The most important rule: protect the blood clot
After a tooth is pulled, a blood clot forms in the empty socket. That clot is your body's bandage. It protects the bone and nerves and lets new tissue grow. Almost all good aftercare comes down to one rule: keep the clot in place.
Your dentist will give you written instructions for your case. Follow them first. This guide covers the common steps that dental sources, including the ADA's MouthHealthy site and Cleveland Clinic, agree on.
The first 24 hours are the most important. If you can, plan to rest at home that day. Have soft food, ice packs, gauze and your pain reliever ready before the visit, so you do not have to run out to the store while you are numb.
The first few hours
Bite down gently on the gauze your dentist placed, and keep steady pressure for about 30 to 45 minutes, or as your dentist says. If bleeding continues, fold a fresh piece of gauze and bite on it for 15 minutes.
Some oozing the first night is normal. Rest with your head raised on an extra pillow. Use a cold pack on your cheek in 15 minute rounds to help with swelling. Do not spit hard, do not poke the socket with your tongue or fingers, and do not touch it with a toothbrush.
The numbness can last for hours. Do not chew on the numb side, because it is easy to bite your cheek or tongue without feeling it. Wait until the feeling comes back before you eat anything solid.
If you were given antibiotics or a prescription pain medicine, take it exactly as written, and finish the antibiotic even if you feel better. Ask your dentist before you take anything else, including aspirin, which can make bleeding last longer.
Eating and drinking
Stay with soft, cool or lukewarm foods for the first few days:
- Yogurt, applesauce and pudding
- Scrambled eggs and mashed potatoes
- Soup that is not hot, and smoothies eaten with a spoon
- Soft pasta and rice
What to avoid at first
Skip anything that can disturb the clot or poke the socket.
- Straws. Suction can pull the clot loose and cause dry socket.
- Smoking and vaping. They slow healing and raise the risk of dry socket.
- Hot drinks, alcohol and spicy or crunchy foods, and foods with seeds or grains
- Hard exercise for a few days, because it can raise your pulse and restart bleeding
- Hard rinsing or spitting in the first day
Pain, swelling and keeping your mouth clean
Pain and swelling are normal. Swelling is often worst in the first couple of days, and day three is commonly the most uncomfortable. After that it should start to ease.
Over-the-counter pain relievers usually help. Ask your dentist which one is right for you and how much to take, especially if you have other health conditions or take other medicines. If your dentist prescribed something, take it as directed. A cold pack in the first day and warm compresses after that can also help.
Keep brushing your other teeth, and brush gently near the area. Do not brush the socket itself until your dentist says it is okay.
After the first 24 hours, rinse gently with warm salt water. Mix half a teaspoon of salt in a glass of warm water, tip your head from side to side and let the water fall out of your mouth. Do not swish hard.
How long healing takes
Cleveland Clinic says you can usually return to routine activities within 48 to 72 hours. The gum on top often closes in one to two weeks. Bone takes longer. For a large tooth like a molar, it can take up to four months for the jaw to fully heal.
If your dentist placed stitches, they may dissolve on their own or need removal at a short follow-up visit. You may also feel a hard edge in the area for a while as the bone reshapes. Mention it at your follow-up.
Each mouth heals at its own pace. Smokers, people with diabetes that is not well controlled and people with gum disease may heal more slowly. Tell your dentist about your health and your medicines before an extraction.
Over the first week, the socket changes from dark red, to a white or yellow layer, to pink gum tissue. The white layer is normal healing tissue and not pus, but if you are not sure, ask. A quick photo or a call to your dentist can settle the question.
Dry socket and when to get help
Dry socket happens when the clot is lost or never forms, leaving bone and nerves exposed. Dental sources put the risk at roughly 2 to 5 out of 100 extractions, higher for lower wisdom teeth.
The warning sign is pain that gets better, then suddenly gets worse about 2 to 4 days later, often with a bad taste or smell, and you may see bare bone in the socket. Over-the-counter pain relievers often do not help much.
Call your dentist if this happens. Dry socket is treatable, usually by cleaning the socket and placing a medicated dressing. Also call if you have a fever, swelling that grows after day three, pus or bleeding that does not stop with pressure.
Go to an emergency room or call 911 if you have trouble breathing or swallowing, swelling that spreads toward your eye or neck, or bleeding that will not stop after 20 minutes of steady pressure. These are rare, but they need care at once.
Extraction care at KDA
Kendall Dental Associates offers surgical extractions and can talk with you about replacing the tooth, with an implant, a bridge or a partial denture. We will give you clear aftercare instructions before you leave.
If something does not feel right after your extraction, call 305-271-1421. Our hours are Monday to Friday, 8:00 AM to 5:00 PM, and we offer emergency care 24/7. You can find us at 8833 SW 107th Ave, Miami, FL 33176, in the Kendall Mall. We accept most dental insurances and most Medicare supplemental plans, and financing is available.
If you are thinking about replacing the tooth, ask about it at your visit. Bone changes after an extraction, and the right timing for an implant or bridge depends on your mouth.
Common questions
How long does it take to heal after a tooth extraction?
You can often return to routine activities in 48 to 72 hours. The gum usually closes in one to two weeks, and the bone can take up to four months for a large tooth.
What can I eat after a tooth extraction?
Soft, cool or lukewarm foods like yogurt, eggs, mashed potatoes, soup and applesauce. Avoid hard, crunchy or spicy food, and skip straws.
When can I brush my teeth after an extraction?
Brush your other teeth the same day, gently. Avoid brushing the extraction site until your dentist says it is okay.
What does dry socket feel like?
Pain that gets worse a few days after the extraction, often with a bad taste or smell. Call your dentist if you think you have it.
When can I smoke again?
As late as possible. Smoking and vaping raise the risk of dry socket and slow healing. Ask your dentist how long to wait.
Should I be worried about some bleeding?
Light oozing the first night is normal. If bleeding is heavy or does not slow after 20 minutes of steady gauze pressure, call your dentist or go to an emergency room.
This article is general information, not medical advice. Your dentist will confirm what is right for you at your exam. General information checked against: my.clevelandclinic.org, my.clevelandclinic.org, mouthhealthy.org, mouthhealthy.org.