After Care following Extractions and Oral Surgery
After you have had a tooth extraction you need to take proper care to allow the area to heal quickly and smoothly. A blood clot needs to form to cover and protect the extraction site. Many of the tips below help the blood clot to form properly and not become dislodged.
Things to do:
It is normal for the area to be a bit tender and sore for the first few days, and in most cases standard over-the-counter pain killers are enough to ease any discomfort. Start taking painkillers immediately after the extraction and don’t wait until you are really sore! It is much easier to prevent pain than to make it go away. Normal paracetamol or ibuprofen based painkillers should suffice. If you cannot take this type of medicine, let us know and we will prescribe something suitable. It is best to avoid aspirin (e.g. dispirin) as this thins the blood and can make your mouth bleed. If standard over the counter medicine does not work, call us and we will prescribe something stronger if necessary.
An extraction can be quite traumatic for some people – so 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 for the first night following surgery, keep your head up with pillows if possible. This is to avoid raising the pressure around the extraction site, and possibly causing fresh bleeding. Do not bend over or do heavy lifting for 2-3 days.
The numbness after the extraction should wear away after a couple of hours. Sometimes numbness can persist but call us if this is the case. Prolonged numbness may be due to swelling or to a longer-lasting local anaesthetic – in this case, the effect is intentional, and will wear off eventually.
If you do have some additional or recurring bleeding – bite on a teabag which has been dampened in cold water for 20 to 30 minutes, or alternatively take and place a clean gauze pad on the area, and try and keep firm pressure on it for 20 minutes. Once the blood has clotted leave the area alone, as the clot needs to settle. If you feel the bleeding is more than it should be, please contact us.
To help the area to heal, use a chlorhexidine mouthwash or gently rinse using warm salt water (1 teaspoon of salt in a glass of warm water) after meals to avoid food catching in the area of the extraction. Spit out gently.
If you are prone to mouth infections we will have recommended an antibacterial mouth rinse. This should be used for 10 days or so following your extraction. This kills bacteria.
Be very careful when brushing near the extraction site for 3-4 days – not to dislodge or damage the fragile blood clot! It may be easier to 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), use a mouthwash as a temporary measure.
Try to remain on a liquid or soft cold food diet for the first day or two. You could try soups at room temperature, yoghurts, fruit, milkshakes, smoothies, mashed potatoes, etc. A Vitamin C supplement may also be helpful. Also its best to avoid spicy foods, hot drinks and fizzy drinks for 3-4 days, to prevent dilating the blood vessels near the extraction site, which could result in bleeding.
If we prescribed antibiotics, follow the instructions and make sure you finish the course.
Swelling and sometimes bruising can occur after surgery, especially with wisdom teeth extractions. The worst swelling, pain and jaw stiffness normally occurs 2 or 3 days after your visit. On the day of the extraction, apply ice packs, holding them to the side of your face for 15 minutes on then 15 minutes off until bedtime. This will help to reduce swelling. Also keep your head elevated until bedtime. Moist heat after 36 hours may help jaw soreness, but keep the area as cool as possible to reduce swelling and bleeding for the first 36 hours.
Many patients are nervous about moving their mouths after a wisdom tooth removal. Try to gently keep stretching your mouth open to get it moving again as this will speed up recovery.
Things to avoid following tooth extraction
- Hot food or drinks until the numbness wears off. You will not be able to determine the temperature of hot drinks or food and you mayburn yourself.
- Poking at the extraction site. Do not brush the area the first day, though you may brush the rest of your teeth normally.
- Sucking, spitting and blowing your nose, [ for 5 to 7 days] especially if you have had a tooth removed from the top jaw behind the eye teeth. This is because positive or negative pressure could dislodge the blood clot or cause the sinus lining to rupture and cause a hole extending from your sinus into your mouth. [you usually get a foul smell or when you swallow liquids, you feel it going into and through your nose]. It is important that should you need to cough, cough with your mouth open. Should you need to sneeze, sneeze with your mouth open and if your nose starts to run, DO NOT BLOW YOUR NOSE, rather take a tissue and dab it dry. If you have a cold or allergies or anything that will make you want you blow your nose or sneeze, its best to take medication to reduce theeffect of this.
- Smoking. 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.
- Alcohol for 24 hours, as it could delay the healing process.