Oral surgery, such as a tooth extraction, requires specific aftercare to prevent complications and ensure a smooth recovery. The primary goal of post-operative instructions is to support the body’s natural healing process, which begins with the formation of a stable blood clot in the surgical site. Following the instructions precisely will help reduce discomfort, minimize the risk of infection, and accelerate the repair of oral tissues. Understanding which actions can disrupt this delicate initial healing phase is the most important step in successful recovery.
Actions that Disrupt the Surgical Site
The foundation of healing after oral surgery is the blood clot that forms in the socket, acting as a natural biological bandage protecting exposed bone and nerves. Any action that creates suction or mechanical force inside the mouth can dislodge this clot, leading to a painful condition known as dry socket, or alveolar osteitis.
Using a straw is a common but harmful mistake, as the sucking motion generates negative pressure that easily pulls the protective clot out of the socket. Similarly, forceful spitting or vigorous rinsing, particularly within the first 24 to 72 hours, can disturb or dissolve the newly formed clot. Instead of spitting, accumulated fluids should be allowed to gently drain from the mouth over a sink.
Patients must also resist the urge to probe the surgical area with their tongue, fingers, or any object, as this mechanical manipulation can break down the clot or introduce bacteria. Even chewing on the side of the mouth where the surgery occurred can place excessive pressure on the healing tissues and should be avoided for several days.
Prohibited Physical Activities and Habits
Physical exertion soon after surgery can negatively impact recovery by increasing blood flow and pressure throughout the body. Strenuous activities like heavy lifting, running, or high-intensity exercise should be limited for at least 24 to 48 hours. This increase in blood pressure can cause the surgical site to bleed more heavily or dislodge the clot necessary for wound closure.
Avoid bending over or engaging in activities that require the head to be positioned below the heart, which also elevates blood pressure at the surgical site. Resting with the head slightly elevated on pillows helps manage swelling and reduces the risk of post-operative bleeding.
Smoking or using any tobacco products should be avoided for a minimum of 72 hours. The act of inhaling creates the same damaging suction force as using a straw, which can physically dislodge the clot. Furthermore, nicotine constricts blood vessels, reducing the supply of oxygen and essential nutrients needed for tissue repair, while the chemicals in tobacco irritate the wound and increase the risk of infection.
Dietary and Temperature Restrictions
Selecting the wrong foods and liquids can cause mechanical irritation or thermal damage to the healing wound. Hard, crunchy, or sharp foods like nuts, popcorn, chips, and seeds must be avoided for at least the first week. These items can easily break into small, abrasive pieces that may become lodged in the socket, disrupting the clot and potentially causing infection.
Extremely hot foods and liquids, such as coffee or soup, pose a risk because they can dissolve the protective blood clot or cause a burn to the delicate tissue. All meals and drinks should be cooled to a lukewarm or room temperature before consumption. Additionally, highly acidic items like citrus juices and spicy foods can sting and irritate the raw surgical site.
Hygiene and Medication Missteps
Maintaining oral hygiene is important to prevent infection, but the initial technique must be modified to protect the wound. Patients should avoid brushing the surgical site directly for at least 24 hours to prevent physical trauma to the clot. When cleaning the rest of the mouth, a soft-bristled toothbrush should be used gently, taking care to keep the toothpaste and brush away from the healing area.
If a mouth rinse is prescribed or recommended, it should only be used after the first 24 hours, and the patient must not swish vigorously. Instead, the solution should be allowed to pool gently over the area before being tilted out of the mouth without spitting. Regarding pain management, patients should confirm with their surgeon which over-the-counter medications are safe. This is because some non-steroidal anti-inflammatory drugs (NSAIDs) or aspirin-containing products may interfere with blood clotting and increase the risk of bleeding.