After Tooth Extraction

Post-operative instructions for after a tooth extraction

Anesthesia Care Instructions

Local Anesthesia

The numbness from the anesthetic injection will wear off within a few hours. You may experience tenderness, mild swelling, or bruising at the injection site. In rare cases, prolonged numbness can occur. Please contact our office if numbness does not wear off within 48 hours of surgery.

IV Sedation

It is imperative that you DO NOT drive a car or operate machinery while taking medications or recovering from the general anesthesia or IV sedation. Your judgment will be impaired. You must be under direct supervision for the first 6 hours after you receive general anesthesia or IV sedation. It is normal to feel tired, forgetful, and groggy. The following instructions are designed to help you during your recovery period.


  • After having general anesthesia, we recommend clear liquids first (such as 7-Up, water, or apple juice). If you continue to feel hungry, this may be followed by soft foods (such as ice cream, Jell-O, pudding, malts) for the first 24 hours.
  • After the initial 24 hour period, maintain a soft diet (soups, scrambled eggs, mashed potatoes, soft chicken, or soft fish) for 2-3 days, then gradually progress to solid foods as tolerated.
  • Avoid food like popcorn, nuts, sunflower seeds, or rice.
  • If you are a diabetic, maintain your normal diet as much as possible and follow your doctor’s instructions regarding your insulin schedule.


  • The medications used during and after surgery may cause nausea. If nauseated, avoid milk and other dairy products, and try to drink clear liquids in small quantities until symptoms resolve. Pain medications should not be taken on an empty stomach.


  • A low-grade fever is common after surgery. It is usually a sign of insufficient liquid intake. Please remember to drink sufficient amounts of clear liquids to keep your body hydrated.


  • This may occur on the arm or hand near the site of your IV. It is very common to have minor bruises. If the arm is inflamed or tender for the first day, apply an ice pack for 30 minutes on and 30 minutes off. If inflammation or tenderness does not resolve on the second day, please contact our office for evaluation.

First Day After Having a Tooth Removed

After an extraction it is crucial that a blood clot forms in the area where the tooth was extracted. Therefore, for the first 24 hours:

  • DO NOT: rinse, spit, or suck through a straw (suction will cause the clot to be pulled out.)
  • DO NOT: drink alcohol or use mouth rinses containing alcohol (these will dissolve the clot.)
  • DO NOT SMOKE FOR 5 DAYS AFTER EXTRACTION. Nicotine will keep tissue growth from occurring and will result in a painful condition known as dry socket.
  • AVOID: exercise or heavy lifting (this can cause your blood clot to be pushed out.)
  • Swelling may occur; ice packs can be used in 15 minute intervals for the first 6 hours to reduce swelling.
  • To prevent or slow excessive bleeding, bite with light pressure on the gauze that has been placed over the extraction site, changing the gauze every 15 minutes or as needed for up to 90 minutes after leaving the office. You should wet the gauze and squeeze excess water out of it before placing it over the extraction site. Placing dry gauze over site will allow the clot to dry to the gauze, resulting in clot removal when changing.
  • Place a folded towel over your pillow in case of any bleeding while sleeping.
  • If you have heavy bleeding, severe pain, or continued swelling 3 to 4 days after extraction please contact our office for a short appointment to check the extraction site.
  • If sutures (stitches) were placed, they will dissolve on their own after a couple of days. If they partially dissolve and are moving around excessively because they are not tied down anymore, feel free to gently grab a loose end and remove them.

Impacted Teeth

Removing impacted teeth is very different from extracting erupted teeth. If you had an impacted tooth removed, you will likely have these symptoms for a short time:

  • Difficulty opening your mouth
  • Pain while swallowing
  • Earache on the side of you surgery

If the impacted tooth was in your lower jaw, you may have numbness in your lower lip or tongue on the side where the tooth was removed. This numbness should go away, but it may last from a few days to many months. You may also have sores on your lips after surgery. Use petroleum jelly (Vaseline) on your lips until they heal.


  • For 2 days after surgery, drink liquids and eat soft foods only. Suitable soft foods include milkshakes, eggnog, yogurt, cooked cereals, cottage cheese, smooth soups, mashed potatoes, refried beans, ice cream, pudding, fruit smoothies, and protein shakes.
  • On day 3 after surgery, eat soft foods that do not require much chewing, such as macaroni and cheese, cooked noodles, soft-boiled, scrambled, or poached eggs, and soft sandwiches. Avoid tough or crunchy foods such as pizza, rice, popcorn, and hamburger. Avoid spicy and acidic foods.
  • Most patients may resume their normal diet 7 days after surgery
  • Medicines to control pain and prevent infection will be prescribed for you. It is very important that you take all medicines as recommended.
  • Start taking your pain medicine before the numbness wears off. Continue to take it as prescribed.
  • The dose for pain medicine is usually 400 mg to 800 mg ibuprofen (Advil, Motrin, or generic) every 6 hours. If you have an allergy or sensitivity to ibuprofen, or have been told not to use it, you may take up to 1,000 mg acetaminophen (Tylenol or generic) every 6 hours.
  • Follow the pain medicine instructions we give you. If we believe you may have more severe pain, we will prescribe a stronger pain medicine.

Oral Hygiene

Begin your normal hygiene routine the day after surgery.

  • Soreness and swelling may not permit vigorous brushing of all areas, but please make every effort to clean your teeth within the bounds of comfort.
  • If you use an electric toothbrush, feel free to use it just as you would a manual toothbrush. Brush very gently around the extraction site being careful not to loosen or remove the clot.
  • If you were given an irrigating syringe, start using it the fifth day after surgery to keep sockets clean.
  • Mix one teaspoon of salt dissolved in a tall glass of warm water, then fill the syringe and gently irrigate any open sockets, especially after eating.

Dry Sockets

Normal healing after tooth extraction should be as follows:

  • The first three days of surgery are usually the most uncomfortable and there is some degree of swelling and stiffness.
  • From the third day on you should experience, gradual, steady improvements.
  • If there is a noticeable, distinct, persistent throbbing pain in the jaw that arises after the 4th day, please call our office. We would like the opportunity to help alleviate any discomfort.

Sharp Edges

You may feel sharp edges near your surgical site. Occasionally small slivers of bone may work themselves out during the first week or two after surgery. They are not pieces of tooth, but if they are bothersome, we will remove them. Please call the office if you are concerned.

Denture Wear

  • If you usually wear a removable dental device that replaces missing teeth and rests on the surgery area, check with usr before starting to wear it again after surgery.
  • It is important not to put any pressure on the surgery site.
  • If your bite feels different when you start wearing the device again, or if you had a dental implant and it feels like the device is hitting the implant, call our office.

Please call our office at Bethesda Office Phone Number 301-530-3600 if you have any questions or difficulties. If it is after hours, follow the prompts to be connected to our answering service. If you feel that your symptoms warrant a physician and you are unable to reach us, please go to the closest hospital emergency room immediately.