Healing advice after extractions & oral surgery
Get the best outcome with help from our friendly team
When you’ve had one or more teeth removed, it’s important to do all the right things to help the area heal quickly and smoothly. This means helping a blood clot to form, to cover the extraction site and allow the area to heal. The tips below will help the blood clot to form properly and not become dislodged.
What you SHOULD do after oral surgery
It’s normal for the area to be tender for the first few days, and in most cases simple over-the-counter pain relief is enough to ease any discomfort. Start taking painkillers immediately afterwards – don’t wait until pain sets in! It’s far easier to prevent pain than to make it go away.
The usual painkillers of choice are ibuprofen (such as Nurofen, ACT 3 and the like) and paracetamol (Panadol etc.). The regime is two x 200mg ibuprofen, followed two hours later by two x 500mg paracetamol, then two more ibuprofen two hours after that etc. If you are unable to take these (for example, asthma sufferers shouldn’t), please let us know and we can recommend an alternative.
Avoid Disprin (aspirin) as this thins the blood and can make your mouth bleed. If you’re still experiencing too much discomfort after a day or so, please contact us or your pharmacist if you feel you need something stronger.
After your surgery
Go home, take it easy for the rest of the day, and don’t exercise for at least 12 to 24 hours. If you want to lie down – and especially for the first night following surgery – keep your head up with pillows if possible. Do not bend over or do any heavy lifting for 2-3 days.
Controlling bleeding after surgery
It’s important to control excess bleeding, however note that it is normal for a little blood to discolour your saliva for the first day or two.
Usually, your dental team will place a gauze pad on the area, and you should try and keep constant, gentle pressure on it. Try to avoid talking or chewing on this pad, as this can stimulate bleeding. You should change this dressing about every 30 to 45 minutes ONLY if you have excessive bleeding. Ideally it won’t need to be changed at all.
If you need to use new clean gauze, fold it into a pad (thick enough to bite on), then moisten it and place it directly on the extraction site. Hold the gauze firmly in place by biting down on the pad or using finger pressure, for about half an hour to an hour. If this doesn’t stop the bleeding, moisten a tea bag with water and fold it in half and bite down on it for 30 minutes (the tannic acid in black tea helps stop bleeding).
Some slight bleeding for the first day or so after your extraction is normal. WARNING: Some people are freaked out by the amount of blood.
Relax – as mentioned, a small amount of blood is mixed with a larger amount of saliva, which can make it look a lot more dramatic than it is! But if you still bleed more heavily after an hour or two, contact Wickham Terrace Dental on 3831 3031.
Cleaning the site after surgery
While you shouldn’t rinse for the first 24 hours, after this initial period you may gently rinse 4 times a day using warm salt water (1 teaspoon of salt in a glass of warm water). Do not spit out forcefully! Rinse after every meal and snack, making sure that the water removes any bits of food around the area where the tooth is missing.
You may also use a chlorhexidine mouth rinse (Savacol, available in pharmacies) for 10 days or so following surgery. This kills bacteria.
Be careful not to dislodge the blood clot when you brush near the extraction site for 3-4 days. You can carefully wipe the area with a clean, wet gauze pad. If you can’t get a toothbrush into your mouth due to swelling or discomfort (after wisdom tooth removal), chlorhexidine mouthwash (see above) is a handy adjunct.
Dealing with swelling after oral surgery
Swelling and sometimes bruising can occur after surgery, especially with wisdom teeth. The worst swelling, pain, and jaw stiffness normally occur 2 or 3 days after your surgery. On the day of the surgery, apply ice packs for 15 minutes on then 15 minutes off until bedtime. This will keep swelling to a minimum. Also keep your head elevated until bedtime. Moist heat after 36 hours may help jaw soreness. Arnica (a homeopathic treatment available from pharmacies and health stores) can be taken orally and/or as a cream to help with the swelling.
After teeth removal, try to gently keep stretching your mouth open to get it moving again. It can be tempting just to not open it wide at all, but this can lead to permanent limitated opening (“trismus”). Don’t overdo the stretching, though!
What you should NOT do after oral surgery
- Don’t be tempted to rinse the area for 24 hours after tooth removal.
- Avoid hot food or drinks until the numbing wears off. You cannot feel pain while you’re numb, and these may burn your mouth. Also take care not to accidentally chew your cheek!
- Don’t poke at the extraction site! Keep your fingers and tongue away from this area.
- Avoid sucking (such as through straws), spitting, and blowing your nose (unless you really have to). This is because positive or negative pressure could dislodge the blood clot. If you have a cold or allergies or anything that will want you blow your nose or sneeze, make sure you take appropriate medications to treat them.
- Try not to smoke for as long as possible afterwards, but at the very least for the rest of the day. Smoking can interfere with the healing process, and also the sucking motion could dislodge the blood clot.
- Avoid alcohol for 24 hours, as it could delay the healing process.
FAQs about the healing process
It usually takes gum tissue about 3-4 weeks to heal, and up to 6 months for bone to heal completely. However, your pain should be lessening by the second day. Of course, this varies from person to person, and also depends on how easy or difficult the tooth removal was.
“Is there a piece of bone coming out where the tooth has been pulled?”
You may feel the sharp edge of the socket with your tongue and sometimes, little bits of bone may make their way to the surface and work their way out. This is perfectly normal and harmless. If a small bit of bone is annoying you, and you don’t want to wait until it comes out by itself, you can ask your dentist to remove it for you.
“I’m still in pain. What should I do?”
Pain that lasts for up to a week or so but is gradually getting better is normal. You could ask us or your pharmacist for stronger painkillers. Pain that starts to get worse after two days is considered abnormal and you may want to come back in and see us. This could be a sign of “dry socket”.
“What should I do about dry socket?”
A dry socket occurs when the blood clot for healing becomes dislodged, or doesn’t form. In that case, the bone and fine nerve endings are not protected and exposed to air, food, and liquids. Dry socket delays the healing process and can be very painful.
“What should I do about dry socket?”
A dry socket occurs when the blood clot for healing becomes dislodged, or doesn’t form. In that case, the bone and fine nerve endings are not protected and exposed to air, food, and liquids. Dry socket delays the healing process and can be very painful.
If you suspect you have dry socket, please contact us on 3831 3031. We will place a medicated dressing in the socket which will almost instantly relieve your pain. If the area is infected, we may also prescribe you a course of antibiotics. The medicated dressing is designed to stay in and dissolve by itself.
If you follow the “do’s” and “don’ts” we’ve talked about above, you’ll minimise your chances of getting dry socket.
“My dissolvable stitches aren’t dissolving! What should I do?”
This is a common problem with dissolving stitches. You can get us to remove them if they don’t come out by themselves. Many people are worried about the removal of the stitches (whether dissolvable or not) but it is an entirely painless process, and you won’t need any numbing for it.
To find out more about our new on-site laboratory call Wickham Terrace Dental today on 3831 3031 or contact us online now.
