What Has Just Happened — and Why Careful Aftercare Matters
Bone grafting involves placing a graft material (which may be synthetic, from a donor source, or from your own body) into an area where bone has been lost. The graft acts as a scaffold for your own bone to grow into over the coming months.
The graft needs to be protected during the early healing phase. Disturbing it — through eating the wrong foods, rinsing too vigorously, or poor hygiene — can cause it to fail. Please follow these instructions closely.
Expect significant swelling, which peaks on day 2–3 and then gradually reduces over 5–10 days.
Expect bruising to appear on day 2–4, which will fade over 1–2 weeks.
Stitches are usually dissolvable and will disappear within 2–3 weeks, though you may have a follow-up appointment to check the wound.
Some graft particles may occasionally appear in the mouth in the first few days — this is not always a cause for alarm, but contact your dentist to be sure.
The First 24 Hours
The first 24 hours are the most critical for protecting the graft and clot.
Do not rinse, spit, or use a straw.
Apply ice packs (10–15 minutes on, 10–15 minutes off) to the outside of your face to reduce swelling.
Keep your head elevated — use extra pillows when resting or sleeping.
Take all prescribed medication (antibiotics and painkillers) as directed. Start them as soon as you get home.
Eat soft foods only — nothing that requires chewing near the surgical site. Cold or room-temperature foods are best today.
Do not disturb the wound — avoid touching it with your tongue or fingers.
Do not smoke.
Pain Management
Bone grafting is a significant surgical procedure. Pain can be more pronounced than after a simple tooth removal, but is manageable with the right approach.
Take prescribed painkillers on a regular schedule for the first 2–3 days, rather than waiting for pain to become severe.
Ibuprofen (if prescribed or suitable for you — avoid if you take blood-thinning medications, have stomach problems, or are pregnant) reduces both pain and inflammation — particularly helpful after bone grafting.
Alternate ibuprofen with paracetamol every 3–4 hours for around-the-clock pain control during the first couple of days.
If you have been prescribed opioid-containing painkillers (such as codeine or co-codamol), do not drive, operate machinery, or drink alcohol while taking them — this is a legal requirement.
Pain should gradually ease from day 3–4 onwards. If pain is increasing after day 4, contact your dentist.
Diet and Oral Hygiene
Diet (first 2 weeks):
Eat very soft foods: yoghurt, mashed potato, scrambled eggs, soft soup, smoothies, soft fish. See our Soft Food Guide leaflet for more ideas.
Avoid chewing near the graft site for at least 2–4 weeks (as directed by your dentist).
Avoid hot, hard, crunchy, sticky, or spicy foods.
Stay well hydrated — drink plenty of water.
Avoid alcohol while taking antibiotics and for 48 hours after surgery.
Oral hygiene:
Day 1: Do not rinse, brush near the site, or disturb the wound in any way.
Day 2 onwards: Gently rinse with warm salty water (half a teaspoon in a glass of warm water) after every meal. Let the rinse fall from your mouth — do not swish or spit forcefully.
If prescribed chlorhexidine mouthwash, use it as directed.
Brush all other teeth carefully, avoiding the graft site for 1–2 weeks. Your dentist will advise when to begin cleaning around the site.
Do not use an electric toothbrush near the site for at least 2 weeks.
Things You Must Avoid
The following can cause the graft to fail:
Smoking — vastly increases the risk of graft failure and infection. Do not smoke for at least 2 weeks before and after surgery, and ideally permanently.
Wearing a denture over the graft site unless specifically approved and adjusted by your dentist.
Vigorous rinsing, spitting, or using a straw (especially in the first week).
Strenuous physical exercise for at least 3–5 days.
Touching or probing the wound.
Any contact sport or activity that risks a blow to the face for several weeks.
When to Contact Your Dentist
Contact your dentist promptly if you experience:
Heavy bleeding that does not stop with 30–45 minutes of firm pressure
Severe pain not controlled by prescribed medication
Swelling that is getting worse after day 4
A temperature above 38°C
The wound opening up or significant amounts of graft material visible or falling out
Pus or discharge from the wound
Persistent numbness beyond 8 hours post-surgery
For out-of-hours urgent concerns, call NHS 111. Call 999 or go to A&E if you have difficulty breathing or swallowing.
This leaflet is for general information only and does not replace professional dental advice. Your dentist will discuss your individual circumstances and any risks specific to you. Treatment outcomes vary between patients depending on individual circumstances.
When to Seek Urgent Help
Contact your dentist immediately if you have heavy bleeding that will not stop, severe pain not controlled by prescribed medication, swelling that worsens after day 4, a temperature above 38°C, visible graft material falling out or the wound opening up, or difficulty breathing or swallowing. Call 999 or go to A&E for breathing or swallowing difficulties.
References
Aligned with guidance from: FGDP(UK), SDCEP, ITI guidelines.