After
After gum treatment
Why your teeth may look longer and feel colder, why sore gums still need cleaning, and what counts as a problem rather than healing.
Get help now if
Ring a dentist, the same day
- Swelling of the gum or face, or a temperature, in the days afterwards
- Bleeding that will not settle with twenty minutes of pressure from a clean, damp pad of gauze or a handkerchief
- Pain that is severe or getting worse after the first few days rather than easing
- A gum abscess — a tender swelling on the gum, sometimes with a bad taste
If the swelling is spreading — towards or under your eye, down your neck, or into the floor of your mouth under your tongue — or if your eye is swelling shut or your eyesight changes, or you cannot open your mouth properly, or you are having difficulty breathing, speaking or swallowing, that is hospital territory rather than a dental appointment. Ring 999 if breathing, speaking or swallowing is affected; otherwise go to an emergency department. Do not drive yourself — have somebody take you, or ring an ambulance.
This is rare after gum treatment, and worth knowing anyway.
If you take a blood thinner and the bleeding does not stop after one twenty-minute round of firm pressure, or stops and then restarts, get help while you are still biting down — ring your dentist or the urgent dental service, and keep the pressure on while you do it.
What was done
The root surfaces below your gum line were cleaned — the tartar and plaque that a toothbrush cannot reach, in pockets that had formed where the attachment had already pulled away.
What happens now is not the treatment. It is healing, and it is slow, quiet and almost entirely dependent on what you do daily.
Today
While you are numb: nothing hot, and do not eat. A numb lip and cheek get chewed without you noticing.
→ After a numbing injection
Once the feeling is back: eat normally, but expect the area to be tender. Soft and lukewarm is kinder for the first day.
Some bleeding when you brush is expected for a few days. Gums that have just been instrumented bleed. It is not a reason to stop.
Painkillers if you need them. Paracetamol first. If you take a blood thinner of any kind — warfarin, apixaban, dabigatran, rivaroxaban, edoxaban, clopidogrel, ticagrelor, prasugrel, dipyridamole, a daily injection such as enoxaparin, or aspirin a doctor put you on — take paracetamol and not ibuprofen, aspirin, diclofenac or naproxen. These raise the bleeding risk alongside those medicines. If your medicine is not on that list and you are not sure which kind it is, ask a pharmacist before taking ibuprofen. And if paracetamol is not enough, or you cannot take it, ring your dentist rather than reaching for ibuprofen — there are other options, and they are a phone call away.
Do not stop your blood thinner on your own. Not warfarin, not apixaban, dabigatran, rivaroxaban, edoxaban, clopidogrel or any of the others. Stopping one unsupervised carries a risk considerably more serious than a gum that bleeds when you brush. If a plan was agreed with you for this appointment, follow that plan. If you are not on one, ibuprofen is an option if you normally take it safely. Follow the packet and do not exceed the dose printed on it.
Keep brushing. Tonight. Gently, and all of it. See below.
The instruction that feels wrong
Sore gums still need cleaning, and the cleaning is the treatment.
Every instinct says leave it alone until it stops hurting. But plaque reforms within hours, and a root surface that has just been cleaned heals best when it is kept clean from the start. Leaving the area alone for a week to let it settle is a common reason a course of gum treatment does not hold.
So: brush gently but completely, including the treated area, twice a day, from tonight. If it is genuinely too sore to get between the teeth on the first day, that is fine — published aftercare advice recognises that interdental cleaning may be uncomfortable until the following day. Get back to it tomorrow, not next week.
NHS self-care guidance, which is what the rest of this comes down to:
- Brush with fluoride toothpaste at least twice a day, and spit rather than rinse afterwards — rinsing washes the fluoride off.
- Clean between your teeth every day, with floss or interdental brushes.
- Do not use mouthwash straight after brushing, for the same reason as not rinsing.
- Do not smoke.
Sensitivity, which is the part people were not warned about
Cold sensitivity after gum treatment is common, can be sharp, and can last several weeks. It is the most frequent reason people think something has gone wrong.
The mechanism is straightforward: root surface that was covered by swollen, inflamed gum is now exposed, and root is not enamel — it conducts cold far more readily.
What helps:
- A sensitive-teeth toothpaste, used as your ordinary toothpaste, twice a day. Smear a little on the sensitive spot with a fingertip afterwards and leave it there, rather than rinsing it away. It works cumulatively, so give it two or three weeks before judging it.
- Lukewarm rather than cold drinks, for a couple of weeks.
- Not avoiding the area when you brush. Plaque on an exposed root makes sensitivity worse, not better.
- Telling your dentist if it does not settle. There are things that can be applied to the root surface.
Your teeth may look different
This is expected, and it is not damage.
- Teeth may look longer, and small gaps may appear between them. Swollen gum shrinks when the inflammation goes. The attachment was already lost; the swelling was hiding it. Tighter, paler, smaller gum is the result you were after, and it does change how your teeth look.
- Teeth may feel slightly loose for a week or two while the tissue settles. Loosening that keeps increasing is different, and worth reporting.
- The gaps are where the interdental brushes go. Awkwardly, the thing you have just been given is also the thing that now has room to work.
The next few weeks
| Day 1 | Numbness, then tender gums. Some bleeding on brushing. Brush gently tonight. |
| Days 2–4 | Soreness easing. Cold sensitivity often starting now, and often the worst of it. |
| Week 1 | Bleeding on brushing reducing. Gums beginning to look tighter and paler. |
| Weeks 2–6 | Sensitivity fading. Gum shrinking back, which is when teeth start to look longer. |
| The review | Pockets measured again. This is where you find out whether it worked, and the numbers are more honest than how it feels. |
Salt water, if you want it
Half a teaspoon of salt in about 250 ml of comfortably warm water, bathed gently around the sore area rather than swilled hard, for the first few days. It is for comfort, not for cleaning — it will not remove plaque, and it is not a substitute for brushing.
Go to the review
The pocket depths at the review are the whole point. They are how you and your dentist find out whether the gum reattached, and which few sites are still not responding and need something different.
Gums that feel comfortable can still have deep pockets, because inflammation below the gum is frequently painless. That is how gum disease gets as far as it does in the first place.
Your dentist’s instructions come first
The instructions you were given by the dentist or hygienist who treated you take precedence over anything on this page. They have measured your gums, know which sites were treated and know what they are expecting at the review; this page does not. Where the two differ, follow theirs.
Sources
- Gum disease, including self-care and urgent symptoms — NHS, last reviewed 20 April 2026
- Root surface debridement aftercare, including interdental cleaning being uncomfortable until the following day — Dental Update, published aftercare advice
- Management of dental patients taking anticoagulants or antiplatelet drugs — SDCEP, 2nd edition, 2022
- Post-extraction haemorrhage, Management of Acute Dental Problems — SDCEP (the anticoagulant escalation rule, applied here by analogy)
Who to ring
Routes and numbers checked .
England
Ring your own dentist.
Otherwise NHS 111, by phone or at 111.nhs.uk, at any hour. They will arrange urgent treatment if you need it.
A GP cannot help with a dental problem.
Scotland
In working hours, ring your own practice — or your health board’s dental helpline if you are not registered with one.
Out of hours — from 6pm on weekdays, and from 6pm Friday to 8am Monday — 111 reaches NHS 24.
NHS 24 is a separate service from NHS 111 in England, on the same number.
Wales
Ring your own dentist.
Otherwise ring your health board's dental helpline — that is what NHS Wales asks you to do first. In Cardiff and the Vale it is 0300 10 20 247. In the Aneurin Bevan area (Blaenau Gwent, Caerphilly, Monmouthshire, Newport, Torfaen) it is 01633 744387, weekdays 9am to 12.15pm and 1.15pm to 4pm, with advice only outside those hours. In Betsi Cadwaladr, Cwm Taf Morgannwg, Hywel Dda, Swansea Bay and Powys, ring 111, at any hour.
Which number you ring depends on where you are, not where you are registered.
Northern Ireland
Ring your own practice first, whatever the day — they will tell you what out-of-hours arrangements they have. If you are not registered, ring local practices, and ask about the Dental Access Scheme if you cannot get seen.
At weekends and on bank holidays, the Emergency Dental Clinics triage by telephone on 028 2566 3510, lines open 8am to noon. You will be given an appointment if you need one.
Do not attend a clinic without an appointment. On a weekday evening or overnight there is no dental service at all — listen to your practice's answerphone, and use 999 or an emergency department only for the signs above.