What should I do after a tooth extraction, and how do I avoid a dry socket?

After a tooth extraction, bite gently on gauze for about thirty minutes to help a blood clot form, then care for the area gently for the next few days. Avoid smoking, using a straw, or rinsing vigorously, since these can dislodge the clot and cause a painful complication called dry socket. Contact your dentist if pain gets worse rather than better.

In short

• Bite gently on gauze for about thirty minutes after the extraction to help a blood clot form over the socket.
• Avoid smoking, drinking through a straw, and vigorous rinsing or spitting for the first day or two, since these can dislodge the clot.
• A soft diet, gentle brushing away from the area, and a warm salt water rinse from the day after the extraction all help healing.
• Dry socket causes pain that gets worse rather than better a few days after the extraction, sometimes with an unpleasant taste or smell.
• Contact your dentist if pain increases, or if you notice swelling, fever or discharge from the site.

This article is part of the extractions and wisdom teeth information on this site for patients in Cape Town.

What should I do in the first day?

An extraction, whether of a wisdom tooth or another tooth, leaves a socket that needs looking after while it heals, and the extractions and wisdom teeth service page has more on the procedure itself. Bite down gently on the gauze or cotton pad placed over the extraction site for around thirty minutes to help a blood clot form, an important first step in healing. If bleeding continues after that, a fresh piece of gauze and another thirty minutes of gentle pressure usually settles it, and blood-stained saliva for a day or two afterward is normal. Avoid rinsing, spitting heavily, smoking or using a straw for at least the first twenty four hours, since the suction or movement involved can dislodge the clot. Rest rather than doing anything strenuous for the first day or two, since this can increase swelling and bleeding.

How do I care for the area over the next few days?

From the day after the extraction, rinse gently with warm salt water a few times a day, especially after meals, without rinsing hard or spitting forcefully. Brush and floss the rest of your teeth as normal, avoiding the extraction site itself for the first day. A soft diet, such as yoghurt, mashed potato or soup, is easier to manage for the first few days, and it helps to avoid hot, spicy or crunchy food near the area. Some swelling and bruising in the first day or two is common, and a cold compress against the outside of the face can help. Jaw stiffness and mild discomfort swallowing are also common afterward and usually ease on their own.

What is dry socket, and how do I avoid it?

Dry socket is a painful condition where the blood clot over the socket does not form properly, or is dislodged before the area has healed. It delays healing, since the clot normally protects the bone and nerve underneath while new tissue grows. Smoking, drinking through a straw, and vigorous rinsing or spitting in the first day or two all raise the risk, so avoiding these helps the clot stay in place. Pain that gets worse, rather than better, a few days after the extraction, sometimes with an unpleasant taste or smell, is the main sign of dry socket, unlike the ordinary soreness expected after an extraction, which generally improves day by day.

What about pain relief?

Over-the-counter pain relief such as paracetamol or ibuprofen usually helps with the discomfort of a healing extraction. Always follow the instructions on the packet, and ask a pharmacist if you are unsure what is right for you. Aspirin is generally best avoided after an extraction unless your dentist has told you otherwise, since it can increase bleeding. Finish any prescribed antibiotics as directed, even once you feel better.

When should I contact a dentist?

Contact your dentist if pain increases rather than eases, or if you notice swelling, a fever or discharge from the site, rather than waiting to see if it passes. What helps wisdom tooth pain, and does the tooth need to come out? covers what leads to an extraction in the first place, and Is a root canal better than an extraction? may help if you are weighing up whether a troublesome tooth should be removed or treated instead. Severe swelling, or difficulty breathing, swallowing or speaking, needs the dental emergency guidance on this site rather than a routine appointment.

How do I reach Dr Davies?

To ask about healing that does not seem right, call Dr Davies directly on her own mobile, which is shown on this page. You can also ask for an appointment through this site. Dr Davies provides extractions at BRS Dental on Strand Street, in Cape Town City Centre, and this page gives general information rather than a diagnosis of your own recovery.