Dental Advice - Extractions

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I’ve just had a tooth out – what are the aftercare instructions?

1. Do not rinse out for the rest of the day to avoid disturbing the blood clot in the socket.
2. The site will be numb for some hours – occasionally the anaesthetic can take 4-6 hours to wear off – this is normal. During this time, you can eat and drink but try and avoid the area as much as possible.
3. Make sure that you do not bite your lip or tongue whilst numb and make sure that any drinks are cool enough drink safely.
4. Do not smoke until the anaesthetic has worn off and preferably for the rest of the day.
5. The site will be sore for several days – take pain relief such as paracetamol or ibuprofen until everything settles down.
6. If the socket starts to bleed find a piece of gauze and fold it up into a ball on bite on it hard for at least 20 minutes without looking. There should be some gauze included in the pack given to you at the end of your appointment.
7. Do not take vigorous exercise for the rest of the day following your extraction as this is likely to start the socket bleeding again.
8. It is advisable to rinse your mouth out with salt water to keep the area clean. Starting on the morning following the extraction, take a tumbler of warm water and dissolve a teaspoon of salt in it. Take a mouthful and gently rinse round and spit out. Finish the rest of the tumbler in the same way – this process should take around 5 minutes.
9. If you have a denture which fits around the extraction site, it is advisable to sleep in it for the first night after the extraction. This is because without the denture, the area will swell and you may not be able to get your denture back in on the following morning.
10. If the socket does not settle after 72 hours contact the surgery for advice.

Help! My extraction socket has started bleeding again.

You will normally see some blood mixed in with your saliva after the extraction. Sometimes there will be small blood clots too which will be dark red in colour. This will possibly continue for the rest of the day and is nothing to be concerned about.
If the socket starts to ooze or bleed after you have left the practice, the blood will be brighter red in colour. If this happens, take out the gauze from the post-op pack given to you at the practice. Fold a piece into a tight pad and bite on it firmly for 20 minutes. Do not move around during this time unless absolutely necessary.
Do not look at the socket again for at least 20 minutes. If the socket is still bleeding, repeat with a second piece of gauze.
If after this time the socket is still bleeding, contact the practice for further advice if still open. After the practice is closed, you have two options:
a) If the problem is minor, leave a message and we will contact you to discuss.
b) If the bleed is more significant, you will need to attend A&E for attention. Shrewsbury/Hereford/Aberystwyth are the nearest A&E departments which can offer appropriate care.

My extraction site is still painful after several days, what should I do?

It is normal for the site to be sore for 2-3 days after an extraction. You should take paracetamol 2 x 500mg, 4 times daily or ibuprofen 2 x 400mg, 4 times daily for the pain, unless your medical history prevents you from taking these drugs. If the pain isn’t improved you can take 4 doses of each drug per day, alternating the two, but only if you can safely take both drugs.
However, if the pain isn’t improving by day 3 you should contact the practice for further advice.
3. The most likely answer is that the blood clot in the socket has broken down leaving an exposed area of bone. This is called a dry socket and it can be very painful.
A dry socket is best treated by the dentist – we will gently irrigate the site to wash away any food debris and place a dressing to cover the exposed area. Sometimes this needs to be repeated several times to completely cure the problem. We do not charge for these appointments if we have extracted the tooth.
Antibiotics are not advised unless the site is swollen or pus is present.

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