After Tooth Extraction in Billerica, Westford & Worcester, MA

Immediately After Surgery

• Keep the gauze pad in place over the surgical site for 30 minutes, then remove and discard it.
  
• Do not rinse your mouth, spit, or touch the wound on the day of surgery.
  
• Begin taking over-the-counter Ibuprofen and Acetaminophen as soon as possible.
  
• If pain is not controlled by OTC medications, take the prescribed medication as directed.
  
• Avoid driving or operating machinery when taking prescription pain medication.
  
• Ice packs may be used to reduce swelling (see below).
  
• Limit activity the day of your procedure and rest in an elevated position.
  

Bleeding

Some oozing and red-tinged saliva are normal during the first 24–48 hours.

For heavier bleeding:

1. Wipe away old clots
   
2. Bite down firmly on clean gauze for 30 minutes
   
3. If needed, bite on a moistened tea bag for 30 minutes to promote clotting
   

Remain calm, stay upright, and avoid physical exertion. If bleeding does not subside, call your office location. If the bleeding is excessive and we are not available, go to the nearest emergency room.

Swelling

Swelling around the cheeks, jaw, and face is normal and often peaks on days 2–3 post-surgery.

To minimize swelling:

• Apply ice packs for the first 36 hours
  
• Use 20-minute intervals while awake
  
• After 36 hours, switch to moist heat for comfort and improved blood flow
  
• Swelling and stiffness may last several days and are expected
  

Pain Management

Pain is a normal part of healing but should improve each day.

Recommended pain relief:

• Ibuprofen (Advil, Motrin): 400–600 mg every 4–6 hours
  
• Acetaminophen (Tylenol): 325–500 mg in between ibuprofen doses
  
• For severe pain, cautiously use your prescribed medication only when OTC options are not effective
  

Avoid alcohol and store medications safely. Dispose of unused narcotics at a secure local drop box.

Diet & Hydration

After anesthesia or IV sedation:

• Start with clear liquids and soft foods
  
• Avoid hot or spicy foods, and chew away from the surgical site
  
• Focus on high-calorie, high-protein intake for healing
  
• Drink at least 5–6 glasses of fluids daily
  
• You may use a straw unless otherwise advised
  

Continue to eat even if your appetite is reduced — nourishment promotes faster healing.

Oral Hygiene

• Do not rinse or spit the day of surgery
  
• Brush your teeth gently the evening of surgery, avoiding the surgical sites
  
• Begin salt water rinses (1 tsp salt in 1 cup warm water) the day after surgery
  
• Rinse 5–6 times a day, especially after meals
  

Good hygiene reduces the risk of infection. Brushing is encouraged, but be gentle around the extraction area.

Discoloration

You may experience bruising or skin discoloration near the surgical site — this is normal. It may appear 2–3 days after surgery. Apply warm compresses after the first 36 hours to help the discoloration resolve faster.

Antibiotics

If antibiotics are prescribed:

• Take them as directed
  
• Discontinue use if you experience a rash or allergic reaction
  
• Contact our office with any concerns
  

Nausea or Vomiting

If you feel nauseated:

• Stop taking narcotic pain medication
  
• Drink clear liquids such as Gatorade, ginger ale, or tea
  
• Continue small sips until your stomach settles
  

If nausea persists, contact our office. If vomiting continues and we are unavailable, go to the emergency room.

Other Common Issues

Numbness

Numbness in the lip, chin, or tongue may occur temporarily. Be cautious not to bite these areas during recovery.

Dizziness

Move slowly from lying to sitting, and sitting to standing, especially if you haven’t eaten much.

Bone Fragments

You may feel sharp areas or small bony projections with your tongue. These usually resolve on their own but can be smoothed out if needed.

Cracked Lips

Apply Vaseline or lip balm if your lips become dry or cracked.

Sore Throat

Soreness during swallowing is common due to muscle inflammation. This typically resolves in 2–3 days.

Jaw Stiffness

Limited jaw movement (trismus) may occur. Gentle stretching and time will improve it.

Sutures

Stitches placed during your extraction help with clotting and healing. They may dissolve on their own or be removed in about a week. If they come loose early, it’s not usually a concern. Removal is painless and quick.

Healing the Socket

There will be a small hole at the extraction site. This will fill in with tissue over several weeks. Keep the area clean with salt water rinses and gentle brushing.

To learn more about what to expect from the procedure, visit our Tooth Extractions service page.

Dry Socket

A dry socket is a painful condition caused by the loss of the protective clot in the extraction site. Symptoms include:

• Persistent, throbbing pain that radiates to the ear
  
• Unpleasant odor or taste
  
• Pain not relieved by medication
  

This is uncommon but can happen. Contact our office if you suspect a dry socket or if pain increases rather than decreases.

When to Contact Us

Call our office if you experience:

• Severe or prolonged bleeding
  
• Fever that persists more than 24 hours
  
• Increasing pain or swelling after 3 days
  
• Signs of infection or dry socket
  
• Concerns about healing, medication, or sutures
  

Visit our Contact Us / Locations page to reach your local office.