Post-Operative Instructions: Oral surgery/Extractions

What to Expect After Surgery

Following a tooth extraction or other oral surgery, some bleeding, swelling, soreness, and bruising are normal. These symptoms are generally most noticeable during the first few days and should gradually improve as healing progresses.

Bleeding

• A small amount of bleeding or blood-tinged saliva is normal following surgery and may continue during the first day.
• Blood mixed with saliva can appear to be more bleeding than is actually occurring.
• Bite firmly on the gauze placed over the surgical site for approximately 30–60 minutes.
• Maintain continuous pressure and avoid repeatedly removing the gauze to check the area.
• If bleeding continues, replace the gauze with a clean piece and apply firm pressure for another 30–60 minutes.
• Remain upright and limit physical activity if bleeding persists.
• Contact our office if heavy or persistent bleeding does not improve with firm pressure.

Swelling & Bruising

• Swelling of the cheek, jaw, or surrounding tissues is expected following some surgical procedures.
• Swelling may increase during the first 48–72 hours before gradually improving.
• During the first day, apply an ice pack to the outside of your face for approximately 20 minutes at a time, followed by 20 minutes without ice.
• After the first 48 hours, warm moist compresses may help with residual swelling, bruising, or jaw stiffness.
• Bruising or discoloration of the skin may occur and generally resolves on its own.

Pain & Medications

• Some discomfort is normal following surgery.
• Take prescribed or recommended pain medication exactly as directed.
• When appropriate for you, over-the-counter medications such as ibuprofen and/or acetaminophen may be recommended.
• Follow the instructions provided by our office and do not exceed the recommended dosage.
• Take medications with food when appropriate to reduce the chance of stomach upset.
• If you were prescribed antibiotics or other medications, take them exactly as directed.
• Do not drink alcohol while taking medications that should not be combined with alcohol.
• Contact our office if pain becomes severe, progressively worsens, or is not adequately controlled with the recommended medication.

Numbness

• Local anesthetic may cause your lips, tongue, cheek, teeth, or surrounding tissues to remain numb for several hours.
• Do not chew while numb.
• Avoid biting or otherwise injuring your lips, cheek, or tongue.
• Following certain surgical procedures, particularly wisdom tooth removal, temporary numbness, tingling, or altered sensation may occasionally occur.
• Recovery can take time, and in rare cases altered sensation may be prolonged or permanent.
• Please contact our office if numbness or altered sensation persists after the local anesthetic should reasonably have worn off.

Jaw Stiffness

• Jaw stiffness and difficulty opening your mouth can occur, particularly following wisdom tooth removal or more involved surgical procedures.
• This should gradually improve as healing progresses.
• Contact our office if jaw stiffness becomes progressively worse or is accompanied by significant swelling, fever, or difficulty swallowing.

Nausea

• Nausea can occur following surgery, sedation, or certain medications.
• When appropriate for your medication, eating a small amount of soft food before taking it may help reduce stomach upset.
• Drink fluids slowly.
• Contact our office if significant nausea or vomiting persists.

Diet

• Drink plenty of fluids.
• Eat soft foods during the initial healing period.
• Good choices include:
  • Eggs
  • Pasta
  • Mashed potatoes
  • Yogurt
  • Applesauce
  • Other foods that require minimal chewing
• Avoid extremely hot foods and beverages on the day of surgery.
• Avoid chewing directly over the surgical site.
• Gradually return to your normal diet as comfort and healing allow.

Oral Hygiene

• Good oral hygiene is important, but the surgical site should be treated gently.
• Do not vigorously rinse, swish, or spit during the first 24 hours.
• Beginning the day after surgery, gently rinse with warm salt water, particularly after eating, unless you have been given different instructions.
• Continue brushing the rest of your teeth normally.
• Avoid directly brushing or disturbing the surgical site during the initial healing period.
• Do not touch or pick at the extraction site with your fingers, tongue, or other objects.

Smoking, Vaping & Tobacco

• Do not smoke, vape, or use tobacco during the healing period.
• Smoking, vaping, tobacco, and nicotine can interfere with healing.
• These products can increase the risk of postoperative complications, including dry socket.

Activity

• Rest following your procedure.
• Avoid strenuous activity for the remainder of the day.
• Gradually return to normal activity as you feel able and as directed by our office.
• If you received sedation or general anesthesia, follow the specific activity and driving restrictions provided to you.
• Do not drive or operate machinery while impaired by sedating medications.

IMPORTANT — DO NOT:

• DO NOT vigorously rinse or spit during the first 24 hours.
• DO NOT drink through a straw or create strong suction during the initial healing period.
• DO NOT smoke, vape, or use tobacco during healing.
• DO NOT touch, pick at, or disturb the surgical site.
• DO NOT chew while your mouth is numb.
• DO NOT perform strenuous physical activity immediately after surgery.
• DO NOT drink alcohol while taking medications that should not be combined with alcohol.
• DO NOT exceed the recommended dose of any medication.

When to Call Our Office

Please contact our office if you experience:

• Heavy or persistent bleeding that does not improve with firm pressure.
• Severe or progressively worsening pain.
• Pain that significantly increases several days after an extraction, particularly after initially improving.
• Swelling that continues to increase after several days rather than beginning to improve.
• Persistent or significant fever.
• Pus, drainage, foul taste or odor, or other signs of possible infection.
• Difficulty breathing or swallowing.
• Persistent numbness or altered sensation after the anesthetic should reasonably have worn off.
• Any other unexpected symptoms or concerns about your healing.

© 2026 John E. Sullivan DDS, P.C.

This document is the property of John E. Sullivan DDS, P.C. and is intended for use within this practice only.