After a tooth is extracted, a blood clot forms in the socket. This clot is a natural dressing covering the wound. Everything you do in the first days is aimed at keeping it in place.
The first 24 hours
- Bite on the gauzeBite firmly on the gauze placed over the socket for 30 to 45 minutes. Talking and changing the gauze often prolong bleeding.
- Do not spit or rinseOn the first day, spitting, rinsing and drinking through a straw dislodge the clot. Swallow the saliva that collects in your mouth.
- Apply coldPut a cold compress on the outside of your cheek, 10 minutes on and 10 minutes off. It reduces swelling and pain. Do not put ice directly on the skin.
- Do not eat while numbYou could bite your cheek or tongue without noticing. Numbness usually lasts two to four hours.
- Eat lukewarm, soft foodYoghurt, mash, lukewarm soup and banana are suitable. Avoid hot, hard, seedy and spicy foods; chew on the other side.
- RestAvoid heavy exercise and bending over. Keep your head raised on a pillow when lying down.
What to avoid on the first day
- Smoking: Do not smoke for at least 48 hours, ideally a week. The sucking action dislodges the clot and smoking delays healing.
- Alcohol: Increases bleeding and interacts with medication.
- Hot food and drink: Widens the blood vessels and can restart bleeding.
- Hot baths and saunas: Not recommended on the first day for the same reason.
- Poking the wound: Do not touch the socket with your tongue, finger or a toothpick.
- Aspirin: Unless your dentist has advised it, do not take aspirin for pain; it increases bleeding. Do not, however, stop any medication you take regularly on your own.
From the second day on
- Rinse gently with warm salt water several times a day, especially after meals (half a teaspoon of salt in a glass of water). Do not swish hard; let the water move around your mouth and fall out.
- Keep brushing your teeth; be gentle around the socket for a few more days.
- If there is swelling, warmth rather than cold is soothing from the second day.
- Take the medication your dentist prescribed as directed and for the full course.
- If stitches were placed they are usually removed after a week.
What is normal and what is not?
To be expected
- Pink saliva or slight oozing on the first day
- Pain for two or three days that is controlled with painkillers
- After surgical extractions, swelling that peaks on the second or third day, sometimes with bruising
- Limited mouth opening for a few days
- A whitish-yellow layer over the socket (this is healing tissue, not infection)
When to call your dentist
- Bleeding that fills the mouth and does not stop despite the gauze
- Severe pain that increases after the third day and spreads to the ear
- Swelling that keeps growing, fever, or difficulty swallowing or breathing
- A bad smell and taste coming from the socket
- Numbness of the lip or tongue lasting more than a day
What is dry socket?
If the clot comes out or dissolves early, the bone is left exposed. It shows itself two to four days after the extraction with severe pain spreading to the ear and temple and a bad smell in the mouth. It is more common after lower wisdom tooth extractions, in smokers and in people who rinse on the first day. Do not wait for it to pass; when your dentist cleans the socket and places a soothing dressing in it, the pain eases quickly.
Should the space be left empty?
Apart from wisdom teeth, the space left by an extracted tooth should not be left empty. A gap leads to the neighbouring teeth tilting and the opposing tooth over-erupting. Once the wound has healed, discuss implant or bridge options with your dentist.
Frequently asked questions
When can I eat after an extraction?
Once the numbness has gone, after about two to four hours, you can start with lukewarm, soft foods. Avoid hot and hard foods on the first day.
How long does bleeding last after an extraction?
Noticeable bleeding stops within half an hour to an hour with the gauze. Slightly pink saliva for the first 24 hours is normal. If bleeding continues, fold a clean piece of gauze and bite on it for another 30 minutes; if it does not stop, call your dentist.
Do I have to take antibiotics after an extraction?
No. Antibiotics are not needed after every extraction. Your dentist decides according to whether there is infection and your general health; do not take antibiotics on your own.
This article is for general information and is not a substitute for diagnosis or treatment. If you have a complaint, please see your dentist.