Extraction Aftercare: The second 24 hours and beyond. / Managing postoperative complications.

You'll need two sets of post-op instructions.

Separate from the aftercare instructions you're given for the first 24 hours after your extraction, your dentist will also provide you with a second set that outlines steps to take during the time period that lies beyond this initial period. (That's the topic of this page.)

It's important that you comply with both sets of directions. Doing so will go a long way toward minimizing your potential for postoperative complications.


Aftercare - 24 hours after your oral surgery, and beyond.

A) Basic aftercare.

For most extractions, the only care that's needed is just maintaining the extraction site in a manner that helps to promote its healing. (Extraction Healing timeline.) This includes:

  1. Favoring the wound so it isn't traumatized.
  2. Keeping the extraction site clean.
  3. If needed, irrigating the socket (per your dentist's instructions).
  4. If needed, having stitches removed at the proper time.

B) Managing post-extraction complications.

The other postoperative care that's needed is managing any complications that develop. This would include issues such as:

1) Bleeding    2) Swelling    3) Dry sockets    4) Tooth chips / Bone fragments

Make sure the instructions you follow are right for you.

Before following the aftercare directions found on this page, you should discuss them with your dentist. They may find reason to revise, add to, or delete from these generalized instructions, depending on your specific needs.

Additionally, at any point during your healing process, if you have a concern or feel you have developed a complication, you should not hesitate to contact your dentist.


A) Basic aftercare.

1) Favor your extraction site.

You'll need to avoid traumatizing your extraction site. For example, it's a good idea to shift your eating to the other side of your mouth for a while. You may find you do this instinctively because your extraction site is a little tender.

The tissues that form during the healing process are quite vascular and may bleed easily if traumatized. You'll also want to be careful so you don't dislodge or damage any stitches, dressings or tissue flaps that have been placed or positioned.

2) Keep your extraction site clean.

In general, the cleaner you keep your extraction site (the hole in the bone where the tooth has been removed, also referred to as the tooth's socket) the quicker it will heal.

Beginning 24 hours after your tooth extraction, you can gently rinse the socket with warm salt water (1/2 teaspoon of salt in a cup of water) after meals and before bed.

Don't be too vigorous and don't use commercial mouth rinses. Either may irritate the extraction site.

3) Extraction site irrigation.

In cases where the wound is large or deep, the extraction site may require periodic "irrigation." This process gently flushes out accumulated food and debris that can interfere with (delay) healing or be the source of a foul taste or smell.

Irrigation isn't used immediately after an extraction but instead later on during the early-to-mid weeks of bone tissue healing. Your dentist will provide you with specific instructions about when to begin.

Irrigation technique.

Socket irrigation involves the use of a syringe that has a curved plastic tip instead of a needle. The syringe is loaded with saline solution (salt water), or even just water. The tip is then placed at the opening of the tooth socket and the syringe is gently expressed so its fluid gently floats accumulated debris to the surface and out of the socket.

Suture material for placing stitches.

4) Stitches.

After removing your tooth, your dentist may find it necessary to place one or more stitches. Some types are resorbable (absorbable), meaning that they will dissolve away on their own. Others are not, and will need to be removed.

Removing stitches is easy and painless.

Non-resorbable stitches are usually removed between 7 to 10 days after they were placed. The process of removing them is usually very easy and quite painless.


B) Managing post-tooth extraction complications.

1) Bleeding.

Immediately following your oral surgery, the bleeding from your extraction site may continue, possibly even for several hours. But the amount that you notice should be ever diminishing. (Related content: Extraction-site bleeding - The first 24 hours.)

At that point 24 hours and beyond from when you had your surgery, any bleeding still taking place should only be minor. You might find some slight amount of bloody oozing or seepage coming from your extraction site. But if you notice more than that, you should be in contact your dentist so they can evaluate your status.

You'll need to make an accurate report to your dentist.

When evaluating your situation, your dentist will be interested in a description of the type and quantity of bleeding that has occurred.

They know that a small amount of blood mixed in with a larger amount of saliva will appear red. But this type of "blood" is quite different, and represents a far less quantity, than if the bleeding you've had has been dark red. Be as accurate as you can when describing your findings to your dentist so they will know what type of attention you require.

2) Swelling.

The trauma of a tooth extraction can cause postoperative swelling. Any swelling that does occurs usually reaches its peak between 24 to 48 hours after your surgery. We discuss this subject in detail here: Preventing / treating post-tooth extraction swelling.

If an extraction site's blood clot is lost, a dry socket will form.

3) Dry sockets.

One possible complication associated with having a tooth extracted is that of developing a "dry socket." This condition typically manifests itself as a dull, throbbing pain that doesn't appear until three or four days after an extraction. A foul odor or taste may be noticed too.

We've dedicated an entire Animated-Teeth.com topic to this subject. You can access it here: Dry sockets - Symptoms, causes, treatments.

4) Bone sequestra and tooth fragments.

Patients sometimes have small bone chips or tooth fragments come to the surface of their extraction site as it heals. We address this subject here: Post-extraction bone chips / tooth fragments - Causes, treatment.


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