Wisdom Tooth Extraction

A Few Simple Guidelines

Sometimes teeth need to be removed due to decay, disease, trauma or wisdom tooth extraction. Having a tooth removed or “pulled” is called a tooth extraction.

When you have a tooth removed, such as a wisdom tooth extraction, it’s natural that changes will occur in your mouth afterward. As a result your dentist may give you instructions to follow after the extraction, and it’s important to talk to your dentist if you have any questions or problems. Here are some general guidelines to help promote healing, prevent complications, and make you more comfortable.

When to Call the Dentist

Call your dentist immediately if you have any of the following issues after your wisdom tooth extraction . Go to a hospital emergency room if you cannot reach your dentist.

  • fever, nausea or vomiting
  • ongoing or severe pain, swelling, or bleeding
  • pain that gets worse with time instead of better

Anesthetics

You will be given an anesthetic to reduce your discomfort before the extraction. Your mouth will remain numb for a few hours after the extraction. You’ll want to be careful not to bite your cheek, lip or tongue in addition to avoiding foods that require chewing while your mouth is numb. Contact your dentist in the event that your the numbness does not go away within a few hours.

Bleeding

Your dentist may place a gauze pack on the extraction site to limit bleeding. This will also help a blood clot to form, which is necessary for normal healing. Leave the gauze pack in place for 30 to 45 minutes after you leave the dentist’s office. Do not chew on the pack. In the event that there is some bleeding or oozing after the pack is removed here’s what to do:

  • First fold a piece of clean gauze into a pad thick enough to bite on. Dampen the pad with clean, warm water and place it directly on the extraction site.
  • Close the teeth firmly over the pad to apply pressure. Maintain this pressure for about 30 minutes. If the pad becomes soaked with blood, replace it with a clean one.
  • Do not suck on the extraction site or disturb it with your tongue.
  • A slight amount of blood may leak from the extraction site until a clot forms. However, if heavy bleeding continues, call your dentist. (Remember, though, that a little bit of blood mixed with saliva can look like a lot of bleeding.)

Do Not Disturb!

The blood clot that forms in the tooth socket is an important part of the normal healing process. You should avoid doing things that might disturb the clot. Here’s how to protect it:

  • Do not smoke, or rinse your mouth vigorously, or drink through a straw for 24 hours. If suction in your mouth is caused by these activities it could loosen the clot as well as delay healing.
  • Avoid alcoholic beverages or mouthwash containing alcohol for 24 hours.
  • Limit strenuous activity for 24 hours after the extraction. This will reduce bleeding and help the blood clot to form.
  • Sometimes the blood clot does not form in the first day or two after the extraction, or it forms but breaks down for some reason. The result is called dry socket. This can be very painful and should be reported to your dentist. A dressing may be placed in the socket to protect it until the socket heals and to reduce any pain.

Cleaning Your Mouth

Do not clean the teeth next to the healing tooth socket for the rest of the day. You should, however, brush and floss your other teeth well and begin cleaning the teeth next to the healing tooth socket the next day. You can also brush your tongue to assist in getting rid of the bad breath and unpleasant taste that are common after an extraction.

The day after the extraction, gently rinse your mouth with warm salt water (half a teaspoon salt in an 8 oz. glass of warm water) after meals to keep food particles out of the extraction site. Try not to rinse your mouth vigorously, as this may loosen the blood clot. If you have hypertension, discuss with your dentist whether you should rinse with salt water. Avoid using a mouthwash during this early healing period unless your dentist advises you to do so.

Medication

If your dentist has prescribed medicine to control pain and inflammation, or to prevent infection, use it only as directed. If the pain medication prescribed does not seem to work for you, do not take more pills or take them more often than directed—call your dentist.

Swelling and Pain

After a tooth is removed, you may have some discomfort and notice some swelling. This is normal. To help reduce swelling and pain, try applying an ice bag or cold, moist cloth to your face. Your dentist may give you specific instructions on how long and how often to use a cold compress.

Eating and Drinking

It is important to drink lots of liquids as well as eating soft, nutritious foods after the extraction. In addition you should avoid hot liquids and alcoholic beverages. Do not use a straw. Begin eating solid foods the next day or as soon as you can chew comfortably. Most of all you should chew food on the side opposite the wisdom tooth extraction site for the first few days. When it feels comfortable, you should resume chewing on both sides of your mouth.

Follow-Up

Your dentist will tell you when to return to the office If you have sutures that require removal.

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