After oral surgery, maintaining a modified oral hygiene routine is necessary to prevent infection and promote recovery. While mechanical disruption to the surgical site must be strictly avoided, the rest of the mouth still needs attention. The primary goal is protecting the newly formed blood clot or suture line, as the ability to resume brushing depends entirely on the healing stage.
Oral Hygiene During the First 24 Hours
The first day following oral surgery requires strict prohibition of oral hygiene near the wound. A blood clot forms in the socket during this time, and mechanical force or sudden pressure changes can dislodge it, leading to alveolar osteitis, or dry socket. Patients must strictly avoid brushing the surgical area and should use minimal effort when brushing non-surgical areas. Vigorous rinsing, swishing, using a straw, or spitting forcefully are prohibited because the suction created can pull the protective clot out. Alcohol-containing mouthwashes should also be avoided, but patients can gently dab surrounding teeth with a clean, moist cotton swab to remove debris.
Techniques for Safe Brushing After 24 Hours
Once the initial 24-hour window has passed, the healing process is stable enough to permit a careful reintroduction of brushing. The objective is to clean the rest of the teeth without disturbing the clot or sutures. Patients should switch to a soft-bristled toothbrush and use only a minimal amount of mild toothpaste, applying very light pressure with gentle, short strokes. The surgical site must be completely bypassed. After brushing, let the excess paste and water passively drip out of the mouth by tilting the head over the sink, instead of spitting forcefully.
Managing the Surgical Site with Non-Brushing Methods
After the first day, the surgical site requires gentle, passive cleaning to manage bacteria and food debris without mechanical abrasion. This is primarily achieved using warm saline rinses, which have soothing and cleansing properties. Prepare the solution by dissolving about one-half to one teaspoon of salt in eight ounces of warm water. The solution should be held in the mouth to gently bathe the surgical area without vigorous swishing or gargling, then allowed to drain out by tilting the head. Repeat this process three to four times a day, especially after meals, and use any prescribed medicated rinses, such as chlorhexidine, exactly as directed starting 48 hours after the procedure.
When to Seek Professional Guidance
While some pain, swelling, and minor oozing are expected after oral surgery, certain symptoms require professional evaluation. Be alert for severe, throbbing pain that starts or worsens significantly three to five days after surgery, often signaling a dry socket. This pain may radiate toward the ear, temple, or neck and is typically not relieved by over-the-counter medication. Signs of an active infection include swelling that increases after the first 48 hours, the presence of pus, or a fever. A persistently foul odor or unpleasant taste, especially with worsening pain, is also a reason to contact the surgeon immediately for diagnosis and treatment.