A Simple Guide for After a Tooth Extraction

Q: What is a dry socket and how do I know if I have one?

A dry socket is what happens when the blood clot falls out of the socket too early, leaving the bone exposed. The main symptom is a severe, throbbing pain that usually starts 3-5 days after the extraction and is not helped by your pain medicine. If you think you have a dry socket, please call our office immediately. It is a very treatable condition.

Q: I see something white in the socket. Is that normal?

Yes, this is very likely a sign of good healing! After the first day, the area will start to fill in with new tissue, which often looks white or yellowish. It is not an infection and is not a cause for concern. Do not try to clean it out.

Q: I had stitches placed. Will they dissolve?

If we placed stitches (sutures), they are typically the kind that dissolve and fall out on their own within 5 to 10 days. Do not be alarmed if you find a small thread in your mouth.

Surgical Care Instructions

Pain Management

It is normal to feel sore after a tooth is removed. The best way to stay comfortable is to stay ahead of the pain.

Standard Protocol: For the first 2-3 days, we recommend a scheduled regimen of 600mg of Ibuprofen AND 500mg of Tylenol (Acetaminophen) taken together every 6 hours. This is highly effective at managing inflammation.
Important Disclaimer: Only take medications as specifically prescribed by our office, considering your unique health history. We will not recommend Ibuprofen if you have kidney disease or GI ulcers, nor Tylenol if you have liver disease.
Prescription Pain Medication: If we prescribed a stronger pain medication, use it only if the Ibuprofen/Tylenol combination is not providing enough relief. Remember that narcotics like Vicodin or Percocet already contain Tylenol. DO NOT take additional Tylenol with your prescription.

Bleeding Control

Seeing a little bit of blood mixed with your saliva is normal for the first day. Heavy, continuous bleeding is not.

Gauze: Bite down with firm, steady pressure on the gauze pack we gave you for 30-45 minutes. If it’s still bleeding after that, change the gauze and repeat.
Tea Bags: If bleeding continues, you can place a wet, black tea bag directly on the spot, cover it with gauze, and bite down firmly for 30 minutes.
Pillowcase Pro-Tip: It’s a good idea to use an old or dark-colored pillowcase on your pillow for the first night. Waking up to a small spot of blood is normal and not a cause for alarm.

Swelling Management

Swelling is a normal part of healing, especially after a surgical extraction.

Ice Packs (CRITICAL): For the first 24 hours ONLY, apply an ice pack to the outside of your cheek for 20 minutes on, then 10 minutes off. This is the best way to reduce swelling.
Peak Swelling: Swelling will be at its worst on the third day after the procedure. After that, it should start to get better. Bruising on the cheek is also normal.
Elevation: When resting or sleeping, keep your head propped up with an extra pillow.

Oral Hygiene/Site Care

The most important job you have after an extraction is to protect the blood clot that forms in the socket. This clot is a natural bandage that is essential for healing. Losing this clot causes a very painful condition called a “dry socket.”

CRITICAL Rules to Protect the Blood Clot:

DO NOT spit for any reason.
DO NOT drink through a straw for at least one week.
DO NOT smoke or vape. The suction and chemicals are the #1 cause of dry sockets.
DO NOT rinse your mouth vigorously for the first few days. Let water gently fall out of your mouth into the sink.

Cleaning Your Mouth

Day of Surgery: Do not brush or rinse your mouth at all. Let the site rest.
After 24 Hours: You may begin gently rinsing with warm salt water (1/2 teaspoon of salt in a glass of warm water) after every meal.
Brushing: You can and should brush your other teeth, but be very careful and stay away from the extraction site for the first few days.

Dietary Recommendations

Stick to a soft, non-chew diet for the first few days. Good choices are smoothies (no straw!), yogurt, applesauce, mashed potatoes, and lukewarm soup.
Avoid hard, crunchy, or spicy foods. Also avoid small foods like seeds, rice, or popcorn that can get stuck in the socket.