After wisdom teeth removal

Why does the clot matter more than anything else?

A socket heals from the blood clot that forms in it. The clot covers the bone, keeps the area comfortable and is the scaffold everything else builds on. Lose it early and you get dry socket: exposed bone, a deep ache that often runs to the ear, and a bad taste, typically starting a few days after the tooth came out rather than straight away.

Almost every instruction below exists to protect that clot. Suction pulls it out, which is why straws, spitting and smoking are the three things worth being strict about. If it does happen, ring us. Dry socket is treatable and we will see you, and it settles much faster once it has been dressed.

The first 24 hours

• Bite firmly on the gauze for a solid 30 minutes without checking it. Replace it if bleeding continues, and use a damp tea bag if you have run out of gauze.
• Do not rinse, spit or use a straw, and do not smoke. Let saliva dribble out rather than spitting it.
• Cold on the cheek, 15 minutes on and 15 minutes off, while you are awake. It does more for swelling on day one than at any other time.
• Stay ahead of the pain. Take what your dentist recommended before the numbness goes, then keep to the packet directions. Ask a pharmacist if you take other medicines.
• Head up, and take it easy. An extra pillow tonight, no heavy lifting, no exercise, no alcohol.
• Eat cool and soft once the numbness has gone, and keep anything hot for tomorrow.
• If you had sedation, someone must take you home, and you must not drive, work or sign anything for the rest of the day. How sedation works here.

Day two to day seven

This is the stretch people are least prepared for, because it often looks like going backwards. Swelling builds into day two or three, your jaw is at its stiffest, and bruising can come out along the cheek or jawline. From about day three it turns, and each day is better than the last.

• Start warm salty rinses from the day after: hold and tip your head gently, do not swish hard, especially after meals.
• Keep brushing the rest of your teeth normally. Go carefully near the sockets, and do not aim a brush into them.
• Warmth from day three is more comfortable than cold for a stiff jaw.
• Open gently. Move the jaw a little through the day so it does not seize, without forcing it.
• Keep smoking off the table for as long as you can manage. This is the single change that most lowers your chance of dry socket.
• Watch the direction of travel. Getting better is the point. Pain that climbs after day three is the sign to ring us.

What can you eat?

For the first day or two: yoghurt, smooth soup once it has cooled, mashed potato, scrambled egg, custard, pasta, well-cooked vegetables, anything you can manage without much chewing. Eat with a spoon, never through a straw, and chew away from the sockets.

Skip anything with small hard bits that can lodge in a socket, such as rice, seeds, nuts, popcorn and crusty bread, until things have closed over. Build back towards normal food as your jaw lets you, rather than on a schedule.

How long does healing take?

The gum closes over the sockets within a couple of weeks, and the bone underneath keeps filling in quietly for months after you have stopped noticing. A simple extraction is mostly behind you within days; a surgical removal, or four teeth at once, takes longer at every stage.

You may feel a hollow with your tongue for a while, and food may catch there until it fills. Rinse it out gently after meals rather than poking at it.

What about the follow-up?

We check the sockets are healing and remove any stitches that need it. If you are not sure whether what you have is normal, that appointment is also the place to ask, and you do not need to wait for it: call Y3 Smiles Dental in the meantime. For what the appointment itself involved, see what happens on the day, and wisdom teeth removal for the reasoning behind taking a tooth out at all.