Do Not Disturb the Area
 For the next few days, and especially the first 24 hours, it is very important to allow your body to form a good clot and start the natural healing process. Swishing, sucking through a straw, and smoking can all dislodge the clot. Keep anything sharp from entering the wound (crunchy food, toothpicks, eating utensils). Be sure to chew on the opposite side for 24 hours.
Patients who received a general anesthetic should return home from the office immediately upon discharge and lie down with the head elevated until all the effects of the anesthetic have disappeared. Anesthetic effects may vary by individual, and you may feel drowsy for a short period of time or for several hours. You should not operate any mechanical equipment or drive a motor vehicle for at least 36 hours or longer if you feel any residual effect from the anesthetic. Do not drive or use appliances or equipment that could be dangerous, such as power tools, stove, lawnmowers, or garbage disposal.
Watch out for dizziness. Walk slowly and take your time. Sudden changes of position can also cause nausea.
Do not make any important decisions. You may change your mind tomorrow.
Do not drink any alcoholic beverages. The drugs in your body may cause a reaction to alcohol and can be dangerous.
Diet: If you feel nauseated or sick to your stomach, drink clear liquids like 7-Up®, broth, apple juice, ginger ale, tea or cola, or eat Jell-O®. If these liquids do not make you sick, try eating soft foods like potatoes, rice, pasta, and cereal.
It is important to maintain an adequate intake of fluids and nourishment for optimum healing. A high-calorie, high-protein diet is recommended. Chewing may be a problem and food choice is therefore limited. If solid foods cannot be taken, supplement a balanced soft diet with 2 or 3 servings of a liquid dietary supplement such as Meritene, Ensure, Sustacal, Nutrament or Instant Breakfast (all of these products can be obtained at a pharmacy without a prescription). Drink plenty of water and avoid alcohol for 48 hours. Avoid hot or hard foods for 48 hours because these can dissolve or dislodge the clot. Avoid using straws or spitting because negative pressure created may cause premature loss of the blood clot resulting in DRY SOCKET. Some food suggestions include the following:
-Fruit Juices
-Strained or blended cooked foods, soups
-Cottage cheese, eggs
-Cooked or thinned cereals
-Pudding, custard, gelatin, ice cream, sherbet
Flying/Change in Altitude Flying after surgery is usually not a problem. Tooth removal sockets are open and to water-tight. Air can get in and out of the surgical areas, and no pressure differences should occur or cause a problem.
If these were prescribed, please take as directed until they are all gone. If you take birth control pills, their effectiveness may be decreased. Use alternate birth control methods for two months.
Swelling is normally expected after oral surgery and may be minimized by the immediate use of COLD packs for the first 8-12 hours. Apply a cold pack to the outside of the face directly over the surgical sites. Do this 30 minutes on and 30 minutes off while awake. The swelling is usually the greatest on the second to fourth day after surgery and then slowly resolves. WARM MOIST HEAT (a hot water bottle or a warm moist towel) may be used over the outside of the face 30 minutes on and 30 minutes off, starting on the SECOND DAY AFTER surgery and continuing until all swelling and/or bruising is gone.
When you leave the office, you might be biting on a gauze pad to control bleeding. Keep slight pressure on this gauze for at least 30 minutes. Don't change it during this time; it needs to remain undisturbed while a clot forms in the extraction socket. After 30 minutes you may remove it. You may bite on another gauze or a tea bag for another 30 minutes if you feel it is still bleeding. Small amounts of blood in the saliva can make your saliva appear quite red. This is normal and may be noticed the rest of the day after the procedure.
Smoking should be stopped following surgery. Healing and success of the surgery will be substantially reduced by the cigarette smoke chemicals in your body. Also the suction created when inhaling cigarettes can dislodge the clot. Smokers are at greater risk of developing a painful Dry Socket. Smoking increases the incidence of postoperative complications (specifically dry socket) and should be avoided for 1 week following oral surgery
Some discomfort is normal after surgery. To minimize pain, Take two Tylenol, Nuprin, Advil, or similar non-aspirin pain relievers every 3 to 4 hours until bedtime to maintain comfort. Take it before the anesthesia wears off. If prescription pain medication is prescribed, take it as instructed on the label. Don't exceed the dose on the label. Taking with food or milk will help reduce an upset stomach. Avoid driving or operating heavy machinery when taking pain prescriptions. Do not drink alcohol while taking prescription pain medications.
Patients should rest and avoid strenuous activities for the remainder of the day. Keeping blood pressure lower will reduce bleeding and aid healing.
The local anesthetic will cause you to be numb for several hours after you leave the office. Be very careful not to bite, chew, pinch, or scratch the numb area. Sometimes the extraction causes residual numbness or tingling for six weeks or longer.
Do not brush your teeth for the first 8 hours after surgery. After this, you may brush your teeth gently, but avoid the area of surgery for 3 days.
Avoid all rinsing or swishing for 24 hours after extraction. Rinsing can disturb the formation of a healing blood clot which is essential to proper healing. This could cause bleeding and risk of dry socket. After 24 hours you may begin gentle rinsing with a saltwater solution (1/2 teaspoon salt + 1/2 teaspoon soda + 8 ounces warm water). Avoid commercial mouthrinses.
The first phase of implant therapy has been completed; the surgical placement of your dental implant(s). Do not disturb the wound. Avoid rinsing, spitting, or touching the wound on the day of surgery. There may be a metal healing abutment protruding through the gum tissue. This is normal.
If your sinus was involved in the procedure, you should avoid blowing your nose or playing wind musical instruments for one week. Use of decongestant medications might be recommended.
Bone Graft
The following information applies when grafting material has been placed into extraction sites to help preserve your jawbone in preparation for possible implant replacement of the extracted tooth.Your bone graft is made up of many particles. You may find some small granules in your mouth for the first several days. Do not be alarmed by these. It's normal to have some of them come out of the graft site and into your mouth. There are some things you could do to minimize the amount of particles that become dislodged.
Follow-Up Appointments
You may need to return to the office to have sutures removed, or just for a brief follow-up healing check.
Please call your dentist if you have:
Uncontrollable pain
Excessive or severe bleeding
Marked fever
Excessive warm swelling occurring a few days after the procedure
Reactions to medications, especially rash, itching, or breathing problems
Following these instructions very closely will greatly help your comfort, and promote uneventful healing of the area. If any of the instructions are not followed, you might have significantly more discomfort, and the success of the procedure.