps:
- Bite on gauze- be sure to bite tight on the gauze your dentist places over the extraction site. This applies pressure to the area where the tooth was removed and helps a blood clot to form. Bite for at least 30 minutes. If there is still bleeding after 30 minutes, replace the gauze with a new piece. Fold the gauze in half and then in half again, place over the socket and bite firmly for another 15- 20 minutes.
- Swallow saliva- DO NOT SPIT! Swallow your saliva. There should not be a lot of blood in your mouth following the extraction if you are applying adequate pressure. If the gauze becomes saturated with saliva, it could cause the area to continue bleeding and not form a good blood clot.
- Do not spit- This bears repeating. Spitting can loosen the blood clot from the socket. If you lose the blood clot you may develop dry socket which hurts worse than a toothache.
- Do not rinse- Do not rinse your mouth the day of your extraction. You may rinse gently, the day after your extraction with warm salt water.
- Do not smoke or drink through a straw- Avoid smoking or sucking through a straw for at least two days following a dental extraction. The suction can dislodge the blood clot from the socket and lead to painful dry socket.
- Eat soft, cool foods- Avoid traumatizing the area when eating. Eat soft foods like mashed potatoes, pasta, soup, rice and the like. Don't eat crunchy foods like popcorn, potato chips or pretzels. Do not eat spicy foods, which may cause bleeding. Chew on the side opposite of the extraction, if possible. Let food cool to room temperature because heat can cause bleeding. If food gets in the space where the tooth was, DO NOT dig it out with a tooth pick. You will probably remove the blood clot which may cause dry socket and pain.
- Wait for anesthetic to wear off before biting or chewing. It may take a few hours for the anesthetic to wear off. Do not chew or bite foods until the numbness has worn off or you may accidentally bite your lip, cheek, or tongue. A milkshake, smoothie, or protein shake are allowed but no straws!
- No bubbly drinks- Do not drink soda or beer for a couple days following the extraction. The carbonation or bubbles can loosen the blood clot, cause dry socket and pain.
- Avoid alcohol- Avoid drinks containing alcohol or using mouthwash with alcohol because it can dissolve the blood clot. Wait at least 2 days following an extraction before using these products.
- No lifting, bending, or strenuous activity the day of your extraction. This will keep your heart rate up and may cause prolonged bleeding.
- Brush your teeth to maintain good oral hygiene and promote healing. Do not brush over the extraction site which may dislodge the blood clot and cause bleeding.
- Take all recommended or prescribed medication as directed by your dentist. This will help control pain, fight infection (if prescribed an antibiotic), and promote healing.
- Call your dentist if you have any unusual symptoms, prolonged bleeding, or pain that is not controlled by recommended medications.
