After treatment

After an extraction

The extraction takes twenty minutes and the healing takes a fortnight. Almost everything that goes wrong in that fortnight goes wrong in the first twenty-four hours, and almost all of it is preventable.

Bleeding stops: 30–60 minutes
Swelling peaks: Day 2–3
Soft food: 3–7 days
Gum closed: 2–4 weeks

What it is

When a tooth comes out it leaves a socket, and the socket fills with a blood clot. That clot is the dressing: it covers the bone, it is the scaffold the gum grows across, and everything you are told not to do in the first day is a way of not disturbing it.

The rest is ordinary healing. The gum closes over the socket in two to four weeks. The bone underneath takes months to fill in, which is why the plan for what replaces the tooth — an implant, a bridge, or nothing — is made before the extraction rather than after it.

Almost every painful week after an extraction started with a straw, a cigarette or a mouthwash in the first twenty-four hours.
Dr. Aykut

Which one you need

The first hour
Bite firmly on the gauze and keep it there. Pressure is what stops the bleeding; changing the gauze every few minutes to inspect it is what keeps the bleeding going.
Before you leave, and just after
The first day
No rinsing, no spitting, no straws and no smoking. Each of those pulls at the clot, and losing it means a dry socket. Cold packs on the cheek, twenty minutes on and twenty off.
The twenty-four hours that decide the fortnight
Days two to seven
Warm salt-water rinses can start now, gently. Soft food, lukewarm rather than hot, chewed on the other side. The swelling peaks around day two or three and eases from there.
Settling
The second week
Stitches, where there were any, are removed or dissolve. Ordinary brushing everywhere, including — carefully — near the socket, because a clean mouth heals faster than a protected one.
Back to normal

What happens to you

Two visits, and a wait at home in between

Pain
What is normal
Soreness for three to five days, easing each day, and answering to ordinary painkillers. Avoid aspirin, which thins the blood. Pain that gets worse after day three is the signal, not the level of pain on day one.
Bleeding
What is normal
Oozing for a few hours and pink saliva into the next day. Fresh bleeding that soaks a gauze pad in twenty minutes is not, and it wants a call.
Swelling
What is normal
A swollen cheek that peaks on the second or third day, sometimes with a bruise. Swelling that starts rising again after it had gone down suggests infection.
Dry socket
What is not normal
A deep ache arriving on day three or four, often reaching the ear, with a bad taste and an empty-looking socket. It is treatable in minutes with a dressing — so it is a reason to be seen, not to wait it out.
Call us
When to stop reading and phone
A fever, swelling that spreads towards the eye or the throat, difficulty swallowing or opening the mouth, or numbness that has not worn off after a day. Wherever you are by then, phone: an early answer is usually a prescription rather than another flight.

Pain
What is normal
Soreness for three to five days, easing each day, and answering to ordinary painkillers. Avoid aspirin, which thins the blood. Pain that gets worse after day three is the signal, not the level of pain on day one.
Bleeding
What is normal
Oozing for a few hours and pink saliva into the next day. Fresh bleeding that soaks a gauze pad in twenty minutes is not, and it wants a call.
Swelling
What is normal
A swollen cheek that peaks on the second or third day, sometimes with a bruise. Swelling that starts rising again after it had gone down suggests infection.
Dry socket
What is not normal
A deep ache arriving on day three or four, often reaching the ear, with a bad taste and an empty-looking socket. It is treatable in minutes with a dressing — so it is a reason to be seen, not to wait it out.
Call us
When to stop reading and phone
A fever, swelling that spreads towards the eye or the throat, difficulty swallowing or opening the mouth, or numbness that has not worn off after a day. Wherever you are by then, phone: an early answer is usually a prescription rather than another flight.

Pain
What is normal
Soreness for three to five days, easing each day, and answering to ordinary painkillers. Avoid aspirin, which thins the blood. Pain that gets worse after day three is the signal, not the level of pain on day one.
Bleeding
What is normal
Oozing for a few hours and pink saliva into the next day. Fresh bleeding that soaks a gauze pad in twenty minutes is not, and it wants a call.
Swelling
What is normal
A swollen cheek that peaks on the second or third day, sometimes with a bruise. Swelling that starts rising again after it had gone down suggests infection.
Dry socket
What is not normal
A deep ache arriving on day three or four, often reaching the ear, with a bad taste and an empty-looking socket. It is treatable in minutes with a dressing — so it is a reason to be seen, not to wait it out.
Call us
When to stop reading and phone
A fever, swelling that spreads towards the eye or the throat, difficulty swallowing or opening the mouth, or numbness that has not worn off after a day. Wherever you are by then, phone: an early answer is usually a prescription rather than another flight.

Pain
What is normal
Soreness for three to five days, easing each day, and answering to ordinary painkillers. Avoid aspirin, which thins the blood. Pain that gets worse after day three is the signal, not the level of pain on day one.
Bleeding
What is normal
Oozing for a few hours and pink saliva into the next day. Fresh bleeding that soaks a gauze pad in twenty minutes is not, and it wants a call.
Swelling
What is normal
A swollen cheek that peaks on the second or third day, sometimes with a bruise. Swelling that starts rising again after it had gone down suggests infection.
Dry socket
What is not normal
A deep ache arriving on day three or four, often reaching the ear, with a bad taste and an empty-looking socket. It is treatable in minutes with a dressing — so it is a reason to be seen, not to wait it out.
Call us
When to stop reading and phone
A fever, swelling that spreads towards the eye or the throat, difficulty swallowing or opening the mouth, or numbness that has not worn off after a day. Wherever you are by then, phone: an early answer is usually a prescription rather than another flight.

Questions

When can I eat normally again?

Soft and cool for the first two days, soft for the rest of the first week, then back to normal as it stops being tender. Chew on the other side throughout, and skip anything with seeds or grains small enough to sit in the socket.

When can I brush?

The same evening, everywhere except the socket itself. From the second day, brush gently near it too. Skip mouthwash for twenty-four hours — the swilling is the problem, not the antiseptic.

When can I smoke?

The honest answer is seventy-two hours, and the real answer is that smoking is the single biggest cause of a dry socket. The suction lifts the clot and the smoke slows the healing underneath it.

Can I fly?

Usually the next day after a simple extraction, and after two or three days after a surgical one. Tell us your flight before the appointment — it changes what we do and when we do it.

When can I exercise?

Light walking straight away. Anything that raises your heart rate properly can restart the bleeding, so leave it for three or four days.

Patients

The people who already came

Six of our patients, filmed at the clinic and talking about their own treatment. They are the clinic’s patients rather than any one procedure’s — what each of them had is in the film.