Sometimes, teeth need to be removed due to decay, disease, or trauma. Having a tooth "pulled" is called a tooth extraction. When you have an extraction, it's natural that changes will occur in your mouth. 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.
Before the extraction, you will be given an anesthetic to reduce your discomfort . Your mouth will remain numb for a few hours after the extraction. While your mouth is numb, you'll want to be careful not to bite your cheek, lip, or tongue. Do not eat any foods that require chewing while your mouth is numb. The numbness should go away within several hours. If it doesn't, contact your dentist.
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. This gauze pack should be left in place for 30 - 45 minutes after you leave the dentist's office.
Do not chew on the pack. There may be some bleeding or oozing after the pack is removed.
If so, here's what to do:
-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.
-Apply pressure by closing the teeth firmly over the pad. 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.
- Do not rinse your mouth vigorously, or drink through a straw for 24 hours. These activities create suction in the mouth, which could loosen the clot and delay healing.
-Avoid alcoholic beverages or mouthwash containing alcohol for 24 hours.
- If you are a smoker, talk to your dentist before the surgery on the ways to quit. You should not smoke after surgery.
- 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. 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. This will help get 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 8oz. 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.
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 still have some discomfort and notice some swelling. This is normal. To help reduce swelling and pain, try applying an ice bag or cold 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
After the extraction, drink lots of liquids and eat soft, nutritious foods. 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. For the first few days, try to chew food on the side opposite the extraction site. When it feels comfortable, you should resume chewing on both sides of your mouth.
If you have sutures that require removal, your dentist will tell you when to return to the office.
Scaling and Root Planing
In an effort to treat your periodontal (gum) disease, we have done a procedure in your mouth that required us to clean the tooth beneath your gum line. This can often cause some soreness of the gums and teeth for a couple of days. To minimize any discomfort and encourage proper healing following your scaling and root planing procedure, please follow these instructions:
WHILE NUMB: After the procedure but before the anesthetic wears off, take aspirin, acetaminophen (Tylenol®), or ibuprofen (Advil®) as you would for a headache. If needed, you can continue to take one or two tablets every four hours for the next few days.
HOME CARE: A saltwater solution (1/2 teaspoon salt + 1/2 teaspoon soda + 8 ounces warm water) swished in your mouth for 2 to 3 minutes a couple of times each day for two or three days will make your mouth more comfortable and aid the tissue in tightening up around the tooth structure.
Use a soft toothbrush at least two times a day. Be gentle and clean thoroughly. Slight bleeding while brushing may occur as the tissues begin to heal. Floss daily as demonstrated in our office.
Crowns and Bridges
You have just had some crowns or fixed bridges cemented onto your teeth. They will replace your missing tooth structure or missing teeth, and they should provide you with years of service, if you observe the following instructions.
WHILE NUMB: Avoid chewing anything until the numbness is gone. This will prevent you from accidentally chewing on your numb tissue, which can cause bruising, soreness, and swelling. Take whatever over the counter medication you typically take for a headache before the numbness is gone. This will help reduce any soreness.
CHEWING: Do not chew hard or sticky foods for 24 hours. The cement must mature to its optimum strength. It is best always to avoid chewing or biting on anything hard like ice. This could damage your restoration.
Pulpotomy / Chrome Crowns
We have just completed a procedure called a pulpotomy on your child. Simply put, we have removed most of the pulp (nerve) from the inside of the tooth, placed a soothing medication, and covered it with a stainless steel crown. This procedure was done on a deciduous tooth (baby tooth) and will shed at some point in the future. In the meantime, this pulpotomy and crown will save the natural spacing in your child’s arch for the permanent tooth, and it will allow them to chew more effectively.
WHILE NUMB: Do not allow your child to eat anything until the anesthesia has worn completely off. This will prevent them from accidentally chewing the numb tissue which can cause bruising, soreness, and swelling. Also watch them carefully while they are numb; if you see them chewing on their numb cheek or tongue, please stop them.
Before the anesthesia wears off, please give your child whatever over-the-counter medication you would give them for a headache. Ibuprofen or Tylenol is usually quite effective. Please call our office at any time if you have any questions or concerns.
Silver Fillings (Amalgam Filling)
We have just removed diseased tooth structure from your tooth or teeth and placed one or more silver amalgam restorations. This silver material should provide you with years of service; however, you should be aware of the following information about your new restorations:
CHEWING: They do not have their maximum strength for 24 hours. Chew only soft foods on the new restorations for 24 hours.
SENSITIVITY: Metals conduct heat and cold faster than tooth structure; therefore, you may experience sensitivity to hot and cold foods for a few days to a number of weeks. This sensitivity should begin to disappear gradually. If it does not do so, please contact us.
BITE: If you feel that your bite is not correctly balanced, please call for an appointment for a simple adjustment. The finished restoration may be shaped slightly different than the original tooth. Your tongue usually magnifies this small difference, but within a few days it should adjust, and you should not note the difference.
We have just removed diseased tooth structure from your tooth or teeth and placed one or more teeth colored resin restorations. This high-quality material should provide you with a number of years of service; however, you should be aware of the following information about your new restorations:
CHEWING: White fillings are as hard as they are going to get when you leave the office. There is no waiting time to eat; however, it is recommended that children NOT eat until the numb feeling has disappeared. Due to the strange feeling of the anesthetic, many children will accidentally chew the inside of their lips, cheeks, or tongue, which can cause serious damage and discomfort. Please watch them carefully to prevent this occurrence.
SENSITIVITY: Sensitivity is common for a few weeks following a dental restoration. Usually, the deeper the cavity, the more sensitive the tooth will be. This sensitivity should gradually improve and disappear. If it does not, please contact our office.