Healing after tooth removal is usually quite straightforward. Your dentist or oral surgeon will give you personalised post-op care instructions, but below you can find some general advice.
- It is normal for the area to be tender for the first few days, and simple over-the-counter pain relief is normally enough to ease any discomfort. Start taking painkillers before the numbing has worn off – don’t wait until pain sets in. It’s easier to prevent pain than to make it go away.
- The usual painkillers of choice are ibuprofen and paracetamol. When taken together, these two drugs enhance the effect of each other because they work in different ways. Check with your dentist or another health care provider that you can take these (for example, people who have asthma shouldn’t take ibuprofen), and follow their directions. Always take ibuprofen with food or milk, as it can irritate the stomach lining otherwise. If you can’t take ibuprofen, your dentist or pharmacist will be able to recommend an alternative. Avoid aspirin (disprin) as this thins the blood and can make bleeding worse. Talk to your dentist or pharmacist if you feel you need something stronger.
- Take it easy for the rest of the day.
- Usually, a gauze pad will be placed on the area right after the extraction. Keep firm pressure on it until the bleeding has stopped. If needed, change it every 30 to 45 minutes. The amount of bleeding can look a bit scary. Relax – a small amount of blood is mixed with a larger amount of saliva, which can make it look a lot more dramatic than it really is!
- If this doesn’t stop the bleeding, dampen a tea bag (ordinary black tea, not fruit or Earl Grey) with cold water and fold it in half and gently bite down on it for 10 minutes or so. The tannin in black tea helps stop bleeding. No fancy teas, please – just an ordinary black tea bag like PG Tips!
- Some slight bleeding is normal. But if you still bleed heavily after an hour or two, go back to your dentist.
- While you shouldn’t vigorously rinse for the first 24 hours, after this initial period you can gently rinse about 4 times a day (after meals and before bedtime). This can help get rid of annoying bits of food around the area where the tooth is missing. Warm salt water is recommended. 1 You can use warm camomile tea instead if you find that the salt water stings. Spit out gently.
How to make salt water
Use a level teaspoon of salt in about 250 ml of boiled, but not scalding, water. Or boil a kettle and once cool, pour into a water bottle and add 4-6 level teaspoons of salt for use on the go.
- Stick to a liquid or soft food diet for the first day or two. Examples include soups, yoghurts, fruit milkshakes, smoothies, mashed potatoes, etc. Avoid spicy foods, very hot drinks and sodas for 3-4 days, to prevent irritation and burns.
- Be careful when brushing 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, chlorhexidine mouthwash (see below) is a handy adjunct.
- In some cases, your dentist may advise you to use chlorhexidine mouth rinse (Corsodyl in the UK, available in pharmacies, Peridex in the US, prescription-only) for 10 days or so following surgery. This kills bacteria.
- After wisdom 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 that can lead to a more permanent limited opening (“trismus”). Don’t overdo it, though!
- Don’t 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 may burn your mouth. Also, take care not to accidentally bite your cheek!
- Don’t exercise for at least 12 to 24 hours. And avoid bending over and doing heavy lifting for 2 to 3 days.
- Be gentle with the extraction site – don’t poke at it.
- Don’t spit and blow your nose more than necessary. If you have a cold or allergies which will want you to blow your nose or sneeze, you may want to take medications to treat these.
- Avoid smoking for as long as possible afterwards, but at the very least for the rest of the day. Although the extraction may have been stressful, smoking interferes with the healing process and can create pain and problems.
- Avoid alcohol for 24 hours, as it could delay the healing process.
How long does it take to recover from a tooth extraction?
Pain tends to lessen by the second day, but this varies from person to person, and also depends on how easy or difficult the tooth removal was. For some people, pain is worst on day 4, especially after more difficult wizzie extractions.
It usually takes gum tissue about 3-4 weeks to heal. The hole in the gum can last for up to 3 months, and the bone can take up to 6 months to heal completely.
You can expect some weird sensations (e.g. occasional stabbing pains or similar) while you’re healing.
Problems after Tooth Removal
Swelling and bruising
There may be swelling and sometimes bruising after surgery, especially after wisdom teeth removal. The worst swelling, pain and jaw stiffness normally happens 2 or 3 days after surgery (although after some difficult wizzie extractions, the pain is often worst on day 4).
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.
A bag of frozen peas, wrapped in a tea towel, makes for a great ice pack!
Moist heat after 36 hours may help jaw soreness. Arnica cream may also help with bruising and swelling.
Food gets stuck in the extraction site
Food will not interfere and with the healing process, and many dentists believe it is better not to touch the extraction site even if food get stuck there. However, after about 4 days, it’s quite safe to try and remove the food, if it’s annoying you.
You can try rinsing with water (and leaving the water to sit on the tooth to make the food come out). Or try a dental irrigation syringe with a curved blunt plastic end. They’re readily available online:
Don’t use sharp objects such as toothpicks!
If you still feel numb more than 6 hours later (especially after lower wisdom teeth extractions), call your dentist or oral surgeon. If you get back in within 24 hours, your dentist or oral surgeon can inject steroids into the nerve area. This can help reduce swelling and may help speed recovery. Prolonged numbness can also be due to a longer-lasting local anaesthetic – in this case, the effect is intentional, so check with your dentist or oral surgeon. Also, some people metabolise local anaesthetic more slowly and stay numb for longer.
“There’s 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.
Pain that lasts for up to a week or so but is gradually getting better is normal. You could ask your dentist or pharmacist for stronger painkillers.
If pain starts to get worse after two days, you may want to see your dentist, as this could be a sign of “dry socket”. However, after wisdom tooth extraction, pain may peak around day 3 to 6, so check with your dentist or surgeon if you’re unsure.
A dry socket (alveolar osteitis) occurs when the blood clot for healing becomes dislodged or doesn’t form. This leaves the bone and nerve endings unprotected and exposed to air, food, and liquids. Dry socket delays the healing process and can be very painful if left untreated.
The following factors increase the risk of developing dry socket:
- being a smoker
- lower tooth (especially wisdom tooth)
- difficult extraction
- being a woman.
But don’t panic! If you suspect a dry socket, see your dentist. They will place a medicated dressing in the socket. This will rapidly reduce pain.
Nowadays, dressings such as Alveogyl are designed to stay in and dissolve over several days by themselves, and there is no need for a second visit. Alveogyl is made with natural fibers, some of which may be left behind in the socket. If this happens, don’t worry – they will be dissolved away by white blood cells. If the dressing falls out, there’s usually no need to go back unless the pain returns.
Other types of dressings may need to be changed every day or two. Ask your dentist what they are using and whether you need to come back.
Don’t rinse your mouth vigorously within 24 hours of getting a dry socket dressing.
Tip: If you’re really worried, schedule the extraction for a Monday or a Tuesday. That way, you can see your dentist immediately in the unlikely event of a dry socket.
You may also like this thread on our forum: Dry socket: searching for answers as to what it looks like and feels like?
Sensitivity in teeth next to an extracted tooth
It’s not uncommon for the teeth next to an extraction site to be sensitive. This may happen when you lose a little bit of bone on the side of the tooth next to the extracted tooth, exposing a small area of the root. When the gum doesn’t cover the root, it can feel sensitive for while. It will get better in time, but if you want to hurry things along, rubbing sensitive tooth toothpaste onto the affected area will help.
“My dissolvable stitches aren’t dissolving!”
This is a common problem with dissolving stitches. Start brushing the stitches away 3-4 days after the extraction. That way, food won’t get trapped in them.
You can get your dentist 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 entirely painless and you don’t need any numbing for it:
I had them removed after 10 days so needed to cut them to take them out – cut is the wrong word it was more of a ‘snip’, I had about 6 to 8 ‘snips’ altogether for 13 extraction sites – then gently using a pair of tiny tweezers pulled them out with barely any feeling at all, kind of a little tug – please note there was NO PAIN what so ever and it took seconds. – from our message boards
Everyone was right – it just felt like a tiny tug. – from our message boards
- Get Well Soon – Helping you to make a speedy recovery after removal of wisdom teeth (Royal College of Surgeons) – An excellent 13-page instruction booklet that includes a traffic light recovery tracker.
- Advice after Tooth Removal – Patient Leaflet – A single-page PDF advice sheet for your patients (source: “Are you positive?” by Mike Gow, Dentistry Scotland Magazine, October 2008, p. 25)
You may also like:
- Soft Food Ideas
- Wizzie removal success stories – read about people’s experiences of wisdom teeth removal
- Tooth Extraction Healing Progress? With Pictures
- Pain in tooth or gum next to extracted tooth
- Removing teeth broken at the gumline
- Bone fragments and sharp protrusion after extractions
- Smoking after tooth extraction
- Pointy bits and lumps after extractions
- Bleeding weeks after extraction
- What causes random pain a week after tooth extraction?
- Stewart, M., Levey, E., and Nayyer, N. (2015). Salt water mouthwash post extraction reduced post operative complications. Evidence-Based Dentistry, Volume 16, pp 27-28.