Your Tooth Extraction Aftercare Guide

Written & Reviewed by Dr David Chen

Congratulations for making it through the hardest part of a tooth extraction which was the surgical removal part of the procedure. It may be over but you still need to recover from it and deal with the aftermath.

tooth extraction cartoon

This is a guide with day to day instructions for tooth removal aftercare. We’ll explain all of the dos and don’ts so that you can maximize your recovery and decrease potential complications.

This is applicable for all types of teeth:

  • Incisors
  • Canines
  • Premolars
  • Molars
  • Wisdom teeth

First Day

The aftercare on the day of taking out your teeth is the most important one in your recovery. All of these instructions should be followed “to the T” because refusal to comply may lead to severe consequences.

The Dos:

  • Take prescribed medications if given
  • Use gauze until it stops bleeding
  • Stick to eating soft foods
  • Rest as much as possible
  • Use a cold compress

The Don’ts:

  • No spitting
  • No rinsing
  • No drinking with straws
  • No smoking
  • No strenuous activities
  • No spicy, acidic, and hard foods
  • Do not play with the tooth hole
  • Do not play with stitches

Pain management

Take all of your prescribed medications before the numbness wears off. Doing so will minimize the chance of feeling pain when you’re in between the anesthesia wearing off and the pain reliever kicking in. Be sure to follow all of the instructions on the labels.

Common pain medications for extractions:

  • Ibuprofen – NSAID for pain, swelling, and inflammation.
  • Acetaminophen – may be combined with codeine to increase potency.
  • Vicodin – very strong pain medication
  • Percocet – very strong pain medication

Commonly used dental antibiotics:

  • Amoxicillin – primary antibiotic
  • Augmentin – if sinus is involved
  • Azithromycin – if allergic to penicillin
  • Clindamycin – if allergic to penicillin
  • Penicillin – similar to amoxicillin

As for how long you will be in pain after the procedure, you can expect it to last about a week or so. The discomfort will typically peak after 48-72 hours and then drastically subside after that. There should be marked improvements with each successive day. During this time you may want to minimize the amount of talking that you do due to the discomfort.

Swelling management

The swelling can be easily managed by using a cold compress. Just remember to alternate having it on and off so you don’t end up with frostbite.

  1. Place cold compress over the affected area.
  2. Alternate with 15 minutes on and 15 minutes off.

Note: If you don’t have a cold compress, you can make your own. Wrap some ice cubes in a wet paper towel and place it inside of a plastic bag. The cold will help numb the pain while the pressure will help reduce the swelling.

Stopping the bleeding

Biting on gauze after an extraction will stop the bleeding in roughly 3 hours. The pressure from biting into it will slow down the bleeding and permit time for the blood clot to develop.

Here is how to use gauze for a bleeding extraction socket:

  1. Take 2 pieces of gauze.
  2. Fold them in half twice.
  3. Place gauze over the socket.
  4. Bite down with firm pressure.
  5. Remove after 30 minutes.
  6. Repeat steps #1-5 until it stops bleeding or 3 hours have passed.
Video instructions

Assuming you’re healthy with no blood clotting disorder and not taking any blood thinners, the bleeding should stop after 3 hours. If the bleeding doesn’t stop, you’ve probably been rinsing, spitting, or drinking through a straw. Those actions can create a lot of pressure in the mouth which can dislodge the not yet stable blood clot.

If you find yourself in a situation where the bleeding doesn’t stop, you can try biting into a black tea bag instead. Black tea contains a lot of tannic acid which has hemostatic properties, that can help stop the bleeding. This is also a great substitute if you run out of gauze.

How to use a black tea bag for a bleeding socket:

  1. Wet the black tea bag.
  2. Place it over extraction site.
  3. Bite with firm pressure.
  4. Switch out to a new one every 30 minutes.

If the bleeding shows no sign of slowing down after 2-3 hours, you should contact your dentist immediately. Alternatively you can seek out urgent care or your local emergency department.

Just to be clear, you’re not supposed to sleep with the gauze in your mouth.

Diet

You have to eat in order to recover because your body needs the nutrients to heal. Although some foods are easier to eat while you’re recovering than others.

Foods you can eat:

  • Applesauce or pureed fruits
  • Soft fruits (bananas, avocados)
  • Steamed vegetables
  • Warm (not hot) soups
  • Oatmeal, congee, porridge
  • Scrambled eggs
  • Smoothies
  • Dairy (Cottage cheese, milk, yogurt) 
  • Soft cooked pasta or noodles
  • Fish
  • Pudding 
  • Mashed potatoes 
  • Ice cream or frozen yogurt

Foods you should avoid:

  • Seeds (chia seeds)
  • Popcorn
  • Nuts (almonds, walnuts, etc)
  • Granola
  • Steak
  • Hard foods
  • Spicy foods
  • Acidic foods
  • Soda
  • Alcohol (beer, wine, liquor)
  • Coffee

If you need to eat or drink, you should remove the gauze from your mouth. You can put a new one back in your mouth after you finish eating.

Rest

You should take the rest of the day off and get as much rest as possible. Try your best to get in some sleep as well because most of the recovery happens while you’re asleep. If you’re unable to sleep, catching up on your favorite tv shows will also work!

What you should abstain from is any strenuous activities which include exercising, cardio, or heavy weight lifting. Essentially all activities that will get your heart pumping may make the bleeding worse. That may undo all of your efforts in trying to get it to stop with gauze.

Oral hygiene

On the first night after your tooth extraction, you may be excused for your routine oral hygiene if you don’t feel comfortable. It’s been a long day and your mouth is a wreck. You’re also not supposed to really rinse so it’s not very practical to brush.

Although if it disgusts you, you can gentle brush and floss. Just make sure that you do not rinse vigorously. Let the water dribble out of your mouth slowly so that you don’t disturb the blood clot.

Day 2-3

On the 2nd and 3rd day the size of the extraction hole should have gotten ever so slightly smaller. The decrease in size may not be noticeable to you but you rest assured because it definitely has. An additional point is that the healing process should’ve improved a lot from the first day. Some restrictions will also be lifted.

The Dos:

  • Take all prescribed medications
  • Eat soft foods
  • Rest as much as possible
  • Frequently rinse with salt water
  • Resume oral hygiene

The Don’ts:

  • No smoking
  • No strenuous activities
  • No spicy, acidic, and hard foods
  • Do not play with the tooth hole
  • Do not play with stitches

Pain management

Continue taking the pain medication and antibiotics if given. The post-surgical pain usually peaks at around the 48 hour mark before it begins to decline so you’re not in the clear yet.

Most of the swelling should’ve subsided at this point and a cold compress is typically not necessary. The anti-inflammatory properties of the ibuprofen should be adequate for controlling any residual swelling.

Note: You should avoid all home remedies to assist with the tooth pain because all that they’ll do is interfere with the healing. This includes using orajel and essential oils.

Bleeding management

You should’ve stopped all actively bleeding after the first night. However it is normal to see some residual small specks of blood here and there.

Diet

Recommendation is to continue to eat soft foods. You may attempt to slowly introduce slightly harder foods each day. Be sure to eat nutritiously so that you have all the nutrients necessary to recover.

Work

Unless you’re in a physically demanding job like construction work, most people should be able to return to work. However if you feel like you need an extra day to recover, you may do so.

Of course, your condition on the second day depends much on how many extractions you had. Listen to your body and give it what it needs. We’re giving out generalizations based on what we typically see from our patients.

  • A single extraction should not impede your daily routine for the 2nd/3rd days.
  • If you had a mouth full of extractions then you should probably take off for the second day and maybe even the third day as well.
  • A couple of extractions may require a second day of rest as well.

Oral hygiene

You must resume all oral hygiene activities immediately. Did you really think a dentist would ever tell you otherwise? In fact, it is of utmost importance to rinse as frequently and vigorously as possible with salt water. This prevents food from becoming lodged in the socket and also dry socket. It is also preferred over an acidic rinse like Listerine.

How to rinse with salt water:

  1. Add a teaspoon of salt to 8 oz of water.
  2. Stir the mixture.
  3. Rinse vigorously for 2 minutes.
  4. Spit out and repeat as many times as needed.
How to video – salt water rinse

Day 4-7

Congratulations, most of the worst part of the aftermath should be over. Recovery and healing should be on the uptrend from this point on. Most of the restrictions are lifted and you may resume most of your daily activities.

You should also notice that the socket should’ve visually gotten smaller. It is a sign that you’re on the right track for recovery.

The Dos:

  • Take all prescribed medications
  • Eat soft foods
  • Frequently rinse with salt water
  • Resume oral hygiene

The Don’ts:

  • No smoking
  • Do not play with socket
  • Do not play with stitches

Pain management

The pain relievers are taken on an as needed basis but the antibiotics are mandatory.

  • The entire course of antibiotics must be finished if you were given them.
  • Taking pain medication is only needed if you’re still in pain. If it is mild and you feel like you can do without them, you can stop taking it. It’ll be easier on your stomach to be taking less pills.
  • Facial swelling should’ve dissipated and a cold compress is unneeded.

You really shouldn’t be in pain by the end of the 7th day. If you are it most likely means that you have a complication.

Bleeding

You shouldn’t be bleeding at all but little specks here and there is still okay. Although you do need to watch out for bad tasting drainage that is white in color. That is an indication of an unresolved infection.

Diet

You can start reintroducing slightly harder foods with each passing day. The goal is to resume your normal diet by the end of the week.

Resume daily routines

  • Work. If you’re still trying to play hookey, your dentist may call you out on it if your boss decides to call the office and ask.
  • Exercise. Run, lift, and do whatever it is you usually do to keep your body healthy!
  • Smoking. The risk for a dry socket should be significantly decreased by the end of the week. If you were to smoke, the end of the week is definitely safer than the first day. Although as a disclaimer, you may still end up with a dry socket so the best thing to do is to quit smoking altogether.

Day 8-14

You should be fully functional by this point in time. There really aren’t any restrictions left for you. Very mild tenderness may still be residually present. The extraction socket should’ve gotten significantly smaller by the end of the second week.

  • Medications. You shouldn’t have anything left to take.
  • Bleeding. No more bleeding.
  • Stitches. The self dissolving stitches should be gone by the end of the second week. The non-dissolvable ones will need to be removed by your dentist.
  • Nutrition. Resume your normal diet.
  • Oral hygiene. We commanded you to resume normal brushing and flossing on the second day. You didn’t miss that did you?
  • Work. You should’ve been back at work a long time ago buddy.
  • Physical activity. Back to your normal routine you go.

Day 15-30

If you’re still looking for sympathy from your significant other or your mother, none will be given. You’re 100% fully functional and fully recovered at this point.

This is beyond the point of even encountering any potential complications. By our standards, there is no more tooth removal aftercare left to do.

The extraction hole should be completely closed by the end of the 4th week.


When to see a dentist

These are all potential complications which may result if you did not follow the directions properly.

  • Persistent bleeding. If you’ve been biting on gauze for 3 hours and then another 3 hours with a black tea bag but there is no improvement, you’ve a complication. You may have an undiagnosed blood clotting disorder. Call your dentist immediately.
  • Worsening pain. Pain will peak around the second or third day but should decline from there. If your pain is increasing after the third day, there is a good chance you may have developed a dry socket.
  • Presence of pus. If you see white fluid oozing out of the socket, you’ve an infection. Although this is unlikely to happen if you’ve been taking your antibiotics. This is more likely if you weren’t given any.
  • Extraction socket feels sharp. If the socket feels sharp when you run your tongue over it you may have a sharp bony spicule. This will need to be smoothed down by your dentist because your body is not remodeling the bone correctly. It is not a leftover piece of tooth root despite what you may think.

Hopefully we’ve answered all of your questions in regards to tooth extraction aftercare.

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A lot of nuances cannot be detected without an in-person clinical exam, which means it is near impossible to diagnose and treat virtually.

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