After a tooth extraction: the first days, healing and dry socket

The blood clot that forms in the socket is what lets it heal, so the first few days are about keeping it in place. Bite gently on the gauze until the bleeding settles, rest, hold a cold pack against your cheek and eat soft food once the numbness has worn off. Don't smoke, vape, use a straw, spit or rinse hard, because any of these can dislodge the clot. Some swelling is normal and is often worst around day three. Call us if the pain builds again after it has started to ease, or if you have a fever or pus.

This guide is for a simple extraction under local anaesthetic, like the tooth extractions we do at Durban Dental Care. If you were given your own aftercare instructions, follow those first.

Bleeding

Firm pressure stops most bleeding. Fold a clean piece of gauze over the socket and bite down for about 15 minutes, then repeat with fresh gauze as often as you need to. If bleeding is still heavy after that, call us on 031 563 2473.

Pain relief

Take pain relief as you were advised at your appointment, or as the label says, and ask a pharmacist if you're not sure which medicine suits you. If a different tooth is keeping you up at night, read toothache at night.

What to eat and drink

Wait until the numbness has worn off before you eat, then start with soft food. Rice, pasta, eggs and yoghurt are easy choices. Chew on the other side of your mouth for the first few days, and go back to your usual food as it feels comfortable.

Ask at your appointment, or call us, before you go back to hot drinks such as coffee, or to alcohol.

Smoking, vaping and straws

Don't smoke or vape while the socket heals. In a systematic review of the evidence, smokers had more than three times the odds of getting dry socket, and sucking on a cigarette, a vape or a straw can dislodge the clot that protects the socket.

Avoid straws for at least a week, or for as long as you were told to; one NHS hospital trust advises 14 days. If you smoke, ask us how long to wait before you smoke again.

Brushing and rinsing

Keep brushing your other teeth, gently, and keep the toothbrush away from the socket until you have been told it is fine to clean there.

Don't rinse hard or spit for the first few days, because both can disturb the clot. Gentle rinsing helps keep the area clean, for example with a mild antimicrobial mouthwash two or three times a day. Ask us which rinse to use and when to start, including salt-water rinses.

As the socket heals

If you had stitches, we tell you before you leave whether they dissolve on their own or need to be taken out.

Once the gum has healed, usually within a few weeks, you can decide whether to fill the gap. For one missing tooth, a fibre bridge is often possible: a tooth-coloured replacement bonded to the teeth either side, without surgery. You can compare the ways to replace one tooth before you decide.

Dry socket or normal healing?

Dry socket happens when the blood clot in the socket does not form or is lost, leaving the bone exposed.

If you have no symptoms of dry socket by about day five, you are probably past the risk. If you think you have it, call us on 031 563 2473. We treat dry socket at the practice.

When to call us, and when to go to a hospital

Call us on 031 563 2473 if you have any of these:

• a fever of 38°C or higher;
• pus around the socket;
• pain that painkillers do not help;
• bleeding that will not stop with firm pressure on fresh gauze;
• signs of dry socket from the table above.

When you call, tell us which tooth came out and when.

We are open Monday to Friday 9am to 4pm and Saturday 9am to 12pm. Go to a hospital emergency unit straight away if swelling spreads towards your eye or neck, or you have trouble breathing or swallowing. If heavy bleeding will not stop with pressure and we are closed, go to a hospital emergency unit too. For a broken or painful tooth rather than a healing socket, see toothache and broken teeth.

Your questions about extraction aftercare