Post Operative Instructions


Bleeding after surgery may continue for several hours. The best way to stop bleeding is to fold 2 pieces of damp gauze over the extraction site and gently bite for 20-30 minutes making sure pressure is being applied to the extraction site. Rest quietly with your head elevated. If bleeding continues, use gauze for an additional 30 minutes. Bleeding should always be evaluated by looking directly at the surgical site. Pink or blood-tinged saliva may be seen for 2-3 days following the surgery and does not indicate a problem.


  • Swelling is the body’s normal reaction to surgery and healing. The swelling will not become apparent until the day following surgery and will not reach its peak for 2-3 days. After this time, the swelling should decrease but may persist for 7-10 days.
  • Swelling may be minimized by the immediate use of ice packs. Apply the ice packs to the outside of the face 20 minutes on and then 20 minutes off while awake for the first 24 hours. After 48 hours, begin use of a warm, moist compress to the cheek.
  • Swelling can also be minimized by sleeping or resting with the head elevated.


  • Unfortunately, most oral surgery is accompanied by some degree of discomfort. If you do not have an allergy to non-steroidal anti-inflammatory medications like Ibuprofen (Motrin, Advil) we recommend taking this prior to the local anesthetic wearing off.
  • More severe pain may require a narcotic pain medication. Alternate Ibuprofen and the narcotic medication. First, take narcotic medication then a couple of hours later take 400 mg (2 tablets / 200mg) of Ibuprofen. (Ibuprofen dosage may vary for younger patients. Please reference bottle for appropriate dosage based on height and weight.) Alternate these medications as prescribed.
  • While taking a narcotic pain medication you may not drive or operate mechanical machinery. The prescribed pain medication will make you drowsy. Once you feel like you can stop the narcotic, use Ibuprofen or Tylenol. All medications should not exceed the recommended dosage.
  • Discomfort should subside daily. If not, please call our office 865-410-3075.
  • Our office offers an alternate to narcotic pain medication by using EXPAREL. This medication is given at the time of surgery and prolongs the numbness for 2-3 days after surgery.
  • Click here for a short video about EXPAREL

*NOTE: If you are taking Plavix or Coumadin, do NOT take Ibuprofen or Aspirin products.



  • After general anesthetic or I.V. sedation, start with clear liquids (water, iced tea, soda, Gatorade, etc). While numb, patients should avoid hot liquids or foods. Once clear liquids are tolerated, patients may have soft foods such as applesauce, pudding or jello.
  • Once numbness wears off patients can progress to solid foods, chewing away from the surgical sites. Patients should avoid foods like nuts, sunflower seeds, popcorn, etc., which may get lodged in the socket areas. Do not use a straw for the first 3-4 days as this can disrupt the blood clot forming in the extraction site.

Fainting precaution

If you suddenly sit or stand from a lying position you may become dizzy, especially if you have not eaten or have had limited fluids. Therefore, immediately following surgery, if you are lying down, make sure to sit for at least one full minute before standing.

Oral Hygiene

  • The best way to prevent infection and ensure healing is to keep your mouth clean. Clean your mouth thoroughly after each meal beginning the day after surgery. Use a soft bristle toothbrush and toothpaste after meals and at bedtime.
  • Should bleeding resume after brushing, repeat the use of gauze as described above. Do not rinse your mouth the day of surgery.
  • Starting the day after surgery, rinsing with salt water will help healing.


For the first 48 hours you should rest and relax with no physical activity. Excessive physical activity, especially lifting, bending over, or straining should be avoided the first 3-4 days after surgery. Sleeping elevated (2-3 pillows) may help avoid additional swelling.


  • Bad breath is common and will disappear as healing occurs. Two to three days following surgery, white, possible hard tissue may be seen in the surgical site. This signifies normal, healing tissue. Complete healing of the extraction site may take 6-8 weeks.
  • When the surgery is difficult, it is necessary to retract the lips firmly, resulting in stretch abrasions in the corners of the month. These heal without scarring but can be helped with constant application of a petroleum ointment. Fever blisters can occur with even the mildest retraction and should be coated with petroleum ointment.


Sutures will resorb or fall out on their own. It is normal for a suture to come out on the day of surgery. If bleeding occurs because the sutures have fallen out, bite on gauze to apply pressure as described on the first page.


If an antibiotic is prescribed, take the tablets or liquid as directed. Take the entire prescription until gone. Antibiotics can be given to help prevent infection. Make sure to call the office if a rash or other unfavorable reaction occurs.

Tobacco and Alcohol

  • Smoking greatly increases the chances of infection and delays healing. This may also lead to dry socket and should be avoided.
  • Alcohol beverages should be avoided for at least 48 hours after surgery and should never be taken in association with an opioid pain medication.

Dry Sockets

  • If a dry socket occurs (loss of blood clot from socket) there is constant pain that may radiate to other areas including ear, jaw, and teeth. Symptoms of a dry socket do not typically occur until the 5th to 7th day after the procedure. If you do not have improvement during the first few days following the procedure, call the office. A medicated dressing may be placed or a medicated syringe may be given if the medications taken by mouth do not resolve the discomfort.
  • To help prevent a dry socket avoid vigorous rinsing, sucking on the wound, spitting, using a straw, smoking and exercising for 2-3 days after procedure. You may gently rinse your mouth with a dilute mouth rinse of your choice after one day.


Foods To Drink And Eat While Numb


  • Water
  • Juice
  • Iced Tea
  • Gatorade

  • Applesauce
  • Jell-O
  • Pudding
  • Yogurt
  • Milkshake (no straw)

Problems or Questions: Please call our office 865-410-3075 if you have a question or a problem. Our concern for you does not stop after surgery is completed. Someone is available 24 hours a day, and we will be happy to return your call within a reasonable amount of time to assist you.

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