Tooth extraction aftercare: The first 24 hours.

Once your tooth extraction has been completed, your dentist will provide you with aftercare instructions. You'll need two sets of directions.

Related page: Extraction Healing timeline.)

Aftercare during the first 24 hours following an extraction.

These directions will cover topics such as:  1) Controlling bleeding.  2) Protecting the blood clot that has formed.  3) Directions for how to minimize swelling and pain.

They will also need to list post-extraction do's-and-don'ts for issues such as:  1) Smoking.  2) What types of physical activities are appropriate.  3) Eating and drinking.  4) Cleaning your teeth.  5) If indicated, the use of antibiotics.

Remember, the care you take (or don't take) during this first 24 hour period will set the stage for the healing process to come.

Make sure you follow directions that are right for you.

Any dentist's instructions for aftercare during the first 24 hours following an extraction will include the topics found on this page. However, before following our directions, you should discuss them with your dentist and confirm that they are appropriate for you.

Your dentist may find reason to revise, add to, or delete from these generalized instructions. And remember, in all cases, if you have a concern or feel you have developed a complication, you should contact your dentist and seek their advice.

A) Stopping post-tooth extraction bleeding.

Some amount of bleeding may occur for some time after your tooth has been extracted.

Place the gauze directly over the socket, then apply firm pressure.

Controlling bleeding with gauze.

In most cases this bleeding can be effectively controlled and ultimately stopped by placing a piece of clean moist gauze over the empty tooth socket, and then biting firmly on this gauze for 45 minutes to an hour.

Make sure that the gauze is positioned so when you bite down it applies pressure directly onto the extraction site. (If you bite down and your teeth come together fully, you may not be placing much pressure on the gauze.)

Applying pressure over an extended period is the key.

It is both firm pressure and maintaining this pressure over a prolonged period of time (45 minutes or so) that are important factors when this technique is used.

Don't keep changing the gauze, and don't chew on it. Just put it in and then clamp down on it for 45 minutes to an hour.

Controlling bleeding with a tea bag.

If the bleeding seems to persist, a slightly moistened tea bag can be more effective than gauze.

One of the components of tea (black tea, the regular stuff you would use to make iced tea) is tannic acid. Tannic acid aids with the formation of blood clots, thus making this method a very effective technique. (Same instructions as above, just substitute the tea bag for the gauze.)

Repeat as needed.

If some bleeding still persists after the completion of a 45 minute application, then repeat these instructions. After each subsequent application, the amount of bleeding that remains should be noticeably less. If heavy bleeding persists, then contact your dentist.

B) Insuring that an adequate blood clot forms, and stays, in the tooth socket.

The blood clot that forms in the extraction socket is an important part of the healing process, so be careful not to do anything that will dislodge it.

Remember, events that occur during this first-24-hours time frame will affect the healing process for days to come. For example, it's thought that the development of "dry sockets" is related to the loss of blood clots.

Blood-clot Don'ts.

As a way of protecting the blood clot, you should avoid vigorous rinsing or spitting during the first 24 hours after your tooth extraction. And since hot liquids tend to dissolve blood clots, stay away from soup or coffee.

You should avoid creating air pressure variations in your mouth, or pressure differences between your mouth and your sinuses (the latter is especially important in the case of an upper tooth extraction), because doing so may dislodge the blood clot from its socket.

This means you should avoid smoking or using a straw (these activities create suction). Also, don't blow your nose. And if you need to sneeze, sneeze with your mouth open. If you play a 'wind' musical instrument, ask your dentist when it will be ok to play again.

C) Minimize activities that may make it harder to control bleeding.

During the first 24 hours after your tooth extraction, you'll want to avoid any activities that might make it difficult to control the bleeding from your extraction site, or interfere with blood clot formation and retention. This means that you should avoid strenuous exercise and work. You should also avoid bending over or lifting heavy objects.

In general, it's not a bad idea to just take it easy during the first 24 hours after your tooth extraction. When you sleep or lie down, position yourself so your head is above the level of your heart. (Prop your head up with an extra pillow.) This type of positioning will lower the blood pressure level at your head end, which is a favorable thing for controlling bleeding.

D) Swelling may occur after a tooth extraction.

Trauma created by the tooth extraction process can cause swelling. It might just be very slight, almost unnoticeable. Or, at the other extreme, a pronounced enlargement that has spread into your face.

We've expanded our discussion of this subject, including post-op instructions for managing it: Post-tooth extraction swelling.

People who smoke are at greater risk for dry sockets.

E) Avoid smoking.

People who smoke tend to experience a higher level of complications with extraction site healing. (This includes the formation of "dry sockets"). If you can avoid smoking for the first 48 hours after your tooth extraction, it will be to your benefit.

F) Post-extraction discomfort and the use of pain medications.

Don't have to expect that you will experience much pain after your extraction. But for those who do, here are some of the options you have.

Your dentist may write you a prescription for a narcotic pain reliever.

OTC medications.

For minor to mild pain, your dentist will probably recommend the use of an over-the-counter (non-prescription) product such as acetaminophen (Tylenol) or ibuprofen (Motrin or Advil).

You will, of course, need to read and follow the directions and warnings that accompany the product you choose.

Prescription medications.

Alternatively, your dentist may prescribe a pain medication for you.

Many prescription pain relievers contain a narcotic (such as codeine). These compounds can have a tendency to upset your stomach, so it's usually best to take them with food.

These products can also make you drowsy or act strangely. So if you take one, you should let those around you know. You should also limit your activities (driving, operating machinery, etc...).

Make sure that you read and follow all directions and precautions associated with your medication's use. If you have any questions, you should discuss them with your dentist or pharmacist.

G) Continue on with prescribed antibiotics.

Any antibiotics prescribed by your dentist should be taken as directed, to completion. This includes continuing on with them even after your tooth has been extracted.

H) Eating considerations.

After a difficult extraction, a soft or liquid diet may be indicated for 24 hours or so after your surgery. For simpler extractions, just making sure that you do your chewing somewhere away from your extraction site should be sufficient.

Hot liquids will tend to dissolve the blood clot that has formed in the extraction socket, so avoid them for the first 24 hours. Also, you should avoid alcoholic beverages for at least 24 hours.

Avoid using mouthwash.

I) Cleaning your teeth.

It's important for you to maintain good oral hygiene over the days and weeks while your extraction site is healing.

On the day of your extraction, it might be best to avoid brushing those teeth that directly neighbor your extraction site. You can resume cleaning these teeth the following day but be gentle.

During the first 24 hours after your extraction, don't rinse vigorously when you clean your teeth. Doing so might dislodge the blood clot that's formed in your tooth's socket. Do not use commercial mouthwash or mouth rinse.

It's also best to avoid the use of commercial mouthwash or mouth rinse. These products may irritate your extraction site.

 All FYI's ► 

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