Doctor Artem Naimushin

First 24 hours

1. Gauze pad. Keep biting on it for as long as your clinician instructed, usually about 20–30 minutes. Remove it gently. Do not eat or fall asleep with gauze in your mouth.
2. If bleeding starts again, sit upright, place slightly damp clean gauze on the socket and bite firmly for 20 minutes without repeatedly checking it. If bleeding continues, contact the clinic. For heavy bleeding, seek help immediately.
3. Do not disturb the socket. Do not touch it with your tongue, fingers or objects. For the first 24 hours do not rinse, spit forcefully or drink through a straw.
4. Food and drink. After removing the gauze, if bleeding has stopped and you swallow normally, you may sip water. While numbness remains, avoid chewing and hot food or drinks.
5. Rest on the day of surgery and keep your head slightly raised when resting.

Sources: Oral Health Foundation; AAOMS.

The following days

1. Choose soft, not-hot foods such as omelette, mashed foods, yoghurt and soft fish. Chew mainly on the other side and return to normal eating gradually.
2. Keep brushing the other teeth. Be careful near the wound and do not put the brush into the socket.
3. From the next day, you may gently bathe the area with warm salty water unless your clinician gave different instructions. Do not rinse vigorously. Use medicated mouthwash only as prescribed.
4. Cold through cloth during the first day may reduce discomfort. Apply briefly with breaks; do not put ice directly on the skin.
5. Postpone intensive workouts and heavy physical work for several days. Return gradually according to the extent of surgery.
6. Do not smoke or vape while healing, especially during the first days. Avoid alcohol in the early postoperative period and when taking medicines that are incompatible with it.

Sources: BAOMS; AAOMS.

What can be expected

Soreness, swelling, bruising and some limitation of mouth opening can occur, especially after a difficult extraction. Swelling is often most noticeable on days two to three and then begins to reduce. After wisdom tooth removal, residual soreness and stiffness can last up to two weeks. Overall, you should gradually feel better.

Sources: BAOMS.

When to contact the clinician

Contact the clinician if pain gets worse after a few days, especially if it spreads to the ear or comes with an unpleasant taste: this can be dry socket and may need treatment. Also report numbness of the lip, chin or tongue after the expected anaesthetic time has passed. Do not wait for a planned review.

For fever, increasing swelling and other warning symptoms, follow the common help block below.

Sources: Oral Health Foundation; BAOMS.

First days

1. Food. While the anaesthetic is working, avoid chewing and hot food. Then choose soft, not-hot food. Do not chew hard foods directly over the surgical area.
2. Hygiene. Brush the other teeth as usual. Around stitches, follow your surgeon’s instructions: the time to start brushing depends on the procedure. Do not direct an irrigator jet at the wound until the clinician allows it.
3. Mouthwash. If an antiseptic is prescribed, follow the start time, frequency and duration. Use it gently, without vigorous rinsing. Do not replace the prescribed medicine with a random breath-freshening rinse.
4. Swelling and rest. During the first day, cold through cloth can be used in short sessions with breaks. Avoid intensive exercise in the first days.
5. Smoking and alcohol. Avoid smoking and vaping while healing. For long-term implant health, stopping smoking completely is preferable. Avoid alcohol for at least the first 24 hours and when taking medicines that are incompatible with it.

Sources: Guy’s and St Thomas’ NHS; AAOMS.

If temporary teeth are fitted

A temporary crown or bridge does not mean implants are ready for normal chewing load. Follow the prescribed diet until your clinician allows otherwise. Do not test stability with your tongue or fingers.

A removable denture may be worn only according to the agreed plan: it must not press on the surgical area. If the implant, healing abutment or temporary restoration becomes mobile, stop loading it and contact the clinic. Do not tighten anything yourself.

Bone integration takes much longer than the disappearance of pain and swelling; the timing of the next stage is decided individually.

Sources: AAOMS; BSP.

Healing control

Moderate soreness, slight swelling, bruising and some blood in saliva may occur after surgery. If pain or swelling increases after initial improvement, an examination is needed.

Attend scheduled follow-up visits even if nothing worries you. Stitch removal timing depends on the material and procedure. Do not remove stitches yourself.

Tell the clinician if the wound edges open, discharge appears, numbness continues, or the restoration interferes when biting.

Sources: Guy’s and St Thomas’ NHS.

Protecting the surgical area

1. Do not blow your nose for two weeks unless your surgeon set another period. Dab discharge gently with a tissue.
2. Sneeze with your mouth open. Do not pinch your nose or try to hold back a sneeze with your mouth closed.
3. Do not deliberately create pressure. Do not force air through the nose, blow balloons, or test whether air passes between the mouth and nose.
4. Discuss flights and diving with your surgeon. Travel depends on the extent of surgery, sinus condition and healing. Avoid diving until cleared.
5. Nasal medicines only as prescribed. Do not start decongestant drops, antibiotics or pressure rinses yourself.

Sources: Cambridge University Hospitals NHS.

Food, hygiene and activity

Choose soft, not-hot food and do not load the surgical side. Keep brushing the other teeth, carefully avoiding the wound. Use medicated mouthwash only as instructed.

Do not smoke or vape. Avoid intensive exercise and heavy work in the first days. Agree return to normal routine with the clinician, especially after extensive bone grafting. General care rules are in the implant aftercare guide.

Sources: AAOMS.

What can happen after surgery

Cheek swelling, bruising, soreness and a blocked feeling on the operated side can occur. Small blood-stained nasal discharge may occur. Feeling back to normal may take two to three weeks; this is not the final bone maturation time.

Sources: Cambridge University Hospitals NHS.

When to contact the clinician

Contact the surgeon the same day if:

1. pain or swelling increases after initial improvement;
2. fever, significant malaise or foul-smelling nasal discharge appears;
3. liquid enters the nose when drinking or air seems to pass through the wound;
4. the wound opens or graft material is discharged;
5. a nosebleed is heavy or does not stop.
6. Do not try to rinse or clean the wound yourself.

Sources: Cambridge University Hospitals NHS.