Tooth Extractions

You and your doctor may determine that you need a tooth extraction for any number of reasons. Some teeth are extracted because they are severely decayed. Others may have advanced periodontal disease or are broken in a way that cannot be repaired. Other teeth may need removal because they are poorly positioned in the mouth (such as impacted teeth) or in preparation for orthodontic treatment.

The removal of a single tooth can lead to problems related to your chewing ability, problems with your jaw joint, and shifting teeth, which can have a major impact on your dental health.

To avoid these complications, we will discuss alternatives to extractions as well replacement of the extracted tooth.

The Extraction Process

At the time of extraction the doctor will need to numb your tooth, jawbone, and gums that surround the area with a local anesthetic.

During the extraction process you will feel a lot of pressure. This is from the process of firmly rocking the tooth in order to widen the socket for removal.

You feel the pressure without pain as the anesthetic has numbed the nerves stopping the transference of pain, yet the nerves that transmit pressure are not profoundly affected.

If you do feel pain at any time during the extraction, please let us know right away.

Sectioning A Tooth

Some teeth require sectioning. This is a very common procedure done when a tooth is so firmly anchored in its socket or the root is curved and the socket can’t expand enough to remove it. The doctor simply cuts the tooth into sections then removes each section one at a time.

Wisdom Teeth Extractions Post-Op Instructions

The removal of impacted teeth is a serious surgical procedure. Post-operative care is very important. Unnecessary pain and the complications of infection and swelling can be minimized if the following instructions are followed. Immediately Following Surgery

  1. The gauze pad placed over the surgical area should be kept in place for 30 minutes, and then changed with clean, damp gauze until the bleeding stops.
  2. Mouth rinsing, brushing teeth or touching the wound area following surgery should be avoided. This may initiate bleeding by causing the blood clot that has formed to become dislodged.
  3. Take the prescribed pain medications as soon as you begin to feel discomfort. This will usually coincide with the local anesthetic becoming diminished.
  4. Restrict your activities the day of surgery and resume normal activity when you feel comfortable.
  5. Place ice packs on the outside of your face where surgery was performed to reduce swelling. Leave the ice pack on for 20 minutes, then off for ten minutes. This can be repeated up to 24 hours.


A certain amount of bleeding is to be expected following surgery. Slight bleeding, oozing, or redness in the saliva is not uncommon. Excessive bleeding may be controlled by placing the damp gauze over the area and biting firmly. Change the gauze every 30 minutes. If bleeding continues, bite on a moistened tea bag for thirty minutes. The tannic acid in the tea bag helps to form a clot by contracting bleeding vessels. To minimize further bleeding, do not become excited, sit upright, and avoid exercise. If bleeding does not subside, call for further instructions.


The swelling that is normally expected is usually proportional to the surgery involved. Swelling around the mouth, cheeks, eyes and sides of the face is not uncommon. This is the bodys normal reaction to surgery and eventual repair. The swelling will not become apparent until the day following surgery and will not reach its maximum until 2-3 days post-operatively. However, the swelling may be minimized by the immediate use of ice packs. Two baggies filled with ice, or ice packs should be applied to the sides of the face where surgery was performed. The ice packs should be left on for twenty minutes and then off for ten continuously. After 24 hours, ice has no beneficial effect. If swelling or jaw stiffness has persisted for several days, there is no cause for alarm. This is a normal reaction to surgery. Thirty-six hours following surgery, the application of moist heat to the sides of the face is beneficial in reducing the size of the swelling.


For moderate pain, two to four 200mg tablets of ibuprofen (Motrin or Advil) may be taken every 4-6 hours. For severe pain, take the tablets prescribed as directed. The prescribed pain medicine may make you groggy and will slow down your reflexes. Do not drive an automobile or work around machinery. Avoid alcoholic beverages. Pain or discomfort following surgery should subside more and more every day. If pain persists, it may require attention and you should call the office.


After the procedure, liquids should be initially taken. Do not use straws. Drink from a glass. The sucking motion can cause more bleeding by dislodging the blood clot. You may eat anything soft by chewing away from the surgical sites. High calorie, high protein intake is very important. Nourishment should be taken regularly. You should prevent dehydration by taking fluids regularly. Your food intake will be limited for the first few days. You should compensate for this by increasing your fluid intake. At least 5-6 glasses of liquid should be taken daily. Try not to miss a single meal. You will feel better, have more strength, less discomfort and heal faster if you continue to eat. Caution: If you suddenly sit up or stand from a lying position you may become dizzy. If you are lying down following surgery, make sure you sit for one minute before standing.

Keep Your Mouth Clean

No rinsing of any kind should be performed until the day following surgery. The day after surgery you can brush your teeth, being careful not to brush near the surgical site. You should also begin rinsing at least 5-6 times a day, especially after eating, with a cup of warm water mixed with a teaspoon of salt or Peridex rinse as directed.


In some cases, discoloration of the skin follows swelling. The development of black, blue, green, or yellow discoloration is due to blood spreading beneath the tissues. This is a normal post-operative occurrence, which may occur 2-3 days post-operatively. Moist heat applied to the area may speed up the removal of the discoloration.


If you have been placed on antibiotics, take the tablets or liquid as directed. Antibiotics may be given to help prevent infection. Discontinue antibiotic use in the event of a rash or other unfavorable reaction. Call the office if you have any questions.

Nausea and Vomiting

In the event of nausea and/or vomiting following surgery, do not take anything by mouth for at least an hour including the prescribed medicine. You should then sip on coke, tea or ginger ale. You should sip slowly over a fifteen-minute period. When the nausea subsides you can begin taking soft foods and the prescribed medicine.

Other Complications

  1. If numbness of the lip, chin, or tongue occurs there is no cause for alarm. As stated before surgery, this is usually temporary in nature. You should be aware that if your lip or tongue is numb, you could bite it and not feel the sensation. So be careful.
  2. Slight elevation of temperature immediately following surgery is not uncommon. If the temperature persists, notify the office.
  3. You should be careful going from the lying down position to standing. You were not able to eat or drink prior to surgery. It was also difficult to take fluids. Taking pain medications can make you dizzy. You could get light headed when you stand up suddenly. Before standing up, you should sit for one minute then get up.
  4. Occasionally, patients may feel hard projections in the mouth with their tongue. They are not roots, they are the bony walls which supported the tooth. These projections usually smooth out spontaneously. If not, they can be removed by your doctor.
  5. If the corners of your mouth are stretched, they may dry out and crack. Your lips should be kept moist with an ointment such as Vaseline.
  6. Sore throats and pain when swallowing are not uncommon. The muscles get swollen. The normal act of swallowing can then become painful. This will subside in 2-3 days.
  7. Stiffness (Trimus) of the jaw muscles may cause difficulty in opening your mouth for a few days following surgery. This is a normal post-operative event that will resolve in time.


Sutures are placed to minimize post-operative bleeding and to help healing. Sometimes they become dislodged, this is no cause for alarm. Just remove the suture from your mouth and discard it. The sutures will dissolve on their own in approximately 5-7 days.

The pain and swelling should peak on the third day and subside more and more each day. If your post-operative pain or swelling worsens or unusual symptoms occur call the office for instructions.

There will be a cavity where the tooth was removed. The cavity will gradually fill in with the new tissue over the next month. In the mean time, the area should be kept clean especially after meals with salt-water rinses or a toothbrush.

Your case is individual, no two mouths are alike. Do not accept well intended advice from friends. Discuss your problem with the persons best able to effectively help you, our doctors.

Brushing your teeth is okay after 24 hours. Avoid the surgical site for the first couple of days.

A dry socket is when the blood clot gets dislodged prematurely from the tooth socket. Symptoms of pain at the surgical site and even pain to the ear may occur 2-3 days following surgery. Call the office if this occurs.

If you are involved in regular exercise, be aware that your normal nourishment intake is reduced. Exercise is not recommended the day of the surgery because it will increase bleeding and swelling.

Please call the office at 360-943-4644 if you have any questions or concerns.

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