AFTER A TOOTH IS REMOVED: THE REST OF IT

The sheet we texted you covers today and tonight. This page covers the rest of the week and beyond. Use only the parts that apply to your child. If anything here is different from what we told you in person, follow what we told you.

For bleeding, for the red flag list, and for what to do tonight, use the sheet we texted you. Do not wait on this page for those.

MORE ABOUT BLEEDING

What normal oozing looks like. Pink or blood-tinged spit is normal, and it can come and go for a day or two. A small amount of blood mixes with a lot of spit and looks like far more than it is. That does not need more gauze. Blood that runs rather than oozes is different. Use the steps on the sheet and call us.

The tea bag. If it is still oozing after two rounds of gauze, use a plain black tea bag. Wet it with cool water, squeeze it out, and have your child bite on it for 30 minutes. Tea has something in it that helps blood clot. Use a plain black tea bag, not herbal.

If your child had conscious sedation today, an adult holds the gauze or the tea bag the whole time, and it comes out before your child sleeps. That rule is on the sheet and it does not change here.

UPSET STOMACH

Some children feel sick after a tooth is removed. It usually comes from swallowed blood, an empty stomach, or the pain medicine. Give small sips of clear liquid a few at a time instead of a big drink. Plain foods first, like crackers, applesauce, or toast. Give pain medicine with a little food in the stomach. Call us if your child throws up more than a couple of times, cannot keep fluids down, or has not urinated in 8 hours.

SALT WATER RINSES

Start the morning after the appointment, not today. Half a teaspoon of salt in one cup of warm water, after meals. Have your child swish gently and then let the water fall out of the mouth over the sink instead of spitting. Keep this up for about a week. Rinsing keeps food out of the hole and keeps the area cleaner while it heals.

KEEPING THE MOUTH CLEAN

Today: brush and floss the other teeth gently. Stay off the spot where the tooth was. No hard rinsing, no mouthwash, no forceful spitting, and no poking at the area with a finger or anything else.

Starting the morning after: salt water rinses after meals, as above.

After about 3 days: start gently brushing that area too. A clean site heals better than a sore, untouched one.

EATING AFTER TODAY

Tomorrow: work back up toward normal food as your child can handle it. Softer versions of regular meals.

Until it is healed, skip: nuts, sunflower seeds, popcorn, chips, granola, and anything with small hard pieces that pack down into the hole.

Drinking matters more than eating. A child who will not eat much for a day is usually fine. A child who will not drink is not.

No straws for the first few days. Send a water bottle, not a juice box.

ICE, THEN WARMTH

Ice makes the cheek feel better. Use it.

First 24 hours: an ice pack or a bag of frozen vegetables wrapped in a thin towel, held on the cheek over the area. 10 minutes on, then 10 minutes off. Do this any time your child is awake during the first 24 hours. That includes the evening of the appointment and the next morning, not just the ride home.

After 24 hours: if the cheek is still swollen, switch to a warm, moist cloth on the same schedule, 10 minutes on and 10 minutes off.

Keep the head up, including for sleeping. Do not wake your child to ice, and do not leave an ice pack on a sleeping child.

WHAT THE NEXT FEW DAYS LOOK LIKE

Swelling usually peaks on day 2 or day 3 and then goes down. Swelling that starts or gets worse after 48 hours is not part of normal healing. Call us.

Jaw stiffness. Opening wide may be tight and sore. Most of the stiffness is gone in 1 to 2 weeks. Do not force the jaw open.

Bruising. Yellow, green, or purple bruising can show up on the cheek or jaw around day 2 to day 4, and gravity can pull it down toward the neck as it fades. It usually clears over 1 to 2 weeks. Bruising by itself is not an emergency. Firm swelling that is spreading is, and that is in the red flag box on the sheet.

What the hole looks like. Over the first week the hole where the tooth was fills with soft whitish or yellowish tissue. That is new healing tissue, not pus and not food. The gum usually closes over the top in about 2 to 3 weeks. The bone underneath takes months to fill in, and that part is silent.

BACK TO SCHOOL AND SPORT

After a simple removal, most children go back to school the next day if the pain is controlled and they are eating and drinking. Back to PE and sports after 24 hours if they feel up to it. Surgical removals take longer, and that is in the block near the bottom of this page. If you are not sure which one your child had, call us and ask.

No band or wind instruments for 3 days, because blowing hard puts pressure on the site. Send a water bottle, not a juice box.

WHEN TO CALL

Call us for anything in the red flag box on the sheet, and also for:

• Blood running rather than oozing, or gauze soaking through twice in 20 minutes, or your child looking pale, dizzy, or unusually sleepy
• Swelling that starts, or gets worse, after 48 hours
• Pain that was getting better and then gets worse after day 3, especially with a bad taste or a bad smell
• A new fever after day 3 together with worsening pain, worsening swelling, or a bad taste. One of those alone is worth a call. All of them together, call right away.
• A stitch that comes out in the first 48 hours
• Your child cannot keep fluids down
• Your child is not drinking much by the next day
• Anything that worries you. We would rather answer a question than miss something.

A temperature under 100.4°F in the first two days is common after surgery. At 100.4°F (38°C) or higher, call us.

None of this is your fault. Bleeding, swelling, and a dry socket can happen after a removal that went well and after care that was done right. If one of them happens, call us and we will take care of it.

STITCHES

Not every removal gets stitches. If your child has them:

• Most of ours dissolve on their own over 1 to 2 weeks. We will tell you which kind your child has.
• If a stitch comes out in the first 48 hours, call us.
• A loose stitch end can feel scratchy against the tongue. Leave it alone. Do not pull it and do not cut it.
• If the stitches have to be taken out, it is a short visit. Tell us if your child is nervous and we will go slow and explain each step first.

DRY SOCKET

Read this part if a permanent tooth came out today. Dry socket is something we watch for after a permanent tooth is removed. It is not what we expect after a baby tooth comes out. If your child had a baby tooth taken out and we did not tell you otherwise, you can skip this section.

A blood clot is the soft scab that forms down in the hole where the tooth was. It covers the bone underneath while the gum grows over. Dry socket is what we call it when that scab comes loose or breaks down too early and leaves the bone uncovered.

When: usually day 3 to day 5. What it feels like: pain that was getting better and then turns worse. Often a deep throbbing ache that can spread toward the ear. There is usually a bad taste or a bad smell.

How often. It is uncommon. Most people who have a permanent tooth taken out never get one. If it does happen, it is not caused by anything you did.

Smoking, vaping, and nicotine pouches. These slow healing, and they are believed to make a dry socket more likely. If your teenager uses any of them, they need to stop for at least the first week. Tell us, and tell us honestly. Nobody is getting in trouble. We just need to know what we are treating.

What we do about it. Call us. We will clean the area gently and place a medicated dressing to cover the bone. The dressing often needs to be changed more than once over the next few days. Dry socket is not an infection, and antibiotics are not the treatment for it.

IF A BABY TOOTH WAS TAKEN OUT

The tooth fairy. Yes. Your child earned this one. We will send the tooth home in a small container unless we needed to keep it. If it came out in pieces, a drawing of the tooth under the pillow works just as well. The tooth fairy takes notes from the dentist too.

Holding the space. A baby tooth holds a spot for the permanent tooth growing underneath it. When a baby molar comes out early, the teeth on either side can drift into the gap, and then the permanent tooth has nowhere to come in. If that is a risk for your child, we will make a space maintainer, which is a small metal piece cemented to a nearby tooth that holds the gap open.

If we are making one:

• We usually take the mold or scan after the gum has healed a little, often 1 to 2 weeks after the tooth comes out.
• It takes about 2 to 3 weeks to come back from the lab.
• The first few days it feels bulky and food catches on it. It usually feels less bulky after a few days.
• It stays in until the permanent tooth is ready to come in, which can be years.
• Call us if it feels loose, if a wire is poking, or if it comes out. A loose one traps food underneath, and a lost one lets the space close.
• Sticky candy, taffy, gum, and chewing on ice pull them off. That is the most common reason they come back to us.

Not every child needs one. If we did not talk about a space maintainer today, your child does not need one right now, and we will keep checking it at every visit.

▬▬ SURGICAL OR IMPACTED REMOVAL ▬▬

This block applies only if we told you today that your child had a surgical or impacted tooth removed. If we did not say that, skip this whole block. None of it applies to a simple removal.

What is different. For a surgical removal, the gum is opened, a small amount of bone is sometimes removed, and the tooth may be cut into pieces to get it out safely. Everything on the sheet and everything above still applies. Expect more of it and for longer.

• Swelling is greater and usually peaks on day 2 or day 3, then goes down.
• Jaw stiffness is greater. Most of the stiffness is gone in 1 to 2 weeks.
• Plan on 2 to 3 days out of school, not one. Some children need longer.
• No PE, sports, weight training, or swimming for about a week. Ask us before your child goes back to contact sports.
• Stitches are more likely, and there are usually more of them.
• Bruising on the cheek and jaw is common.

Rinsing with a syringe (only if we gave you one)

If we left the site open instead of closing it, we may send you home with a small curved-tip syringe.

• Do not start until 48 hours after the surgery. Starting earlier can wash out the scab that is protecting the hole.
• Fill it with plain tap water. Nothing else. No salt, no peroxide, no mouthwash.
• Rest the tip at the opening. Do not jam it down inside. Flush gently until the water runs clear.
• Four times a day, after meals and before bed, through day 7.

Why we ask: food packs down into an open site, and rinsing it out keeps the area cleaner while it closes.

Numbness of the lip or chin that lasts

Lower wisdom teeth sit close to a nerve that gives feeling to the lower lip, chin, and gums on that side. Sometimes that nerve gets bruised during the removal. When it does, the lip or chin feels numb, tingly, or just different, and it lasts longer than the normal few hours.

If the lip or chin is still numb 12 hours after the appointment, call us. We will see your child, map out and write down exactly where the numbness is, and follow it over time. When feeling does come back, it comes back slowly, and we will stay with you through it.

If the numbness is not clearly getting better, we will refer your child to an oral and maxillofacial surgeon. That referral is time-sensitive, so we will not wait to see what happens. Do not wait this one out on your own. We want to know.

Nicotine

No smoking, vaping, or nicotine pouches for at least the first week. See the dry socket section above for why.

Reviewed August 2026