Post-Operative Instructions for: Extractions


 1.     General information: The site where the tooth has been removed is essentially a root shaped hole containing a blood clot. Trouble-free healing is dependent on this initially fragile clot remaining undisturbed as much as possible. Most extraction sites heal with minimal trouble. Please keep turbulence in your mouth to a minimum for 24 hours after the extraction. For at least 8 hours after the extraction, do not rinse, eat, gargle or touch the wound with your fingers or tongue. You may brush your other teeth normally that evening, keeping away from the extraction site(s) but be aware that some bleeding may follow.


2.     Painkillers: You will benefit from taking an anti-inflammatory painkiller (such as Nurofen 400mg 6 hourly or Voltarol Retard 100mg 12-18 hourly) for the first 48 hours. If you are unable to take such non-steroidal anti-inflammatory drugs for medical reasons (e.g. stomach or oesophageal ulcer or moderate to severe asthma), please take 1g of Paracetamol every 6 hours for 48 hours. This can be supplemented with dihydrocodeine 20mg if required (the combination of paracetamol and dihydrocodeine is available as Co-dydramol over the counter). Paracetamol or Co-dydramol can be used in addition to the anti-inflammatory painkillers if necessary for up to three days. You should not need to take this medication for more than 4-5 days. Please inform me if pain increases after 4 days as it may indicate that an infection has occurred and requires attention.


3.     The effect of the local anaesthetic will normally wear off after 2-6 hours depending on the site anaesthetised and the amount used. Occasionally it may persist for longer. Take great care not to bite or otherwise traumatise the numb site during this time. Do not attempt to drink hot fluids for at least 8 hours. The application of heat on the day of extraction will both encourage further bleeding and swelling and can locally scald the site without your being aware of it.


4.     Please let me know the same evening if numbness persists for over 8 hours without diminishing.


5.     Bleeding: We will check that any bleeding has stopped before you leave the surgery. Be aware that movement, exertion, eating or drinking may re-start bleeding. (A small volume of blood will be present as natural washout from the socket with your saliva flow). You will be provided with sterile gauze when you leave the surgery. Please roll this into a tight bundle to use as a compress, moisten under a tap, wring out any excess water then place over the extraction site and bite down firmly for at least 10 minutes by the clock. Ensure that the gauze is applying pressure to the wound and is not merely trapped between your other teeth. If there is further bleeding, repeat with a new pack. If you feel that the wound is bleeding beyond your control or persisting into the night, please call me on my mobile. I would be grateful if this number is reserved for emergencies only.


6.     Aftercare: The following day (or at least 8 hours after bleeding has stopped), start to carry out gentle hot salt-water mouth rinses every 3-4 hours. An antiseptic mouthwash such as Corsodyl will also be of help in limiting any infection. Antibiotics are not normally required after an extraction though a covering antibiotic m have been given to you prior to surgery. Additional antibiotics may be given if any kind of additional bone graft has been carried out or a particularly extensive infection was present. Usually, these would be one or two of the following:

  • Amoxicillin 500mg three times a day (every 8 hours) for 7 days
  • Clindamycin 150mg four times a day (every 6 hours) for 7 days if you are allergic to penicillin.
  • Metronidazole 400mg three times a day (every 8 hours) for 7 days

It is important that you take and complete the antibiotic course(s) as prescribed. I would recommend daily supplements of “ friendly bacteria” by having a pot of bio yoghurt or one of the proprietary probiotic drinks available on the market.


7.     Please inform me immediately if you have any kind of skin rash or swelling, persistent abdominal pain, vomiting, or bloody stools with any of these antibiotics on the surgery number during surgery hours or on the above mobile number outside surgery hours.


8.      It is recommended that you do not plan any strenuous activity or swimming for at least 4 days after the extraction and that you avoid excessive alcohol intake. Please avoid alcohol if antibiotics have been prescribed.


9.     Please also remember that a course of antibiotics will reduce the efficacy of the contraceptive pill. Please use an additional form of contraception during and for 3 days after the course of antibiotics.


10.  If sutures have been placed, they will usually need to be removed after 7-10 days even if they are dissolvable. An appointment will be arranged for you before you leave the surgery. If sutures are left in for too long then they themselves may become a focus for future infection.




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