Instructions after tooth extraction: aftercare guide

Caring for the socket well in the first few days helps it heal comfortably. These instructions after tooth extraction explain what is normal, what to do and what to avoid, and when to call your dentist. They apply to routine extractions and to wisdom tooth removal. Your dentist may give you extra instructions for your own treatment, and those come first. If anything worries you after your extraction, please contact our front desk.

Tooth extraction aftercare: the first 24 hours

Illustration: simple do's and don'ts for the first day after an extraction. Not a patient photograph.

After a tooth is removed, a blood clot forms in the socket. The clot protects the bone and nerve endings underneath and is the start of healing, so most of the advice for the first day is about keeping it in place.

Bite on the gauze. Keep firm, steady pressure on the gauze pad placed over the socket by closing your teeth together.
Do not rinse or spit for the first 24 hours. Swallow your saliva, and wipe your mouth with a clean tissue if needed.
Do not drink through a straw. Drink straight from a glass; sucking can loosen the clot.
Do not smoke or use tobacco. Smoking delays healing, raises the risk of infection and is linked to a higher risk of dry socket.
Avoid hot drinks and alcohol on the first day, and keep food away from the socket. Lukewarm drinks are best for the first few days.
Rest. Avoid strenuous exercise and heavy lifting for the first 48 hours, because it can restart bleeding.
Keep your tongue and fingers away from the socket and any stitches.
Keep your head raised with an extra pillow on the first night, and take any gauze out of your mouth before you sleep.

How to stop bleeding after extraction

Some bleeding after a tooth extraction is normal. A little oozing or pink-stained saliva can continue for several hours, and sometimes for up to about a day. After an upper back tooth is removed, a little bleeding from the nose can also happen; contact the clinic if it does not stop quickly.

Fold a clean, damp gauze pad (or the pad your dentist gave you) and place it directly over the socket, not between the teeth.
Bite firmly and steadily for about 30 to 45 minutes without checking it.
If the socket is still bleeding, replace the gauze with a fresh pad and bite again.
Some dentists suggest biting on a damp, cool black tea bag instead, because tea contains tannins that may help the blood clot.
Sit quietly with your head raised; avoid talking, eating or exercise while the bleeding settles.

Call us straight away if bleeding is heavy (for example, the gauze soaks through quickly or your mouth keeps filling with blood), if it does not stop after you have tried firm pressure as above, or if it starts again and will not settle. Bleeding should have settled well within 3 days; if it has not, contact the clinic so we can check the socket.

Swelling, bruising and jaw stiffness

Some swelling is normal, especially after wisdom tooth removal or a surgical extraction. It is usually at its worst over the first 48 hours and then starts to settle, although it can take several days to go. Some people also have bruising on the cheek or a stiff jaw.

On the first day, hold a cold pack wrapped in a cloth against your cheek for 15 to 30 minutes at a time, with a 10-minute break in between.
Repeat the cold pack on the second day if you need it.
From the third day, warm, moist compresses can ease jaw stiffness, alongside the gentle salt-water rinses you start the day after the extraction.

Contact us if the swelling is getting worse after the third day, if you have difficulty opening your mouth that is not improving, or if you have a fever.

Pain relief and medicines

Mild to moderate soreness is common for the first few days and should improve day by day.

Take any medicines exactly as prescribed by your dentist, with a full glass of water.
If you were prescribed an antibiotic, complete the course; see our article on antibiotics in dentistry.
Some pain medicines can make you drowsy, so do not drive, operate machinery or drink alcohol while taking them.
If you take other medicines, including blood thinners, do not stop or change them without speaking to your doctor.

Call us if you have an allergic reaction (such as a rash, itching or swelling), nausea, vomiting or diarrhoea, or if you cannot keep your medicines down. Seek urgent medical help if you have difficulty breathing or swallowing.

What to eat after tooth extraction

Once the numbness has worn off, eat soft, cool or lukewarm foods, such as yoghurt, curd, dal, khichdi, mashed potatoes, soup that has cooled down, scrambled eggs or a smoothie eaten with a spoon.
Cold, soft foods can feel soothing on the first day, but eat them with a spoon, not a straw.
Avoid hot, spicy, crunchy, hard or sticky foods (such as nuts, seeds, chips and toffee) for the first few days, because they can irritate the socket or get stuck in it.
Chew on the other side of your mouth.
Drink plenty of water and keep eating regular meals; good nutrition helps healing.

You can go back to your normal diet gradually as you feel able. For ideas, read what to eat after a tooth extraction.

Cleaning your mouth while the socket heals

Next morning: brush your other teeth gently with a soft toothbrush, but avoid the extraction site for the first 2 to 3 days. Then start to clean near the socket gently as it heals.
From the day after the extraction: rinse gently with warm salt water a few times a day, especially after meals. Dissolve about half a teaspoon of salt in a glass of warm water, let it wash gently around your mouth, and then let it fall out of your mouth into the sink instead of spitting forcefully.
If your dentist has prescribed an antiseptic mouthwash, use it as directed. Avoid alcohol-based mouthwashes for the first few days.
If you use a water flosser or interdental brushes, keep them away from the socket until your dentist says it is safe.

Stitches

If you have stitches, your dentist will tell you whether they dissolve on their own or need to be removed at a short review appointment, which is usually about 7 to 10 days after the extraction. Leave them alone until then, and keep the area clean with gentle salt-water rinses. If a stitch comes loose, do not pull it; contact the clinic.

Upper back teeth and the sinus

The roots of some upper back teeth sit close to the sinus above them. If your dentist tells you that the sinus was close to or opened into the socket, avoid blowing your nose, sneeze with your mouth open, and avoid straws, flying and swimming for as long as your dentist advises. If you have a blocked or runny nose, ask us before taking any decongestant.

Dry socket: signs and prevention

Illustration: a healing socket protected by a blood clot (left) and a dry socket where the clot has been lost and the bone is exposed (right). Simplified. Not a patient photograph.

A dry socket (alveolar osteitis) happens when the blood clot breaks down or is lost before the socket has healed, leaving the bone exposed (Kolokythas and colleagues, 2010). It usually shows up a few days after the extraction rather than straight away, as pain that gets worse instead of better. The pain can spread to the ear, jaw or neighbouring teeth, and there may be a bad taste or bad breath.

Things linked with a higher risk of dry socket include smoking, a difficult or surgical extraction (especially of lower wisdom teeth), a previous dry socket, poor cleaning of the mouth and, in some studies, the oral contraceptive pill. Following the instructions above, especially not smoking, not using straws and not rinsing on the first day, helps protect the clot.

A dry socket is painful but treatable. Your dentist will gently clean the socket and may place a soothing dressing; a review of studies looked at several local treatments of this kind (Daly and colleagues, 2022). Read more on our dry socket page and in myths and facts about dry socket.

When to call your dentist

Contact ADC promptly if you have:

bleeding that is heavy or does not stop with firm pressure, or bleeding that has not settled within 3 days
pain that gets worse after the second or third day, or is not controlled by your prescribed medicines
swelling that keeps increasing after the third day
a fever, pus, or a bad taste that does not go away
numbness of the lip, chin or tongue that has not worn off by the next day
an allergic reaction, or nausea and vomiting that stops you taking your medicines

Get urgent medical help if you have difficulty breathing or swallowing, or rapidly spreading swelling of the face or neck.

Replacing the missing tooth

Once the socket has healed, it is worth thinking about whether the tooth should be replaced, because the bone of an empty socket gradually shrinks and neighbouring teeth can drift. Read why replacing lost teeth is important and how dental implants help prevent jaw bone loss, and see our tooth replacement and dental implants pages. In some cases an implant or a bone graft can be planned at the time of the extraction, so ask about this before your tooth is removed.

Tooth extraction at ADC, Chandigarh

At ADC – Centre for Restorative and Implant Dentistry, each extraction is planned after an examination and X-rays, and you are given written aftercare instructions to take home. If the tooth is to be replaced, the extraction and the replacement can be planned together. Learn more on our tooth extraction and wisdom tooth extraction pages, read tooth extraction: a step-by-step guide and recovery tips, or see our FAQs after tooth extraction. The clinic is in Sector 21, Chandigarh, within easy reach of Mohali, Panchkula and Zirakpur.

Frequently asked questions

How long does bleeding last after a tooth extraction?
Most bleeding stops within a few hours with firm pressure on the gauze, although a slight ooze can continue for up to about a day. If bleeding is heavy or will not stop with pressure, call us. Bleeding should have settled within 3 days; if it has not, the socket should be checked.

When can I rinse my mouth after an extraction?
Do not rinse or spit for the first 24 hours. From the next day, rinse gently with warm salt water a few times a day, especially after meals.

When can I eat normally after a tooth extraction?
Eat soft foods for the first few days and chew on the other side. Go back to your usual diet gradually as the socket feels comfortable; this can take longer after wisdom tooth removal or a surgical extraction.

Can I smoke after a tooth extraction?
It is best not to smoke at all while the socket heals. Smoking delays healing and increases the risk of infection and dry socket. If you would like help to stop, ask our team.

How do I know if I have a dry socket?
Pain that gets worse a few days after the extraction, instead of easing, with a bad taste or an empty-looking socket, can be a sign of dry socket. Contact your dentist, who can clean and dress the socket.

Book a review or consultation in Chandigarh

This article is general information, not advice for any individual. Please follow the instructions your dentist gives you for your own treatment. If you have had a tooth removed and are worried about bleeding, pain or swelling, or would like to discuss replacing a missing tooth, please contact ADC – Centre for Restorative and Implant Dentistry:

Online booking: ADC Zoho Bookings
Phone: +91-708-780-0016
Email: help@theadc.dental
Clinic: ADC- Centre for Restorative and Implant Dentistry, 1197, Sector 21B, Sector 21, Chandigarh, 160022, India

Mon–Fri 10:00 AM–6:30 PM; Sat 10:00 AM–5:00 PM; Sunday closed. You can also request a consultation online.

Reviewed by Dr. Mohit Dhawan, MDS (Prosthodontics, Crown & Bridge and Implantology).

References

NHS. Wisdom tooth removal: recovery and complications — nhs.uk
Kolokythas A, Olech E, Miloro M. Alveolar osteitis: a comprehensive review of concepts and controversies. Int J Dent. 2010 — PubMed 20652078
Daly BJ, Sharif MO, Jones K, Worthington HV, Beattie A. Local interventions for the management of alveolar osteitis (dry socket). Cochrane Database Syst Rev. 2022 — PubMed 36156769