How long it hurts after an extraction
The anaesthesia wears off after 2–4 hours, and then comes the first and strongest wave of pain, into the night. The advice we give every patient: take a painkiller while the anaesthesia is still working, not once it hurts. On days two and three the pain is moderate and throbbing, more swelling than pain. From day 4–5 most patients stop taking tablets. After a wisdom tooth, especially a lower one, add a day or two. If pain increases on day 3–4, that is not normal; see the section on dry socket.
Bleeding: what is normal
Pink saliva for the first 1–2 hours is normal. Bite on the gauze for 20–30 minutes, then discard it; do not change it every five minutes, that stops the clot forming. If bright red blood still flows after 2 hours, fold clean gauze, place it on the socket and bite firmly for 30 minutes without a break. If that fails, or bleeding restarts the next day, call. If you take blood thinners, tell us before the extraction.
When and what to eat
After 2 hours, once the anaesthesia has gone (otherwise you can bite your cheek without feeling it). Day one: cool and soft, yoghurt, cottage cheese, banana, cold soup, porridge. Nothing hot, spicy or crumbly. From day 2–3, normal soft food, chewing on the other side. Nuts, chips, seeds and other crumbly food only after a week, because crumbs lodge in the socket. Drink straight away, but no straws and nothing hot.
Can I smoke?
No. At least 3 days, better 5–7. Smoking is the main cause of dry socket: the sucking motion pulls out the clot, nicotine narrows blood vessels and slows healing, smoke infects the socket. Smokers get dry socket 3–4 times as often. If you cannot go without entirely, at least the first 24 hours, then as rarely as possible without deep drags. E-cigarettes create the same sucking motion and are just as harmful to the clot.
Can I drink alcohol?
Not for the first 24 hours: alcohol dilates blood vessels and can restart bleeding, and it irritates the wound. Not while you are taking painkillers or antibiotics, because the combination strains the liver and weakens the medication. After that in moderation, but no spirits and no beer through a straw.
When can I exercise or use the sauna?
No exertion for the first 24–48 hours: raised blood pressure restarts bleeding and increases swelling. A gentle walk is fine. Light training from day 3–4; full load, weights and contact sport after a week, after a complex extraction 10–14 days. Sauna, steam room, hot bath and sunbed not before a week: heat dilates vessels and increases swelling and bleeding risk. Swimming pool also after a week, once the gum has closed.
Stitches
Dissolving stitches start to loosen after 5–7 days and are gone by day 10–14; you may feel a loose end, which is normal, do not pull it. If regular stitches were placed, the dentist gives you a date for removal (usually day 7–10, painless, two minutes). Do not brush over the stitches; gentle salt-water rinses are fine from day two.
Dry socket: how to recognise it
Dry socket (alveolitis) happens when the clot falls out or breaks down and the bone is left exposed. Signs: pain that gets worse again on day 3–4 after improving, often radiating to the ear or temple; a socket that looks empty and greyish with no dark clot; a bad taste and smell. It is not dangerous, but very painful, and it does not pass quickly on its own. We treat it in one visit: the socket is rinsed and a soothing antiseptic dressing placed, with relief usually within hours. Call +371 22428688.
When to call immediately
- bleeding you cannot stop with gauze in 30 minutes;
- temperature above 38 °C or chills;
- swelling that keeps growing after day 3 or affects swallowing or breathing;
- numbness of the lip, chin or tongue for more than a day;
- pain that increases rather than decreases.
What next: the gap
After 1–2 months it is worth talking to the dentist about replacing the tooth, with an implant (ideally 2–3 months after extraction, before the bone shrinks) or a prosthesis. Without replacement, the neighbouring teeth start tilting into the gap within a year. How the extraction itself works and what it costs is on the tooth extraction page.
