Wisdom teeth and tooth removal

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:

• Gently rinse your mouth every 4 hours and after meals with antiseptic mouthwash or use a warm salt water rinse. This should be continued until the area has fully healed.
• Keep your teeth as clean as possible, but be careful and gentle with brushing for the first few days.
• 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, apply pressure to the area by biting hard on a rolled-up piece of gauze or a 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, you may need to be seen 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 acetaminophen and ibuprofen for the first few days until the pain subsides. Ibuprofen and acetaminophen are the most effective forms of dental pain relief. However, you can speak with your dentist if something stronger is required.

A dry socket is when the blood clot at the tooth extraction site does not form or is dislodged before the wound is healed. This clot protects 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 an appointment or further treatment.