After Tooth Extraction
After tooth extraction, it’s important for a blood clot to form to stop the bleeding and begin the healing process. Bite on a gauze pad for 30-45 minutes immediately after the appointment. If the bleeding or oozing still persists, place another gauze pad and bite firmly for another 30 minutes. You may have to do this several times to staunch the flow of blood.
After the blood clot forms it is important to not disturb or dislodge the clot. Do not rinse vigorously, suck on straws, smoke, drink alcohol or brush teeth next to the extraction site for 72 hours. These activities may dislodge or dissolve the clot and hinder the healing process. Limit vigorous exercise for the next 24 hours, as this increases blood pressure and may cause more bleeding from the extraction site.
After the tooth is extracted you may feel some pain and experience some swelling. An ice pack or an unopened bag of frozen peas or corn applied to the area will keep swelling to a minimum. Take pain medications as prescribed. The swelling usually subsides after 48 hours.
Pain Management Suggestions:
NSAIDs (IBUPROFEN, NAPROXEN, ASPIRIN):
- NSAIDs are by far the most effective medications for pain after oral surgery, however some patients cannot take them (due to ulcers/reflux, blood thinners, asthma, etc.).
1) Take 3 ibuprofen (Advil, Motrin) tablets (200mg each) every 6 hours as needed. Try to get the first dose taken before the local anesthetic/numbness wears off. If needed, a maximum of 4 tablets can be taken every 6 hours – up to 3,200mg per day.
2) Take 1-2 naproxen sodium (Aleve; 220mg) every 12 hours as needed. Do not exceed 4 tablets (880mg) per day.
- If you need better pain control after taking the NSAIDs (or if you cannot take NSAIDs), you should take Tylenol (acetaminophen):
3) Take acetaminophen (Tylenol) 325-1000mg every 4-6 hours as needed. DO NOT take more than 4,000mg of acetaminophen per day.
PRESCRIPTION OPIOID PAIN MEDICATIONS:
If you’ve taken adequate doses of an NSAID and/or Tylenol and feel that your pain is not tolerable, then it is appropriate to add the prescription opioid:
4) If you received a prescription for codeine (Tylenol #3) or hydrocodone (Vicodin, Norco, Lortab, etc.) – you can take that if you need better pain control.
*Be aware that these have Tylenol/acetaminophen in them, so you must be careful to be mindful of the maximum daily dose of Tylenol, which is 4,000mg.
5) If you received a prescription for oxycodone or hydromorphone/Dilaudid: these do not contain Tylenol/acetaminophen. You should be sure to try an NSAID and Tylenol before adding these medications.
- Pain from a tooth extraction usually resolves within 1-2 days, although infections can prolong pain for another day or two. If you are not seeing progress in your pain after 2 days, you should call our office.
Oral Surgery Nurse’s Line – (319) 337-8384
After Hours /Weekends – Mercy Hospital of Iowa City – (319) 339-0300, ask for the oral surgeon on call.
It is important to resume your normal dental routine after 24 hours. This should include brushing and flossing your teeth at least once a day. This will speed healing and help keep your mouth fresh and clean.