Wednesday, August 22, 2007

Post Operatory Instructions after a Tooth Extraction

I thought this would be great list to put online, based on patient requests. As always, your dentist may modify or change these instructions to suit your specific circumstances. These are the general instructions that I give:

  1. After the extraction, bite on the gauze given to you for at least 20 minutes until the bleeding for the most part stops. You may have to change the gauze if it gets soaked.
  2. Start taking your pain killers/antibiotics right away. The usual course is Motrin 600mg 4 times a day for 5-7 days then continue if you have pain.
  3. Be gentle, there is a blood clot that forms in the area that is crucial for proper healing, so ingest only soft foods for the first week to 10 days (soups, yogurt, soft pasta, rice etc.), no peanuts or anything hard as I am usually the one who has to fish it out if it gets stuck in there.
  4. Brush up to the extraction area, but not on the site for 7-10 days. You may gently swish with salt water to clean the area. Be careful to spit very gently as you may spit out the blood clot needed for proper healing
  5. Swelling usually reaches its peak about 2-3 days afterwards. Use a cold pack or ice cubes in a freezer bag to apply to the cheeks and jaw for about a minute, then allow a minute to rest, followed by a minute on again. Repeat as much as you can tolerate.
  6. Any fluids ingested should be around room temperature and definitely avoid the use of a straw as this again can disturb the clot
  7. Don't smoke or drink during the healing period
  8. We've always told our patients that it's a wise idea to put an old sheet over your pillow case the first night as the combination of residual anaesthetic, salivation, and a bit of oozing from the area sometimes makes a bit of a mess on good sheets/pillow covers
  9. If after 2-3 days the pain really increases, then the likely cause is the loss of the blood clot and exposure of bone (often called dry socket). Call immediately for an emergency appointment. We will likely restart the bleeding and pack the area
  10. If you have sutures, most likely they are resorbable and will fall out within about 2-3 days.
  11. If there is residual numbness in the area, call us for quick assessment, the overwhelming majority of these cases resolve themselves in a couple of weeks to a month, but some can take as long as a year.
Whew, I hope I've covered most of the usual questions. Like I said, these are the usual instructions given to our patients, but each case is different, consult your local dentist.

Take care,


Hans Skariah, B.Sc., DMD
Promenade Court Dental Health Group in Mississauga
2233 Hurontario St., Mississauga, ON, Canada
(1/2 km north of the QEW in the Dome Building)
(905) 273-7100