A tooth extraction is the removal of a tooth from its socket, often necessary due to decay, trauma, or crowding. Proper aftercare is essential for preventing infection, managing discomfort, and ensuring the socket heals correctly. Following specific guidelines minimizes the risk of complications, particularly the painful condition known as dry socket. This allows the body’s natural healing process to proceed efficiently and ensures a smooth recovery.
Immediate Post-Procedure Care
The first 24 hours are vital for forming and preserving the protective blood clot, which acts as a biological bandage in the empty socket. Maintain firm, consistent pressure on the gauze pad placed over the site for 30 to 45 minutes to control bleeding and initiate clotting. If bleeding continues, replace the gauze with a fresh, sterile piece and bite down again for another 30 minutes, or use a damp tea bag, as the tannic acid aids in clotting.
To manage swelling, apply an ice pack or cold compress to the cheek adjacent to the extraction site for 15 to 20 minutes at a time, followed by 15 to 20 minutes off. Use this cold therapy intermittently for the first 24 hours only, as it constricts blood vessels and limits inflammation. During this initial period, strictly avoid any action that creates negative pressure in the mouth, which could dislodge the clot and lead to a dry socket. This includes spitting, rinsing, smoking or vaping, and drinking through a straw.
Managing Diet and Hydration
Maintaining hydration is important for healing, but drink without using a straw to prevent suction from disrupting the clot. For the first 24 to 48 hours, stick exclusively to a diet of soft, non-chewy foods that require minimal effort. Excellent choices include yogurt, applesauce, mashed potatoes, and soft-cooked eggs.
Avoid consuming hot liquids, such as coffee or soup, until they have cooled to a lukewarm temperature, as excessive heat can dissolve the blood clot. Also avoid crunchy, sharp, or sticky foods, like nuts, chips, and tough meats, for at least one week, as they can irritate the site or become lodged in the socket. When eating, chew on the side of your mouth opposite the extraction site to protect the wound and prevent debris accumulation.
Maintaining Oral Hygiene During Recovery
After the first 24 hours, you can begin a modified oral hygiene routine to keep the area clean and reduce the risk of infection. Do not rinse your mouth at all during the initial 24-hour period. Gently rinse your mouth four to five times a day with a warm saltwater solution, made by dissolving a half-teaspoon of salt in eight ounces of warm water.
The saltwater rinse acts as a mild, soothing antiseptic that helps cleanse the wound without irritating the healing tissues. When rinsing, simply let the solution pool over the extraction site and allow it to drift out into the sink, avoiding vigorous swishing or forceful spitting. Brush your teeth gently, taking care to avoid the extraction site itself for several days, and do not use commercial mouthwashes, which can contain alcohol that irritates the wound.
Recognizing and Addressing Complications
While some mild pain and swelling are expected for a few days, certain symptoms indicate a complication and require immediate professional attention. Persistent or heavy bleeding that soaks through fresh gauze after 3 to 4 hours of constant pressure is a warning sign. Signs of infection, such as fever, pus draining from the socket, or a foul smell and taste that worsens after the first few days, should prompt a call to your dentist.
The most common complication is alveolar osteitis, or dry socket, which causes intense, throbbing pain that begins one to three days post-extraction and often radiates to the ear, eye, or neck. This occurs when the protective blood clot is lost, leaving the underlying bone and nerves exposed. If you experience pain not managed by prescribed medication or notice the socket appears empty instead of containing a dark clot, contact your dental professional for evaluation and treatment.