Please be aware, the information on this page relates to Luton & Dunstable University Hospital

Removal of Teeth, Post-Operative Care Advice

Information for patients

This information sheet answers common questions about care after having procedure to remove single of multiple teeth. If you would like further information, or have any particular worries, please do not hesitate to ask you surgeon. In all cases, the surgeon will explain the instructions verbally to you and answer any questions you may have during the appointment.

Will I be in pain?

  • Pain is expected after extraction(s), once the effect of the local anaesthetic has worn off.
  • The effect of the local anaesthetic may last anywhere between 90 minutes to 4 hours.
  • Pain usually tends to worsen on the second or third day after surgery and improves thereafter.

Recommendation:

  • Regular over-the-counter painkillers such as Paracetamol and/or Ibuprofen are suitable for pain relief, if there are no known allergies.
  • Do not bite the lip, inside of the cheek or tongue when you are still numb as it may cause damage to these structures.

Will I have swelling or bruising?

  • It is normal to develop swelling and bruising after surgery.
  • Swelling may increase on the second or third day after surgery and resolves in about 7-10 days time.
  • Bruising can occasionally occur in some patients which tends to last longer than the swelling, although this is completely harmless.

Recommendation:

  • Ice-packs may be used over the surgery site in the first 24-48 hours to reduce the amount of swelling and bruising.
  • Keep your head elevated using multiple pillows to reduce swelling.

Will I have bleeding?

  • The sockets are checked for bleeding before discharge by your surgical team.
  • However, minimal bleeding or oozing is expected in the first 24 hours of the surgery which usually does not require attention.
  • Some blood stains on the dressing, clothes and bed linen when you sleep may be expected.
  • Some medications may increase the risk of bleeding and require precautions – please discuss this with the surgeon.

Recommendation:

  • Avoid strenuous exercise or activity and any heavy lifting for at least 72 hours. Keep your head elevated using multiple pillows to reduce swelling.
  • Do not rinse your mouth vigorously for the first 24 hours.
  • If bleeding is continuous or heavy, apply firm continuous pressure on the site of bleeding using the provided clean damp gauze for at least 15 minutes.
  • If the bleeding continues, apply pressure for further 15 minutes.
  • Contact the emergency numbers given at the end of this leaflet if bleeding continues in spite of the above measures.

How do I care for the extraction site or stitches?

  • Your surgeon will advise you if you have received any stitches, which usually dissolve in about 7-14 days time. Although some stitches may stay longer than normal.
  • On occasions, special dressing to reduce bleeding is place in the socket which will dissolve at the same time as your stitches.
  • Extra care is required if you are diabetic or immunocompromised due to your health or medications you take regularly.

Recommendation:

  • Avoid eating hard or chewy food for the first 24-48 hours. A soft diet is recommended during this period.
  • Avoid consuming hot food or drinks on the day of surgery to avoid burning yourself when you are numb.
  • Maintain strict oral hygiene by regular tooth brushing and use of mouthwash.
  • General tooth brushing (twice daily) is recommended for the first 24-48hours.
  • On the day following surgery, use the prepared warm salty mouthwash to rinse you mouth at least 3-4 times a day after every meal for 10 days.
  • Salty mouthwash my be prepared by adding and mixing 1/2 teaspoon of salt in 1 cup of warm water (250ml)
  • Alternatively, you may use a gentle mouthwash that you regularly use at home if it is more convenient.
  • Avoid scratching or traumatising your extraction socket as it may disturb or displace any healing tissue or cause bleeding.
  • Do not smoke or vape for at least 72 hours to prevent delayed healing and painful ‘dry socket’.

Will I get an infection?

  • In general, all surgeries can lead to infection, although the risk is low.
  • The risk of infection increases with poor oral hygiene, diabetes, immunosuppression, smoking/vaping, certain medications and poor wound care.
  • The common features of infection may include redness of the gums, increased pain, swelling, discharge, fever and feeling generally unwell.
  • Dry socket  is a common pain inflammatory condition where a healing clot fails to form in the extraction socket. The symptoms usually start in the first 24-48 hours. The risk is higher in patients who smoke or vape, who have had prolonged or complex extractions.
  • On occasions, some patients may be on medications which delay healing of extraction sockets. Your surgeon will perform a careful risk assessment and advise you of any additional measures required.

Recommendation:

  • Please strictly follow all the aftercare advice outlined above.
  • If you have been diagnosed with dry socket, you will require regular suitable painkillers, gentle mouthwashes and insertion of a soothing agent into the socket. Antibiotics are usually not required.
  • If signs of infection are noted, please contact the emergency numbers given at the end of this leaflet or the GDP/GP. You may require a course of antibiotics to treat the infection.

Will I need any time off work?

  • This is entirely left to the patient’s discretion and is dependent on your profession and the complexity of the surgery.
  • Longer recovery period is required if you have had the procedure under general anaesthesia.

Recommendation:

  • We do not recommend that you go back to work or university on the day of surgery.

Will I need more treatment?

  • The surgeon will advise you if more than one sitting is required to complete the planned treatment.
  • On occasions, a follow-up appointment may be provided if the procedure was deemed complex, to discuss results or if healing check was required.

Recommendation:

  • Please attend all follow-up appointments as advised to prevent discontinuity of care.
  • The follow-up appointments are organised and sent by letters. Please ensure that the receptionist has your up to date address and phone number.

Emergency contact numbers

Monday to Friday- 9am to 5pm- 01582 718062

Monday to Friday – 5pm to 9am and during weekends – Please phone the main hospital switchboard on 01582 491166 and ask for On-call Oral and Maxillofacial doctor.

Online resources

Removal of wisdom teeth – BAOS:

https://www.baos.org.uk/wp-content/uploads/2019/03/Removal-of-Wisdom-Teeth-final.pdf

Your guide to having tooth removed – NHS England:

https://www.england.nhs.uk/mids-east/wp-content/uploads/sites/7/2017/07/pt-info-leaflet-extractions.pdf