The First 24 Hours
Bite on the gauze for at least 45 minutes. Change the gauze earlier if it becomes saturated. Continue to use the gauze as long as the area bleeds, but do not sleep with the gauze in place. Do not move your jaw until the bleeding stops. To avoid disturbing the blood clot, do not spit, rinse, use a straw or drink hot liquids. Do not smoke for as long as possible to allow healing at the blood clot. Smoking can cause dry sockets. Keep your head elevated above your chest to reduce swelling.
The most common cause of persistent bleeding is not having the gauze placed directly on the surgical site. The gauze should be placed directly on the gum behind the last molar (for wisdom teeth) or directly on the gum at the extraction site (for regular teeth). Change the gauze if it becomes saturated. Otherwise, leave it in until the bleeding changes to a small red or pink area on the gauze. Gauze may be discontinued at this point. Bleeding should be controlled before sleep at night. Do not sleep with gauze in place except during the initial 6 post-op hours while someone else is monitoring your condition. A small amount of bloody saliva is normal for the first 24-48 hours. Hint: Cover your pillow with a towel to prevent blood stains.
Take the prescription medication as directed for pain. Hint: Try not to take medication on an empty stomach, especially pain medication. You may take Motrin (ibuprofen) or aleve (naproxen) in addition to your narcotic pain medication as directed, provided you are not allergic to these medications or have stomach problems. Avoid alcoholic beverages as long as you are taking pain medication.
Do not brush your teeth until the next day. The first day after surgery you may begin to brush and floss carefully.
Nausea and Vomiting
Nausea and vomiting can occur, usually because of swallowing blood. Make every attempt to control bleeding. Medications can also cause nausea. Taking small sips of a carbonated beverage (coke) or ice chips and resting quietly will help ease an upset stomach. If liquids cause more nausea, discontinue drinking until your stomach feels more comfortable.
After 24 Hours
If the pain initially improves, then suddenly get worse, or becomes severe, a dry socket may be developing. Call the office for instructions and re-evaluation. The corners of your mouth may develop fever blisters, or become sore. This should resolve within a few days. There may be pain or difficulty opening your mouth or chewing from muscle stiffness. Your Jaw Joint (TMJ) located in front of your ear may be sore or stiff. These difficulties should gradually improve. Teeth in the area may be sensitive to hot and/or cold. This usually improves rapidly, but it may persist for several months if the adjacent tooth roots are exposed.
If you had lower teeth removed, there is a chance of persistent numbness of the lower lip or tongue. If this numbness is present after 24 hours please call the office for an examination.