For patients
After your surgery.
Written to be used at two in the morning by somebody who is sore and worried. Start with the block below — it is the only part you must read straight away.
01
Bleeding
A small amount of blood mixes with a lot of saliva and looks alarming. Judge it by whether a gauze pack is soaking through, not by the colour of what you spit into the sink.
- Roll a clean gauze square into a firm pad and place it directly over the socket, not just between your teeth.
- Bite firmly and hold for one full hour. Do not open to check. Checking is the single commonest reason bleeding carries on.
- Sit upright with your head above your heart. Do not lie flat, and prop yourself up on an extra pillow at night for the first two nights.
- If it is still bleeding after an hour, replace with a fresh damp pad — or a damp ordinary black tea bag, which works well — and hold for another hour.
- No rinsing, spitting, straws, smoking or hot drinks for 24 hours. All four disturb the clot.
- Still bleeding after two hours of genuine firm pressure? Call the after-hours line.
If you take a blood thinner — warfarin, apixaban, rivaroxaban, clopidogrel, aspirin or similar — you will ooze for longer than other people and that is expected. It is not a reason to stop your medication, and you should not stop it unless the doctor who prescribed it has told you to.
02
Swelling and bruising
Swelling gets worse before it gets better, and peaks around 48 to 72 hours. Day two being worse than day one is the normal course, not a setback.
First 24 hours — cold
A cold pack wrapped in a tea towel against the outside of the cheek: 15 minutes on, 15 minutes off, while you are awake. Not directly on the skin, and not overnight.
From day three — warmth
Once the swelling has peaked, switch to a warm compress and gentle warm salt-water rinses. Warmth helps the swelling and bruising disperse; cold at this stage does nothing.
Bruising
Often appears on day two or three, sometimes tracking down the neck under gravity, and frequently looks much worse than it feels. It goes yellow-green before it fades and is usually gone within two weeks.
Trismus — not being able to open
Very common after lower wisdom teeth. The muscles have been stretched and are guarding. It typically improves over seven to ten days. Gentle stretching within comfort helps; forcing it does not.
03
Pain relief and timing
The single most useful thing on this page: take the first dose before the local anaesthetic wears off, and then take it on a clock rather than waiting for pain to arrive.
| Time | Take | Why |
|---|---|---|
| Before you leave | First dose, while still numb | Getting ahead of the pain is far easier than catching up with it |
| +3 hours | The other medicine | Staggering means something is always working |
| +6 hours | First medicine again | Keeps a steady level rather than peaks and troughs |
| +9 hours | Other medicine again | Continue the alternating pattern through day two |
| Day 3 onward | Reduce as comfort allows | Most people need much less by day three |
For most dental pain, a scheduled combination of paracetamol and an anti-inflammatory gives better relief than an opioid, with fewer side effects. That is why we prescribe opioids sparingly and are happy to explain why if you were expecting one.
04
Eating and drinking
Eat. People who stop eating feel far worse, heal more slowly, and get more nausea from their medication. Cool and soft, then work upwards.
| Stage | Typically | Examples |
|---|---|---|
| Cool liquids | First few hours | Water, milk, cool soup, smoothies from a spoon — never a straw |
| Cold soft | Rest of day 0 | Yoghurt, ice cream, cold custard, mashed banana, cottage cheese |
| Warm soft | Days 1–3 | Scrambled egg, mashed potato, dhal, porridge, soft pasta, well-cooked fish |
| Soft chew | Days 3–7 | Minced meat, soft bread without crusts, tinned fruit, soft rice |
| Normal | Week 2 onward, as comfort allows | Return to your usual diet, still chewing away from the site |
Avoid for a week: anything with small hard fragments — nuts, seeds, popcorn, crisps, granola, rice with the socket on that side. They lodge in sockets and are miserable to get out.
No straws, for 5 days. The suction can lift a clot straight out of a socket, and that is how dry socket starts. Sip from a cup.
05
Keeping your mouth clean
A clean mouth heals faster. The trick is being gentle where the surgery was and completely normal everywhere else.
- Day 0: do not rinse at all. Not even water. The clot needs to be left alone.
- From day 1: warm salt-water rinses — half a teaspoon of salt in a mug of warm water — after every meal and before bed. Hold it over the area, then let it fall out of your mouth. Do not swish hard and do not spit forcefully.
- Brushing: brush all your other teeth normally from the first night. Avoid the surgical site itself for the first few days, then bring the brush closer as it becomes comfortable.
- Mouthwash: if we gave you chlorhexidine, use it as directed. It stains teeth with long use, which is why we prescribe it for a defined period rather than indefinitely.
- Irrigation syringe: if we gave you one for a lower socket, start using it around day 5 to flush food debris out, and keep going for a few weeks until the socket has closed.
06
Dry socket
Properly, alveolar osteitis. It is the commonest thing that goes wrong after an extraction, and it is the reason to read the paragraph opposite carefully.
More likely if
- the tooth was a lower wisdom tooth
- you smoke or vape
- you take a combined oral contraceptive
- you have had dry socket before
- the extraction was difficult or took a long time
How common
Published series report roughly 1–5% of extractions overall, and substantially higher figures for lower wisdom teeth in smokers. Those are literature ranges, not our results — we do not publish outcome statistics.
07
Numbness
Some numbness is the anaesthetic. Some is the nerve having been handled. Knowing which is which is mostly a matter of time.
Local anaesthetic wears off within two to six hours depending on what was used. Until it does, be careful: you cannot feel your lip or tongue, and biting or scalding them is easy and unpleasant. Take care with hot drinks.
Numbness or tingling that persists beyond that usually means a nerve near the surgical site has been bruised or stretched. After lower wisdom teeth this affects the lower lip and chin, or the tongue on that side. After lower jaw surgery it is close to universal at first.
Most of it recovers, and recovery is often slow — weeks to months, with pins and needles as the sensation returns. Altered sensation persisting beyond six months is generally considered permanent. We will have discussed this with you before your surgery, and we will keep reviewing it afterwards. Please tell us at every appointment how it is changing, because that pattern is what tells us how it is likely to end.
Numbness that comes on later, with a spreading swelling, is different and needs a call today.
08
Sinus precautions
Only if we told you they apply — after an upper back tooth, an upper implant, or a sinus graft. If we did not mention the sinus, this section is not for you.
For two weeks:
- Do not blow your nose. Wipe it instead.
- Sneeze with your mouth open, so the pressure goes out rather than up.
- No straws, no smoking, no wind instruments, no diving.
- Avoid heavy lifting and straining.
- Avoid flying if you reasonably can.
- Use any decongestant or nasal spray exactly as we prescribed it.
A little blood-tinged fluid from the nose on that side in the first few days is expected after a sinus graft. Air or liquid passing between your mouth and nose, or a whistling noise when you breathe, is not — call us.
09
Normal, or worth a call?
| Sign | Expected | Call us if |
|---|---|---|
| Oozing pink saliva | For most of the first day, and on and off for two or three days | Bleeding that soaks a gauze pack in under 20 minutes after an hour of firm pressure |
| Swelling | Increasing until 48–72 hours, then reducing every day | Swelling that is still increasing on day four, closes your eye, or crosses your neck |
| Bruising | Appearing on days 2–4, yellow-green by day 7, sometimes tracking down the neck | Bruising with a hard, hot, spreading area |
| Pain | Worst on days 1–2, then improving each day | Pain that gets suddenly worse on days 2–5 after improving — see dry socket |
| Restricted opening | Common after lower wisdom teeth, improving over 7–10 days | Unable to open more than a finger width with fever, or unable to swallow |
| Bad taste or smell | Common for a few days while food debris clears | A foul taste with severe pain, or discharge of pus |
| Numb lip or tongue | Normal for hours after local anaesthetic; sometimes days to months after some procedures | Numbness with a spreading swelling, or numbness you were not warned about |
| Raised temperature | A mild rise in the first 24 hours | Over 38.5 °C, or any fever with increasing pain after day two |
10
Day by day.
Recovery varies a great deal between people and between procedures. This is the usual shape of it after a straightforward extraction; a graft, a full arch or jaw surgery all run longer.
Questions people actually ask
The ones that come in at night.
Specific to your procedure