Immediately after the tooth extraction or wisdom tooth extraction, your dentist places gauze in your mouth and tells you to bite down. “The pressure will help stop the bleeding” he says. You’re supposed to switch it out every 30 minutes until it stops bleeding.
Next, they proceed to tell you the four most important don’ts for the aftercare:
The instructions were duly noted but when you got home, there was an excessive amount of blood pooling in your mouth. The instructions escape you for a moment and you do the unthinkable. You accidentally rinsed your mouth after a tooth extraction.
You just did what you were told not to do. Should you return to your dentist? What’s going to happen? What should you do now?!
Worry not, we’re here to guide you through this crisis from your accidental blunder.
Consequences of rinsing after tooth extraction
If you accidentally rinse your mouth after the extraction such as with Listerine or plain water, one of two things can happen.
- Bleeding worsens. Immediately after rinsing, the tooth socket starts gushing out blood. It is almost as if someone turned the facet back on. Prior to rinsing, the bleeding was slowing down but now it has reversed course.
- Nothing happens. Surprisingly, absolutely nothing happened after rinsing your mouth. You were waiting and expecting something to occur but nothing ever did.
Rinsing may increase risk of bleeding
Rinsing too soon after the surgical extraction of a tooth may lead to more bleeding. The pressure that is created from vigorous rinsing can potentially dislodge the blood clot which is trying to form.
During the first few hours after the procedure, the clot that forms is very unstable. It is usually not until the next day or 24 hours later that the blood clot stabilizes enough to withstand rinsing pressure.
If you rinse before the blood clot has stabilized, it will come out and that is when you start bleeding again. However that is usually not a problem if it has been given time to be fully stabilized. For this reason, we recommend abstaining from rinsing until the next day.
The clotting process is referred to as hemostasis which occurs over many hours:
- Blood vessel constriction. Within 30 minutes of an extraction, vascular spasms ensue which leads to vasoconstriction. Constricting them leads to less outward bleeding.
- Platelet plug formation. The platelets arrive and adhere to one another. They form a temporary platelet plug that can stop the bleeding but is not very stable.
- Activate coagulation cascade. The cascade leads to activation of platelets which strengthens them.
- Fibrin clot formation. The final step of the coagulation cascade leads to fibrin deposition. The blood clot stabilization happens during this stage.
Can it cause a dry socket?
Contrary to popular belief, rinsing after an extraction does not cause a dry socket (alveolar osteitis). Although it is unknown as to what causes the condition, what we do know is that it is a biological process and not mechanically induced. That is why activities which may forcefully dislodge the blood clot (rinsing) do not lead to it.
Why rinsing did not make the bleeding worse
Sometimes you can get lucky and the mouth rinsing did not make the bleeding worse. Perhaps the blood clot has stabilized just enough to withstand the intraoral pressure. Alternatively, maybe you only rinsed lightly so the pressure wasn’t enough to dislodge the clot.
Disappointment or a sigh of relief? Consider yourself lucky but, don’t you dare do that ever again. You may not be so fortunate the next time you do it!
How to deal with accidentally rinsing
What you should do afterwards to correct your mistake of rinsing after an extraction would depend on what happened. Is it bleeding or is it not bleeding? We’ve created a decision tree diagram to help you determine what you should do.
To be crystal clear, these instructions are valid for all teeth and that includes your wisdom teeth. They are universally applicable.
It’s bleeding
If the extraction socket has started bleeding again, you must resume biting on gauze.
- Take two pieces of gauze.
- Fold them in half twice.
- Place gauze over extraction socket.
- Bite down with firm pressure.
- Remove after 30 minutes.
- Repeat steps #1-5 until it stops bleeding.
If you’ve run out of gauze, you can use a wet black tea bag as a substitute. The tannins in it have hemostatic properties which actually makes it more effective for stopping the bleeding.
- Wet the black tea bag.
- Place it over extraction site.
- Bite with firm pressure.
- Switch out to a new one every 30 minutes.
Last but not least, do not forget to NOT rinse again by accident so that it doesn’t happen another time.
It’s not bleeding
If the socket isn’t bleeding then consider yourself lucky because you don’t have to do anything. Just make sure that you don’t do it again please. It may not turn out as favorably the next time you rinse.
As a reminder, you’re also not supposed to spit, drink through a straw, nor smoke. All of those three create the same effect as rinsing. They generate a lot of intraoral pressure that can potentially dislodge the unstable blood clot.
When can I rinse again?
It is safe to rinse your mouth the next day or 24 hours after the tooth extraction. By that time the blood clot should’ve stabilized enough to withstand the rinsing pressure.
In fact, once you’re able to rinse again, you should do it as vigorously and frequently as possible with salt water. There are many benefits to doing so.
- Decrease inflammation.
- Prevents food from getting stuck in the extraction hole.
- Keeps the area clean of food, debris, and bacteria.
Takeaway
Patients who accidentally rinse after their extraction are not uncommon. After all they’ve had a long day that was both physically and mentally traumatizing. They did have a tooth surgically removed so can you blame them if they forgot in the heat of the moment?
The good news is that you can redeem yourself by correcting your mistakes. Usually by resuming the use of gauze will mitigate the bleeding which may occur from rinsing. You were supposed to have been biting on gauze for about 3 hours but now you have to redo it again. You’re most likely going to have to bite on gauze or tea bags for an additional 3 hours.
Essentially you’d have been putting pressure on the socket for a grand total of 6 hours… But hey, it was your fault and now you have to deal with it! Just make sure you don’t do it again and remember to review all of the tooth extraction aftercare instructions.