Post-op instructions: Tooth extraction with bone graft

If the area is still bleeding, your dentist gave you gauze to bite on. Make sure the gauze is damp, not dry, so it doesn't stick to the clot when you take it out. Bite on it for at least 10 to 15 minutes at a time, up to 30 minutes, and switch to a fresh piece when it's soaked through. Apply light but steady pressure directly on the surgical area.

A little bleeding or oozing is normal in the first 24 hours, but most people clot within the first few hours. Things that make bleeding worse in the first day: touching the area or the stitches, not keeping firm pressure with damp gauze, rinsing, and drinking anything hot.

For the first 5 to 7 days: no straws, no spitting, no vigorous rinsing. The suction can pull the clot out of the socket and expose the bone (a dry socket), which is painful and needs further care. A bone graft or platelet-rich fibrin in the socket lowers that risk, but the same rules apply.

Don't sleep on the side of the procedure. Add an extra pillow so your head stays above your heart. Avoid bending over, lifting anything heavy, or anything that raises your heart rate and blood pressure.

Ice for the first 24 hours: ice pack on the outside of the face, 20 minutes on and 20 minutes off while awake. After 24 hours, stop icing unless the area is still throbbing. From then on you want good blood flow to the area, because that's what heals it.

Ibuprofen helps with swelling. If your surgeon prescribed a steroid for the first few days, take it exactly as written.

Some soreness is expected. Follow your doctor's instructions for pain medication. For most people that's ibuprofen (Motrin, Advil) and acetaminophen (Tylenol). They work in different ways, so they can be taken together or staggered about three hours apart. If you're taking both as directed and it isn't helping, call us.

Severe pain is not normal after this procedure. If the pain is excruciating, something may be going on in the surgical area, like an infection or a dry socket, and we want to see you.

First 24 hours: cool, soft, or liquid foods, since you can't rinse yet. After the first day, warm soft foods, chewing on the side that wasn't treated.

Until the area has healed and the stitches are out, avoid anything crumbly or crunchy (cookies, chips, popcorn, nuts) and anything with small seeds (sesame, chia, black seed). Once stitches are out, the gum is still not fully closed. Wait until it has closed over before going back to crunchy foods.

After the first 24 hours, rinse gently after every meal, even if it's just water. If you were given a prescription rinse, use it as directed. Otherwise make a salt water rinse: 1 teaspoon of salt in a cup of room-temperature water, stir, and rinse gently for about a full minute.

Don't brush directly on the surgical area or the stitches. Use a soft toothbrush on the rest of your mouth. No electric toothbrush near the area until it has fully healed; you can use it on the opposite arch if your dentist says that's fine.

Taking your prescriptions matters. Depending on your case your doctor may have prescribed an antibiotic, pain medication, a steroid for swelling, and a mouth rinse. If you were given an antibiotic, finish the whole course even if you feel fine.

Go home and rest today. Strenuous activity, gym workouts, swimming, and for some procedures even air travel can affect healing, so check with your doctor first. No smoking or nicotine of any kind while you heal. It cuts blood flow to the area and is one of the biggest causes of dry socket and failed grafts.

Call if you have pain your medication isn't controlling, pain that went away and then came back, swelling that keeps getting worse after day three, a fever, a bad taste or smell from the area, or bleeding that won't stop with pressure.