Best mouthwash for after wisdom teeth removal

After tooth extraction, appropriate care should be taken to prevent infection and ensure uneventful healing. First of all, it means to use of antiseptic mouth rinse. It is unacceptable to clean extraction socket in any way. The idea of using antiseptic solution includes both removing food particles and preventing accumulation of bacterial plaque.

Extraction socket is a hole in the jawbone which appears after the tooth is removed. Doctor cleans it up, removes damaged tissue and granulations and makes sure that no root particles are left in the wound. At this stage bleeding is normal and should not be stopped intentionally. Blood clot filling the socket will protect it from the infection and turn into a bone tissue over time. Rinsing mouth vigorously can cause displacement of the blood clot and lack of natural protection of the wound. In turn, this can be a reason of developing dry socket. It is especially important during 24-48 hours after extraction. That’s why it is recommended to make mouth bath for 1-2 minutes instead of rinsing.

What can we use as a mouthwash after tooth extraction? In the best case scenario when oral hygiene condition is perfect, there are no carious and damages teeth, tooth extraction was less traumatic, the initial problem was not presented with suppuration, or in the other words there is no source of infection in the mouth, we can say that antiseptic mouthwash is not a necessity and the simple saline or sodium bicarbonate solution can be used to rinse the mouth. But this kind of ideal situation is rare and usually using antiseptic solution is recommended after tooth extraction to avoid the complications.

Herbal extracts such as chamomile, calendula, etc. occasionally are used as a mouthwash but it is not the best choice after tooth extraction. They do have anti-inflammatory, soothing effect, promoting fast healing but not anti-bacterial properties. Extract may contain herbal particles which can retain in the wound and cause an infection.

The most recommended oral antiseptic in modern dentistry is chlorhexidine. There are mane researches proving its effectiveness towards many species of pathogenic bacteria in oral cavity. Besides, unlike other antiseptics, chlorhexidine can stay active in the soft tissue for certain amount of time. There are different concentration chlorhexidine products available in the market. They can be used for different purpose — bacterial plaque prevention, adjunctive treatment during periodontal therapy, after gum surgery or tooth extraction, before and/or after dental implant placement, etc.

We should remember that chlorhexidine is a powerful antiseptic. It is very important to choose the right concentration and regime. Therefore, it should always be prescribed by a dentist.

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• August 3, 2018
• News

I’ve had my tooth out – what should I do now?

Take it easy for the rest of the day. Take as little exercise as you can, and rest as much as you can. Keep your head up to avoid any bleeding.

What precautions should I take?

Avoid hot food or drinks until the anaesthetic wears off. This is important as you cannot feel pain properly and may burn or scald your mouth. Also be careful not to chew your cheek. This is quite a common problem, which can happen when there is no feeling.

If you do rest, try to keep your head higher for the first night using an extra pillow if possible. It is also a good idea to use an old pillowcase, or put a towel on the pillow, in case you bleed a little.

Should I rinse my mouth out?

Do not be tempted to rinse the area for the first 24 hours. It is important to allow the socket to heal, and you must be careful not to damage the blood clot by eating on that side or letting your tongue disturb it. This can allow infection into the socket and affect healing.

Is there anything else I should avoid?

Avoid alcohol for at least 24 hours, as this can encourage bleeding and delay healing. Eat and drink lukewarm food as normal but avoid chewing on that area of your mouth.

When should I brush?

It is just as important, if not more so, to keep your mouth clean after an extraction. However, you do need to be careful around the extraction site.

What do I do if it bleeds?

The first thing to remember is that there may be some slight bleeding for the first day or so. Many people are concerned about the amount of bleeding. This is due to the fact that a small amount of blood is mixed with a larger amount of saliva, which looks more dramatic than it is.

If you do notice bleeding, do not rinse out, but apply pressure to the socket. Bite firmly on a folded piece of clean cotton material such as a handkerchief for at least 15 minutes. Make sure this is placed directly over the extraction site and that the pad is replaced if necessary.

If the bleeding has not stopped after an hour or two, contact your dentist.

How soon can I have a cigarette?

It is important not to do anything which will increase your blood pressure, as this can lead to further bleeding. We recommend that you avoid smoking for as long as you can after an extraction, but this should be at least for the rest of the day.

Is there anything I can do to help my mouth?

Different people heal at different speeds after an extraction. It is important to keep your mouth and the extraction site as clean as possible, making sure that the socket is kept clear of all food and debris. Don't rinse for the first 24 hours, and this will help your mouth to start healing.

After this time use a salt-water mouthwash, which helps to heal the socket. A teaspoon of salt in a glass of warm water gently rinsed around the socket twice a day can help to clean and heal the area. Keep this up for at least a week or for as long as your dentist tells you.

It is important to keep to a healthy diet; and take a Vitamin C supplement, which will help your mouth to heal.

I am in pain, what should I take?

There will usually be some tenderness in the area for the first few days, and in most cases some simple pain relief is enough to ease the discomfort. What you would normally take for a headache should be enough. However, always follow the manufacturer's instructions, and if in doubt check with your doctor first. Do not take aspirin, as this will make your mouth bleed.

Are there any medicines I should avoid?

As we have said, it is important not to use anything containing aspirin as this can cause further bleeding. This happens because aspirin can thin the blood slightly. Asthma sufferers should avoid Ibuprofen-based pain relief. Again check with your chemist or dentist if you are worried or feel you need something stronger.

I am still in pain, what could it be?

Sometimes an infection can get in the socket, which can be very painful. This is where there is little or no blood clot in the tooth socket and the bony socket walls are exposed and become infected. This is called a dry socket and in some cases is worse than the original toothache!

In this case, it is important to see your dentist, who may place a dressing in the socket and prescribe a course of antibiotics to help relieve the infection. You may also feel the sharp edge of the socket with your tongue and sometimes small pieces of bone may work their way to the surface of the socket. This is perfectly normal.

Will my dentist need to see me again?

If it has been a particularly difficult extraction, the dentist will give you a follow-up appointment. This could be to remove any stitches that were needed, or simply to check the area is healing well.

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