After the Removal of Multiple Teeth

Post-Operative Instructions

**** Please read ALL of these instructions carefully! ********

Sometimes the after-effects of oral surgery are quite minimal, so not all of the instructions may apply. 

Day of Surgery

First Hour:  Bite down gently but firmly on the gauze packs that have been places over the surgical areas, making sure they remain in place.  Change them after the first 45 minutes.  If active bleeding persists, place enough new gauze to obtain pressure over the surgical site from another 30 minutes.  The gauze may then be changed as necessary. (Typically ever 30 to 45 minutes)

Exercise Care:  Do not disturb the surgical area today.  Do NOT rinse vigorously or probe the area with any objects.  You may brush your teeth gently.  DO NOT SMOKE for at least 48 hours, as this is very detrimental to the healing process and can cause dry socket.

Bleeding: Intermittent bleeding or oozing overnight is normal.  Bleeding may be controlled

Persistent Bleeding:  Bleeding should never be severe.  If so, if so it usually means the packs are being clenched between teeth only and not exerting pressure on the surgical sites.  Try repositioning the packs.  If bleeding remains uncontrolled please call our office.

Swelling: Swelling is often associated with oral surgery.  It can be minimized by using a cold pack, ice bag or a bag of frozen peas wrapped in a towel and applied firmly to the cheek adjacent to the surgical area.  This should be applied for 20 minutes on and 20 minutes off for the first 48 hours after surgery.

Pain: Unfortunately most oral surgery is accompanied by some degree of discomfort.  You will usually have a prescription for pain medication.  If you take the first pill before the anesthetic has worn off and you should be able to manage any discomfort better.  Some patients find that the stronger pain medication can cause nausea, but if you precede each pain pill with a small amount of food, chances for nausea will be reduced.  The effects of pain medication vary widely among individuals.  It is important to take the Ibuprofen you may have been prescribed as written.  Pain medication: If you find that you are taking large amounts of pain medication please call our office.  Also please note that pain medication will not be called in after business hours or on weekends.  If you anticipate needing more prescription medication, you will need to call our office during normal business hours.

Nausea: Nausea is not uncommon after surgery. Sometimes pain medications are the cause.  Nausea can be reduced by preceding the pain medication with a small amount of food and taking the pill with a large volume of water.  Try to keep taking clear fluids and minimize dosing of pain medications.

Diet: Eat any nourishing food that can be taken with comfort.  Avoid extremely hot foods.  Do not use a straw for the first few days after surgery.  It is sometimes advisable, but not absolutely required, to confine the first days intake to liquids and pureed foods.  It is best to avoid foods like nuts, seeds, popcorn, etc., which may get lodged in the surgical sites.  Over the next several days you can progress to more solid foods.  It is important not to skip meals.

Sharp Edges: If you feel something hard or sharp in the surgical areas, it is likely you are feeling the boney walls which once supported the extracted teeth.  Occasionally small slivers of bone may work themselves out during the following week or so.  If they cause concern or discomfort, please call the office.

Instructions for the second and third days

Mouth Rinses: Keeping your mouth clean after surgery is essential .  Use 1 teaspoon of salt to a small glass of warm water and gently rinse.  Repeat at least 2-3 times daily until you return for your follow up visit with us.


Brushing: Begin your normal oral hygiene routine as soon as possible after surgery.  Soreness and swelling may not permit vigorous brushing, but please make every effort to clean your teeth within the bounds of comfort.

Hot Applications:  Beginning the third day after surgery you should start placing a warm moist compresses over the areas of swelling for 20 minutes at a time several times a day to help soothe tender areas.  This will also help decrease swelling and stiffness.

Healing: Normal healing after tooth extraction should be as follows:  Most people experience the most swelling and soreness on the third and fourth days following surgery.  The remainder of the post-operative course should be a gradual steady improvement.  If you don’t see continued improvement, please call our office.  If you are given a plastic irrigating syringe, DO NOT use it for the first 5 days.  Then use it daily according to the instructions until you are certain the tooth socket has closed COMPLETELY and that there is not a chance of any food particles lodging in the socket.


It is our desire that your recovery be as smooth and pleasant as possible.  Following these instructions will assist you, but if you have questions about your progress, please call our office.  A 24-hour answering service is available to contact the doctor on call after hours.  Calling during office hours will afford a faster response to your questions or concerns.

PLEASE NOTE: Telephone calls for narcotic prescriptions (pain medication) renewal are ONLY accepted during regular office hours.