Extraction aftercare and recovery: What to expect (and do) the day after having your tooth pulled and beyond.

- Routine care - Salt water rinses, stitches removal. / How to manage complications - Swelling, dry sockets, bone chips.

You'll need two sets of post-op instructions.

Separate from the aftercare instructions you're given for the first 24 hours after your extraction, your dentist will also provide you with a second set of directions that outline steps you should follow the next day and beyond. (That's the topic of this page.)

It's important to comply with both sets of directions. Doing so will go a long way toward minimizing your potential for developing postoperative complications.


Aftercare - 24 hours after your surgery and beyond.

The same basic instructions set is followed for all types of extractions.

We've noted below where additional steps might be indicated for larger, more involved wounds, such as those resulting from the removal of impacted wisdom teeth.

A) Basic aftercare.

In most cases, the only care that's needed during this time frame is just maintaining the extraction site in a manner that helps to promote its healing. (Extraction healing time line.)

This includes:

  1. Favoring the wound so it isn't traumatized.
  2. Keeping the extraction site clean.
  3. If needed, irrigating the socket (per your dentist's instructions).
  4. If needed, having stitches removed at the proper time.

B) Managing post-extraction complications.

The other postoperative care that may be needed is managing any complications that develop. This would include conditions such as:

1) Prolonged bleeding.    2) Swelling.    3) Dry sockets.    4) Tooth chips. / Bone fragments.

Get your dentist's input.

The instructions found on this page are common guidelines typically used as a part of post-extraction care and recovery.

Your specific situation may involve special circumstances. And for that reason you should discuss these directions with your dentist so they may amend them as is needed.

Additionally, at any point during your healing process, if you have a concern or feel you have developed a complication, you should not hesitate to contact your dentist.


A) Basic aftercare.

1) Favor your extraction site.

You'll need to avoid activities that might traumatize your extraction area. That's because ...

  • They might disrupt or interfere with its healing process.

    This would include events that might dislodge or damage any stitches, dressings or tissue flaps that have been placed or positioned.

  • The new tissues that form are quite vascular (they contain many fragile blood vessels) and they will bleed easily if provoked.

Eating.

It makes good sense to shift your eating activities over to the other side of your mouth for a few days. (You may do this subconsciously anyway because your extraction site is a little tender.)

It's also not a bad idea to choose relatively softer foods, as opposed to hard or crunchy ones that might inadvertently slip over to the wrong side and trigger an event.

Cleaning your teeth.

Don't be too aggressive with your toothbrush and floss.

  • During the first few days you should just do the best that you can, in terms of cleaning the teeth on each side of the space without disrupting the extraction site itself.
  • Later on, after the healing process has progressed somewhat, you'll find it easier to be more thorough without causing disruption of the site.

2) Keep the extraction area clean.

In general, the cleaner you keep your extraction site the quicker it will heal.

Beginning 24 hours after having your tooth pulled, you can gently rinse the area with warm salt water (1/2 teaspoon of salt in a cup of water) after meals and before bed.

Don't be too vigorous. Doing so may disrupt the blood clot or new tissue that has formed.

Salt water, or even just tap water, makes the right choice. Don't use commercial mouth rinses because they may cause irritation.

3) Extraction site irrigation.

In cases where the wound is large and/or deep (like after an impacted wisdom tooth has been removed), food and debris may accumulate. If so, the extraction site may require daily "irrigation."

This process is used to gently flush out accumulated debris that may: 1) Interfere with healing, 2) Be the source of a foul taste or smell or 3) Create an environment that promotes the formation of a secondary bacterial infection.

Irrigation isn't used during first days immediately following your surgery but instead later on during the early-to-mid weeks of bone tissue healing. Your dentist will provide you with specific instructions about when to begin.

Irrigation technique.

Socket irrigation involves the use of a syringe that has a curved or bent blunt-end tip instead of a sharp needle. It's filled with saline solution (salt water), or even just water.

The tip is placed at the opening of the tooth socket and the syringe is slowly expressed so its fluid floats accumulated debris to the surface and away. It's not a forceful activity but instead one that creates a gentle flushing.

A needle and suture material for placing stitches.

If stitches are placed, ask if and when they should be removed.

4) Stitches.

After removing your tooth, your dentist may find it necessary to place one or more stitches. Some types are resorbable (absorbable), meaning that they will dissolve away on their own. Others are not, and will need to be removed.

Removing stitches is easy and painless.

Non-resorbable stitches are usually removed 7 to 10 days after they were placed. The process of removing them is usually very easy and quite painless.


B) Managing post-tooth extraction complications.

1) Prolonged bleeding.

Immediately after your tooth has been pulled, there will be bleeding from your extraction site and it may continue, possibly even for several hours. But the amount that you notice should be ever diminishing. (Related content: Extraction-site bleeding - The first 24 hours.)

At that point 24 hours and beyond from when you had your surgery performed, any bleeding still taking place should only be minor. You might find some slight bloody oozing or seepage coming from the area. But if you notice more than that, you should contact your dentist so they can evaluate your status.

You'll need to make an accurate report to your dentist.

When evaluating your situation, your dentist will be interested in a description of the type and quantity of bleeding that has occurred.

They know that a small amount of blood mixed in with a larger amount of saliva will still appear red. But this type of "blood" is quite different, and represents far less quantity, than if the color of the bleeding you've noticed is dark red. Be as accurate as you can when describing your findings to your dentist so they'll know what type of attention you require.

2) Swelling.

Trauma created during the tooth extraction process can cause postoperative swelling. Any swelling that does occurs usually reaches its peak between 24 to 48 hours after your surgery.

For detailed information, use this link: Preventing and treating post-tooth extraction swelling.

If an extraction site's blood clot is lost, a dry socket will form.

3) Dry sockets.

One possible complication associated with having a tooth pulled is developing a "dry socket." (They're especially commonplace after having a lower wisdom tooth removed.)

This condition typically begins as a dull, throbbing pain that doesn't appear until three or four days after the extraction. A foul odor or taste may be noticed too.

We've dedicated an entire topic to this subject. You can access it here: Dry sockets - Causes, symptoms and treatments.

4) Bone sequestra and tooth fragments.

Patients sometimes have small bone chips or tooth fragments come to the surface of their extraction site as it heals. We address this subject in detail here: Post-extraction bone chips / tooth fragments - Causes, treatment.

Our next page explains the normal time line of extraction site healing. ▶

[Reference sources for this topic.]

 

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