• Reference Number: HEY1201/2021
• Departments: Oral Surgery, Dentistry and Max Fax
• Last Updated: 17 February 2021

Introduction

This advice sheet has been produced to give you information about mouth care following oral surgery. It is not meant to replace discussion between you and the healthcare team.  If after reading it, you require further explanation please discuss this with the healthcare team.

Cleaning your mouth

It is important to keep your mouth clean. On the first night brush your teeth as normal but avoid the operation site. Do not rinse your mouth out. In the morning after surgery, you may use a salt-water mouthwash. Dissolve a teaspoon of table salt in a cup of warm water.

As an alternative use an antibacterial mouthwash. In the days following surgery brush your teeth as usual. Be gentler around the extraction, surgery site(s) and any stitches you may have.

Food and drinks

Avoid eating whilst the area is still numb. You could accidently chew your lip and tongue. Eat only soft foods until you can chew comfortably. Avoid hot drinks and alcohol on the day of treatment. This can cause bleeding. Too hot a drink could also cause you to burn your mouth accidentally. Be careful eating hard and sharp foods such as nuts and crisps as these will potential cause bleeding and discomfort.

Activity

Oral surgery is a minor operation. Take things easy for the first few hours afterwards. We advise taking some time off work. This may need to be a few days off, if your surgery was particularly difficult. If you have had a general anaesthetic or sedation your judgement may be affected. Therefore, avoid signing legal documents for at least 24 hours. Similarly, you should not look after children or dependents, operate machinery or drive.

Smoking

Please avoid smoking on at least the day of treatment. Ideally try not to smoke for a minimum of 5 days afterwards. This will reduce the chance of having a ‘dry socket’. Dry socket is a very painful condition that can occur after dental extractions. It is more common in smokers. 

Mouth opening

Mouth opening maybe reduced after extraction of wisdom teeth and difficult lower molars. This could last for up to 2 weeks. It should improve day by day. If it does not and if you are worried contact the dentist or surgeon who treated you. 

Stitches

Your stitches are ‘dissolvable’ and should disappear on their own. This can take up to 14 days. If you are unsure or concerned telephone you dentist or surgeon for advice. Brush your sutures with your toothbrush after 4 days to help them dissolve.

Pain

Dental operations can be painful however careful your surgeon has been. The pain usually lasts 1 – 2 days after surgery. It is recommended that you use your usual painkillers from the chemist. Ideally, (if you are able to take them), is to start taking pain medication when your local anaesthetic is wearing off. Do not wait for pain to be high level before starting taking them. Evidence shows that the best pain relief is provided by taking paracetamol 500-1000mg WITH ibuprofen, 400-600mg every 6 hours. The pain should gradually improve by day. If things are not getting better please contact your dentist or surgeon for advice.

Pain can return 3 – 10 days after your surgery. Probably you have a ‘dry socket’. This is a kind of local infection that is due to food debris collecting in the socket where a blood clot has not formed properly. This requires washing out, and sometimes a dressing being placed. Antibiotics are not usually necessary. 

Bruising and swelling

You may get some bruising on your face and neck. Do not worry. This is quite normal and soon goes away. Your face may swell the first 2 days after certain operations. It will then take about 5 days to return to normal.

If you are not improving, especially if any swelling is “hard and hot” please contact your dentist or surgeon for advice. The person who carried out your treatment should have given you emergency contact telephone numbers. 

Bleeding

You may have some bleeding in your mouth even though you have been stitched. Do not be alarmed. Most bleeding will stop within 30 minutes after the operation finishes. You may notice your saliva is blood stained for a day or two afterwards. If you bleed a lot you should bite down hard, for up to 20 minutes, on any swab or gauze you were given. A rolled up clean linen handkerchief (not tissue) could also be used. Sit quietly whilst you do this. Do not rinse your mouth. If you cannot stop the bleeding, you should contact your dentist or surgeon. If you are really worried go to your local Emergency Department. 

Altered sensation, sharp shooting pain and or numbness

After some operations, your tongue or lip may be numb, tingling and or painful. This is usually only temporary and lasts for a few hours. In some cases, it may last longer or be permanent. If you have any change in sensation and or numbness, on the day after surgery please contact your treating dentist or surgeon straight away.

Some of information included in this advice sheet has been provided by the https://www.baoms.org.uk/patients/procedures/

Should you require further advice on the issues contained in this advice sheet, please do not hesitate to contact the Maxillofacial Unit (01482) 463218