Like most minor operations, teeth extractions can vary from person to person and also from tooth to tooth. Some teeth may be more difficult to remove than others, so to minimise disruption to your day-to-day activities it is important to follow the post-operative instructions given by your dentist.
There are some other helpful things you can do to aid recovery following tooth removal and to experience pain free dentistry.
Before the tooth removal
- Eat and drink beforehand. This is for two reasons. Firstly, you will be numb in the area of the extraction for several hours afterwards, which will make it difficult to eat and drink. And secondly, we understand that it can be daunting to face an extraction, so a light meal and good hydration in advance should help to avoid feeling faint during or after the procedure.*
- Take standard pain relief such as paracetamol or ibuprofen 30 minutes to one hour before the extraction. This can help to ensure pain free dentistry when your local anaesthetic wears off. Alternatively, your dentist may recommend taking pain relief as soon as the procedure is over, so make sure you have some ready to go.
- Plan to stay home. If possible, avoid booking your tooth removal appointment immediately before a major social event or holiday, as there may be post-operative issues needing to be addressed. Ideally, allow seven days before a major social or sporting event. Although most people can go on with their day as normal, it is sensible to allow for common post-operative complications such as a dry socket (see below).
*Some exceptions may apply, such as if teeth extractions are performed under general anaesthetic, intravenous sedation (sleep dentistry) or nitrous oxide (“happy gas”).
After the tooth removal
Below are some common (but not exhaustive) post-operative instructions and their justifications most likely to be given by your dentist.
- No smoking or drinking alcohol for 24 hours. Smoking increases the chance of delayed healing and of post-operative infection. It is best to avoid smoking for as long as possible until the extraction site is healed, but it is crucial in the initial healing stages. Alcohol can also increase the chance of bleeding as it increases blood pressure.
- Avoid drinking through a straw. The suction effect can increase chances of bleeding in the early healing stages.
- Avoid strenuous exercise and manual labour in the first 24 hours after teeth extractions. Again, this will increase your blood pressure, which can lead to post- operative bleeding.
- Attempt to stop any bleeding. If bleeding occurs after you have left the surgery, you can usually stop this using sterile gauze provided by your dentist. Use your finger to push the gauze into the extraction site and apply firm pressure (usually by biting) for 15 to 20 minutes. If this does not stem the bleeding, contact the dental surgery (or, if out of hours, accident and emergency) as failure for a blood clot to form can, in rare cases, indicate a clotting disorder.
- Eat soft foods, avoiding spicy or very acidic foods for comfort. Sometimes your jaw joint may ache from being held open wide for the procedure, so foods that require little chewing can be helpful. While numb, avoid very hot foods or beverages, as you can accidentally burn yourself.
- Rinse with warm salt water 24 hours after the tooth removal. As detailed on your post-operative instructions sheet, this should be done twice daily or more if required, combined with gentle tooth brushing, especially in the healing area. This helps to keep the area clean and reduce infection. However, you are advised to avoid rinsing and spitting out during the first 24 hours following tooth removal, as this can disrupt the formation of the blood clot that is necessary for healing.
What is a dry socket?
“Dry socket” or acute alveolar osteitis, is a common post-operative local infection essentially caused by the healing clot being dislodged from the extraction site. This exposes nerves and necrotic bone, which can cause symptoms of a bad taste and severe pain developing 2 to 3 days after the extraction that is not relieved with standard painkillers (and sometimes stronger ones). Dry socket is more common:
- in smokers
- if post operative instructions are not followed (i.e. avoiding rinsing and spitting in the first 24 hours after extraction)
- in patients with an impaired immune system such as diabetes
- after a difficult extraction or a surgical extraction requiring sutures
- if you have previously had a dry socket.
However, sometimes dry sockets occur for unknown reasons, so if you suspect you have the symptoms of dry socket, don’t hesitate to call your dentist, as treatment is simple and effective. Treatment typically involves cleaning out the socket and placing a sedative dressing; antibiotics are not necessarily required.
If you follow the advice above and that prescribed by your dentist, you are more likely to experience pain free dentistry.