illustrations from chapter 6 of Tom Sawyer book by mark twain

Growing up, I remember being terrified of Mark Twain's fictional Aunt Polly after she tied a piece of string around Tom's tooth (and around his bed post), before lunging at him with a piece of hot coal. What a price Tom had to pay for trying to dodge school with a case of the Mondays!

"Your tooth, indeed! What's the matter with your tooth?"

"One of them's loose, and it aches perfectly awful."

"There, there, now, don't begin that groaning again. Open your mouth. Well—your tooth IS loose, but you're not going to die about that. Mary, get me a silk thread, and a chunk of fire out of the kitchen."

- Aunt Polly and Tom, The Adventures of Tom Sawyer

Fortunately for all of us, modern dental surgery has evolved significantly since the late 1800's!

These days, a general dentist can perform oral surgery, such as crown lengthening, bone grafting, soft tissue grafting or tooth extractions. Unlike Aunt Polly, we've completed dental school and have a great deal of experience and a vast array of precise instruments to help us extract teeth.

Barring anything surgical (where I have to use special instruments to cut the bone and dig around below the gum line), a tooth extraction itself is generally pretty quick and easy. Believe it or not, it usually takes longer to numb up the area than it does to actually pull a tooth. What I'm more concerned about is the 24 hours following the procedure.

Realistically, it's no different than when you were a kid and fell over and skinned your knee. We always want a clot to form and scab over, except in this case, it's probably not a good idea to pick at the one in your mouth. This is why I will ask you to bite down on a gauze pad once the tooth is out, and why you leave the office with a long list of "what NOT to do's."

Here's what you need to avoid for 24 to 48 hours after your tooth has been pulled:

1. Avoid Stress

Much like the general goal in the rest of life, the goal after an extraction is not to get your blood pressure up. Getting your blood pressure up stimulates blood flow and may push it into the empty socket, which could dislodge the clot.

So if you've had a tooth extracted, you have the perfect excuse as to why you can't help your neighbor move their heavy couch, or start marathon training (for at least two or three days at any rate).

2. Avoid Certain Medications

Don't take any medications that can cause blood thinning, such as aspirin, without your dentist's approval. It's important your dentist knows what prescription medications you take and it's likely your after care list speaks to it specifically, but if you're in doubt, call your dentist and ask!

3. Avoid Dry Socket

Dislodging the clot can lead to "dry socket" which basically means that the surgical site is left open, exposing the nerves and bone inside your gums which, in turn, can cause pain and lead to an infection (not fun).

4. Avoid CERTAIN Foods & Alcohol

The good news is that you won't have to do any extreme fasting after an extraction, but putting any sharp, hard or pokey objects into your mouth is not advised, including, but not limited to: popcorn, carrots, chips, ice, pretzels, uncooked spaghetti, and the end of your pen.

You'll also want to avoid any really spicy foods which can irritate the site and may slow down the healing process. Now is not the time to indulge in those intense dishes, even if you normally have a high tolerance for heat.

Liquids and soft foods are always a better idea! Having a tooth extracted is a great excuse to have a milkshake (with a spoon), but if you're looking for something healthier, you're also safe with scrambled eggs, soups, yogurts, fruit, smoothies and mashed potatoes.

Anything containing Vitamin A or C contributes to the healing process but while you might feel like you need a drink, unfortunately alcohol does not actually facilitate a faster recovery.

5. Avoid Sucking

Again, kind of a general goal across the board, you should avoid sucking - though in this case we mean in the literal sense. Any kind of sucking motion can dislodge the clot, so you're going to have to drink that milkshake with a spoon. And smoking is a definite no-no!

6. Avoid Brushing & Flossing, No Really

This is one of the few times that your dental office will advise you against brushing or flossing, at least in that area. But it is a good idea to gently rinse your mouth out after a meal or snack. Occasionally, we will suggest an antibacterial mouth rinse (chlorhexidine) to kill any bugs and help keep things clean. But don't rinse aggressively, either!

To Call or Not to Call . . .

Bottom line is this; as long as you follow the post-operative instructions, there shouldn't be any need to come back to the office. Our biggest concerns are if you experience excessive bleeding, swelling, or pain that can't be controlled by medication.

Interesting SideBar - We read that Ed Helms had an implant removed for that movie?! That's why it looks so realistic, because he's really missing that tooth. Talk about total dedication. And, by the way, his dentist was consulted and on board.


We'd encourage you to give your dentist a call if you've got a tooth that's bothering you, but to go to school or work if you've just got a case of the Mondays.

We'd also encourage you to read, or re-read, or listen to Mark Twain's, The Adventures of Tom Sawyer (you can find digital copies at Lit2Go).

We wouldn't, however, encourage you to see how far you can project your spit from the new gap between your teeth as a way to impress your friends.

"As Tom wended to school after breakfast, he was the envy of every boy he met because the gap in his upper row of teeth enabled him to expectorate in a new and admirable way. He gathered quite a following of lads interested in the exhibition; and one that had cut his finger and had been a centre of fascination and homage up to this time, now found himself suddenly without an adherent, and shorn of his glory."

from The Adventures of Tom Sawyer by Mark Twain

If you would like to talk about tooth extractions, give us a call at (207) 782-5308!

We'll be happy to schedule an appointment to discuss your options with you,

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Additional note: A general dentist may also refer you to an oral maxillofacial surgeon in special cases. A specialist with the multi-syllabic moniker of Oral Maxillofacial Surgeon (Oral, meaning the mouth; and Maxillofacial, meaning jaw and face; and Surgeon, meaning, well, surgeon) is trained to treat everything above your shoulders; head, neck, face and jaw. They've completed four years of dental school, followed by a hospital residency (which means they also have an M.D. after their names).

While most people associate oral surgeons with taking out wisdom teeth (sometimes called "third molars"), they actually do much more, including; inserting dental implants, treating tempomandibular jaw (TMJ) issues, trauma surgery, and cleft palate reconstruction. Don't let it scare you if we recommend an additional specialist to help treat your case! We're always looking out for your best interest.