A tooth extraction creates an open wound. The immediate biological goal following the procedure is to achieve hemostasis, which means stopping the flow of blood from the socket. This process is initiated by the formation of a stable blood clot. The gauze pad placed over the site is a temporary tool used to apply gentle but firm pressure, effectively starting the body’s natural healing cascade.
The Critical First Hour of Gauze Use
The initial gauze pad is meant to be held in place for a specific duration to facilitate the necessary clotting process. You should maintain firm, consistent biting pressure on the pad for approximately 30 to 60 minutes immediately following the extraction. This sustained pressure encourages the small blood vessels to constrict and allows the platelets to aggregate and form a stable clot.
After the initial time has passed, the gauze should be carefully removed to check the wound site. If the bleeding has slowed to a light pink tinge or simple oozing, you can generally discontinue the use of the gauze. If bright red or active bleeding persists, replace the used gauze with a fresh, sterile pad, folding it into a tight, small square that fits directly over the socket.
Continue to apply firm pressure for another 30 to 45 minutes, changing the gauze every hour until the bleeding subsides. Moisten the gauze slightly before placing it back in your mouth to prevent it from sticking to the forming clot upon removal. If active bleeding continues and does not slow down after two hours of consistent pressure, contact your dentist or oral surgeon for further guidance.
Protecting the Blood Clot and Extraction Site
The blood clot that forms in the socket is a biological shield that protects the underlying bone and nerve endings. This clot acts as a natural dressing and is the foundation upon which new gum tissue will eventually grow to close the wound. Dislodging this clot can expose the bone, leading to a painful condition known as alveolar osteitis, or dry socket.
For the first 24 to 48 hours, specific behaviors must be avoided to keep the clot secure. Any action that creates negative pressure or suction in the mouth can pull the clot from the socket, so refrain entirely from using straws, spitting, or smoking. The chemical compounds in tobacco smoke restrict blood flow, which interferes with the natural healing response.
Avoid rinsing your mouth vigorously during the first day; instead, let any fluids gently fall out of your mouth to prevent disturbing the wound. Stick to a diet of soft, cool foods like yogurt, mashed potatoes, or scrambled eggs, and avoid chewing on the side of the extraction. Hot liquids like coffee or soup should be avoided, as the heat can increase blood flow to the area and dissolve the protective clot.
Managing Expected Pain and Swelling
Pain and swelling are expected after a tooth extraction. Swelling typically peaks around the third day following the procedure. To manage the initial swelling, apply an ice pack or cold compress to the outside of your cheek near the extraction site for the first 24 to 48 hours.
Use the cold pack in 20-minute intervals, alternating 20 minutes on and 20 minutes off. This cycle helps to constrict the blood vessels, reducing inflammation and providing a localized numbing effect. Keeping your head elevated with pillows while resting also helps to minimize blood pooling and subsequent swelling.
Pain can be managed with over-the-counter medications, such as ibuprofen and acetaminophen, taken as directed by your dental professional. Taking these medications before the local anesthetic completely wears off can help maintain pain control. If your dentist prescribed stronger medication, use it only as directed, particularly for the first few days when discomfort is typically at its highest.