OK, so you have just had a tooth removed, or are about to have this procedure. What do you need to do to give yourself the best chance of a speedy and painless recovery?
Your dentist will give you instructions on what to do at home, before you leave the surgery, following an extraction. It is important that you closely follow any tooth extraction aftercare instructions that the dentist gives you.
The advice is aimed at reducing any problems that may occur after the treatment, i.e. giving you the best chance of an uncomplicated recovery. Pain and bleeding are the two main possible problems which need to be controlled.
Tooth Extraction Aftercare: Pain Control
After having a tooth removed, you can expect some tenderness in the area for the first few days. Any tenderness and discomfort is usually mild and will be gone within a few days. The level of pain will vary with the difficulty and complexity of the procedure.
Take whatever pain relief your dentist recommends with the aftercare instructions and stick to the recommended dose. Non-steroidal anti-inflammatories (NSAIDs) such as ibuprofen are often the ideal choice although your dentist may prescribe something stronger. Take the first dose before the numbness has worn off after the extraction.
Do not take aspirin for pain relief after getting a tooth out, as it may make the wound bleed.
Bleeding and Clot Control
A wound in the mouth will usually bleed more than one on the skin, as the saliva prevents a scab from forming. Pressure on the wound is necessary to help form a blood clot and thus reduce the bleeding. The main aim in the few hours and days after an extraction procedure is to not disturb this clot.
The dentist will immediately place a pack for you to bite on after the tooth is removed, this will put pressure on the wound and help form a clot. Keep the pack in place for at least 20 minutes after the procedure. You can expect some oozing from the socket for about 24 hours. Even a minor amount of bleeding may appear worse than it is, as it will be mixed with a larger amount of saliva. If there is any further bleeding place some gauze (which the dentist should provide you with) on the socket and again bite on it for at least 20 minutes.
If in doubt or if bleeding goes on for more than a few hours, contact your dentist. To keep the clot undisturbed, aftercare in the first 24 hours after tooth extraction should include:
- Avoid hot drinks, and take small sips when drinking fluids. Do not use a straw (the resultant suction pressure can dislodge a clot).
- Eat soft foods in small mouthfuls.
- Do not smoke or drink alcohol.
- Do not rinse your mouth and avoid spitting.
- Take it easy. In particular avoid exercise.
- It may help to prop your head up with an extra pillow when lying down.
After this 24 hour recovery period has passed, rinse your mouth out about four times a day for 4/5 days, after meals in particular. Gently do so with a mouthwash or with warm salt water (one-half teaspoon of salt in a cup of luke-warm water). Mouth-rinsing will help to keep the area clean from debris and food, help quicken healing and reduce the chances of getting an infection.
- ‘Chlorhexidine’ gel applied to the wound site can also aid healing by killing bacteria at the site.
- Swelling may occur after an extraction, although again this is more likely with difficult procedures. Ice packs, placed on the face for 15 minutes at a time, with a 15 minute break between times, can reduce any swelling.
- If stitches are placed, they may be the type that will dissolve away over a week or two. Alternatively you may need to return to have the stitches removed. Your dental surgeon will advise you on this.
Healing Time After Tooth Extraction
The initial healing phase, which closes up the socket, usually takes 2-3 weeks. The surrounding bone can take 3- 6 months to completely settle into place. However, pain should be lessening by the second day.
As the gum tightens up faster than the bone heals, you may feel the sharp edge of the socket with your tongue. Sometimes little pieces of bone (‘spicules’ or ‘sequestra’) may make their way out from the wound. This is a normal part of the post tooth extraction healing process.
Pain that lasts a few days during recovery and up to a week is normal, so long as the pain is getting better each day. If you experience a worsening pain after about two days, this may indicate a ‘dry socket’ or some other complication, which you can read more about here.