After an extraction

Bleeding: Bite down on the gauze we placed for 30 to 45 minutes with firm, steady pressure. Some oozing and pink-tinged saliva for a few hours is normal. Replace gauze if needed, keeping consistent pressure. Avoid repeatedly checking by opening the mouth — the clot needs to form undisturbed.

Ice: Apply ice to the outside of your face over the extraction site for 20 minutes on, 20 minutes off for the first 24 hours. This reduces swelling. After 24 hours, ice is less useful and warmth can be more helpful if swelling persists.

Pain management: Take whatever was recommended before the local anesthetic wears off, not after the pain has already started. If ibuprofen was recommended and you have no contraindications, it works well for the inflammatory component of post-extraction pain. Follow the dosing instructions given to you.

No straws, no smoking: The suction created by straws or smoking can dislodge the blood clot that is forming in the socket. This can cause dry socket, which is significantly more painful than normal post-extraction soreness. Avoid both for at least 72 hours, and ideally for the first week.

Swelling typically peaks at 48 to 72 hours after an extraction, not immediately after. Do not be alarmed if you wake up more swollen on day two than you were on the evening of the procedure — this is expected.

Starting on day two, you can rinse gently with warm salt water (half a teaspoon of salt in eight ounces of warm water) after eating. Let the rinse fall out of your mouth rather than spitting forcefully. Gentle rinsing keeps the area clean without disrupting the healing tissue.

Soft foods are easiest: yogurt, scrambled eggs, soup, mashed potatoes, pasta. Chew on the opposite side from the extraction when possible.

By day four, most people feel significantly better than the first two days. Swelling should be decreasing, and pain should be manageable with over-the-counter medication or resolving on its own.

Continue avoiding hard, crunchy, or small seed foods that can lodge in the healing socket. The socket is closing from the outside in, and small particles that get into it can cause irritation or infection. Gentle rinsing after meals continues to help.

If pain is worsening rather than improving after day three, or if you notice increasing swelling, fever, or a bad taste from the area, call us.

First 24 hours: No straws, no smoking, no forceful spitting or rinsing, no vigorous exercise (raises blood pressure and can restart bleeding), no alcohol.

First week: Hard or crunchy foods, carbonated drinks (the bubbles can disrupt the clot), small seeds (sesame, rice, poppy) that lodge in the socket, hot beverages immediately after the procedure.

Bone graft material is placed in the socket to preserve the shape of the jawbone in preparation for an implant or to support healing when significant bone was lost. It looks like fine white granules or powder in and around the socket.

It is normal for a small amount to come loose in the first few days — you may see white particles in your saliva. Do not pick at the area or try to remove what you see. The membrane or sutures holding the graft in place should not be disturbed. If significant amounts of material seem to be dislodging or if the area looks dramatically different from what was described to you, call us.

Call the same day if: Bleeding has not slowed after two hours of consistent gauze pressure. You feel numbness in the lip or chin that was not present before the extraction.

Call within 24 to 48 hours if: Pain is increasing significantly on day two or three instead of improving. You have a fever over 101°F. Swelling is increasing after day three. You notice a significant bad taste or smell from the area. You have severe, aching pain radiating to the ear or jaw with an empty-looking socket — this may be dry socket, which is treatable.