Wisdom Teeth and Tooth Removal: What to Expect

After tooth extraction, regular tooth or wisdom, the first 24 hours are the most important period to ensure proper recovery. Once a tooth is removed, it leaves behind an open socket where the tooth and its roots were seated, for this socket to heal, it requires a blood clot to form inside to allow new gum and bone to grow. It is critical that this clot forms and is undisturbed otherwise a condition known as "dry socket" may develop which can be very painful requiring further treatment.

During the first 24 hours after a tooth extraction, you should avoid the following as these things can result in the dislodging or prevention of clot formation in the socket;

• Rinsing or washing your mouth
• Spitting
• Drinking from a straw
• Hot drinks
• Alcohol
• Smoking (including cannabis and vaping)
• Exercise or effort for the first 24 hours

Around 24 hours after the extraction, you should look to start doing the following:

1. Gently rinse your mouth every 4 hours and after meals with antiseptic mouthwash or use a warm salt water rinse (teaspoon of table salt in a mug of freshly boiled water, allowing it to cool until it is warm). This should be continued until the area has fully healed which can take 3-4 weeks depending on the tooth extracted and if it had to be surgically removed.
2. Keep your teeth as clean as possible, but be careful and gentle with your brushing for the first few days.
3. Eat soft, easy to chew food, preferably chewing on the other side of your mouth to where the tooth was removed for the first few days.

You may get a small amount of bleeding for the first few days. If the bleeding is persistent you should apply pressure to the area by biting hard on a rolled-up piece of gauze or clean handkerchief for 10 minutes. Make sure it is placed directly on the bleeding area. If possible, you should try to avoid rinsing your mouth for a further 12 hours. If the bleeding is profuse, or not stopping then you may need to be reviewed by your usual dentist or an emergency dentist.

Pain and discomfort are expected after tooth extraction and some swelling is to be expected. You should use simple over-the-counter pain relief such as paracetamol and ibuprofen for the first few days until the pain subsides. Ibuprofen and paracetamol are the most effective forms of dental pain relief, however, if something stronger is required, you may try co-codamol (codeine and paracetamol) after speaking to your pharmacist.

A dry socket is when the blood clot at the site of the tooth extraction does not form or is dislodged before the wound is healed. This clot serves to protect the bone and nerve endings at the bottom of the socket and allows new gum and bone to develop. When the bone and nerve are exposed, it can lead to intense pain that radiates along the nerve on the side of your face. This socket can also become inflamed and infected when food debris becomes lodged inside, adding to the pain. Dry socket pain usually develops one to three days after the extraction and cannot be treated with over-the-counter remedies.

If you begin to develop increasing pain, inflammation, swelling or suspect you are developing an infection, you should contact your dentist for advice regarding a review or further treatment.