After a tooth extraction

Removing a tooth, and especially an impacted wisdom tooth, is surgery. Following these instructions carefully keeps pain, swelling and the risk of infection down.

Straight after the extraction

• Keep the gauze pad over the socket for an hour, then take it out and throw it away. Do not spit it out.
• Do not rinse hard or touch the area. Either can dislodge the blood clot that has formed and start the bleeding again.
• Take the painkiller we prescribed as soon as you feel discomfort, usually as the numbness wears off.
• Keep the day of surgery quiet, and go back to your normal routine when you feel comfortable.
• Until the numbness wears off, take care not to bite your lip or tongue.

Bleeding

• Some bleeding is expected. Slight oozing, or redness in the saliva, is common.
• Frequent rinsing and spitting makes bleeding worse. Avoid both.
• If it bleeds more, put a gauze pad over the socket and bite firmly for 30 minutes. Repeat if needed. Sit upright, stay calm and avoid exercise.

Swelling, bruising and a stiff jaw

• Swelling around the mouth, cheeks, eyes and the side of the face is the body’s normal reaction to surgery. It usually shows the day after and is at its largest two to three days after.
• On the day of surgery, hold an ice pack wrapped in a cloth against the side of your face, 15 minutes on and 15 minutes off.
• From 36 to 48 hours after surgery, moist heat (a warm, damp cloth on the side of the face) helps the swelling go down.
• Bruising in black, blue, green or yellow can appear two to three days after, as blood spreads under the skin. It is normal, and moist heat helps it fade.
• A stiff jaw that makes it hard to open your mouth for a few days is normal and settles with time. So does a sore throat or pain when swallowing, usually within two to three days.

Food and drink

• Do not use a straw; drink from a glass. Sucking can pull the clot out.
• Eat soft food, chewing away from the socket. Try not to skip meals: you heal faster and feel stronger when you keep eating.
• High-calorie, high-protein food helps. Drink at least 5 to 6 glasses of fluid a day.
• No alcohol while you are healing and taking medicines.

Keeping your mouth clean

• No rinsing of any kind on the day of surgery. You can brush that night, gently, keeping away from the socket.
• From the day after, rinse gently 3 to 4 times a day, especially after eating, with warm salt water: a teaspoon of salt in a cup of warm water.
• The socket fills in with new tissue over the next month. Keep it clean after meals with salt-water rinses or a soft toothbrush.

Medicines

• If we prescribed an antibiotic, take it as directed. Stop it and call us if you get a rash or another unusual reaction.
• If you feel sick or vomit, take nothing by mouth for an hour, including medicines. Then sip tea or a ginger drink slowly over 15 minutes. Once the nausea settles, go back to soft food and your medicines.
• A slightly raised temperature just after surgery is common. Paracetamol, taken as the packet says, helps bring it down. If the temperature lasts, call us.

What can feel strange, but is normal

• Numbness of the lip, chin or tongue is usually temporary. You can bite a numb lip without feeling it, so be careful.
• Sharp edges you feel with your tongue are the bony walls that held the tooth, not roots. They usually smooth out on their own; if not, we can remove them.
• Dry, cracked corners of the mouth from being stretched: keep your lips moist with petroleum jelly.
• Dizziness. Not eating before surgery, and painkillers, can make you light-headed. Sit for a minute before standing up from lying down. If you exercise, start gently and stop if you feel light-headed.

Stitches

• Stitches help control bleeding and healing. If one comes loose, that is not a problem: take it out of your mouth and throw it away.
• We remove the rest about a week after surgery. It takes a minute, needs no injection and does not hurt.

A dry socket

A dry socket is when the blood clot comes out of the socket too early. Pain at the socket, sometimes spreading to the ear, starts two to three days after surgery. Call us and we arrange to see you: a simple dressing in the socket eases it.

Every mouth is different. If something worries you, ask us rather than friends: we know your case.