After tooth extraction, a blood clot usually forms in the tooth socket. This is the first step in the natural healing process and lays the foundation for your body to heal the extraction site. Since the blood clot is so important to the healing process your dentist will ask you to bite down on a gauze pad to help stop the bleeding and form a stable clot. In some cases, your dentist can place a few stitches to close the gum edges around the extraction site; stitches will help form and stabilise the clot too. The stitches are usually self-dissolving; but sometimes non resorbable stitches will be used. Ask your dentist if you have to come back to have the stitches removed.
In some rare cases, the blood clot in the socket can break loose, causing the bone to be exposed. This is a painful condition referred to as dry socket, and usually requires the dentist to cover the socket with a sedative dressing for a few days while a new clot forms. An extraction wound that has dry socket will not only be painful it will also take longer to heal. This is precisely why it is so critical to care for an extraction site properly after tooth removal.
After the Extraction
While the process of pulling out a tooth is generally safe, the procedure leaves an open wound in your mouth. Since the mouth is host to many different types of bacteria it is important to help the extraction socket heal as quickly as possible. Proper oral hygiene, including on the first day, will help you feel better, prevent infection, and promote faster recovery.
When brushing your teeth after tooth extraction:
- Brush your remaining teeth every morning and evening to ensure that your mouth remains clean for faster healing. Also clean your tongue to help eliminate any unpleasant taste after the extraction and more importantly to keep bacteria levels low.
- Use a soft-bristled brush and clean your mouth gently and slowly using small circular motions.
- Don’t clean the teeth adjacent to the wound area for the rest of the day, but you can start cleaning them the next day. Avoid allowing the brush to hit the extraction socket for the first three days.
- If your wound was stitched up, consider rinsing your mouth. On the day of the extraction, rinse your mouth gently with a solution of salt and warm water after every meal to keep food particles away from the wound area. Don’t rinse vigorously to avoid the risk of dislodging the blood clot. Use ½ teaspoon salt for 8 ounces (240 ml) of warm water
- On the first day after the procedure, start rinsing your mouth thoroughly in the morning and evening using 0.12% chlorhexidine solution until the stitches dissolve. Rinse your mouth for at least one minute before spitting out the solution. Chlorhexidine solution is a prescription antibacterial rinse prescribed by your dentist. It is not necessary to use chlorhexidine to care for every tooth extraction. Your dentist will let you know if it would help you in your unique situation.
- For most tooth extractions you should be able to return to normal brushing and flossing 1 week after the tooth removal.
Other tips which can help maintain the clot in an extraction socket include: don’t drink from a straw for the first 24 hours, maintain a soft diet for the first 24 hours, and take care to chew on the opposite side from the surgery
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My gums feel bruised by where my 2 teeth were pulled. The dentist had a hard time getting out the root tip so I has to get stitches back up. Now my gums feel bruised and are black in colour, what should I do? Is this normal for a longer healing process due to all that pulling and tugging and stitches?
Hi Christine, you are correct that the nature of the dental surgery will influence the healing process. More invasive surgeries will typically result in more swelling, more bruising and more pain. Some very simple tooth extractions are totally pain free. It is always best to consult your dentist if you are concerned about postoperative healing; your dentist would be able to let you know if the experience you are having is normal for the type of tooth extraction you had. I always give my patients my cell phone number after surgery so that I can answer those very questions for them.
I just had my wisdom tooth removed today I haven’t brushed or rinsed my mouth I intend brushing ok the second day can I use a tooth paste I don’t want to have dry socket will toothpaste cause any harm
I hope everything healed up without any problems Violet. Using tooth paste after tooth removal will not lead to dry socket. The risk factors for dry socket are: smoking, birth control medications, having a lower wisdom tooth (much less common with top teeth) removed and gender (females are at slightly higher risk). You can brush your teeth after removal of teeth but avoid brushing the surgical sites for the first few days. Using tooth paste is safe. Always check with your dentist to see if there are any special precautions as every surgery is different and every patient will heal differently.
3 days after my tooth extraction I started having a rotten blood test and breathe in my mouth is going to go away any time soon or do u have to go see my dentist
I got 4 teeth pulled 2 days ago I have cleaned my both with salt water and have been very careful but my side where my teeth were pulled still hurts so bad does anything know if that’s normal also how do you know you have Dr socket? Thank you for any help given!!
Hi Jordan, pain after tooth removal typically peaks at 48h. What you are experiencing could be within the range of normal healing. It’s important to remember that the amount of pain experienced after removal of a tooth is a function of the difficulty of the extraction, the healing capabilities of the individual, and management of the pain with appropriate medications. Pain varies greatly between individuals. As you correctly pointed out is possible that you could have a dry socket, which would result in more prolonged pain and more severe pain. If you are concerned after tooth removal the best person to talk to is the dentist who removed the teeth. The dentist would be most familiar with your surgery, health and pain medications; and only your dentist could diagnose a dry socket which requires visiting the dental office and allowing the dentist to examine the surgical site. I routinely give my patients at Pearl Dental my cell phone number so that they can contact me if they are having trouble after surgery as I can advise them if their post surgical experience is typical or requires after hours care. I hope everything resolved uneventfully for you.
Hi,
I got my wisdom teeth pulled out two days ago. I notice slight bleeding after brushing my teeth. Is this normal?
Thanks!
Yes Christine, that is normal. The surgical sites should stop bleeding soon after the removal of the teeth; but it will be easy to cause minor bleeding again during the first few days after surgery. This is why I advise not to brush the extraction sites for at least three days and avoid chewing in those areas for the first few days too.
Just got two teeth extracted today should I use warm water with salt after brushing my teeth before i go to bed or do I only do that the following day
Hi Luis, I usually only recommend salt water rinses for the first 24 hours. Don’t be too worried though; salt water rinses aren’t absolutely necessary but some people feel it helps keep the extraction site cleaner. It’s more important that you rest and avoid eating or brushing the area.
3 days after my tooth extraction I started having a rotten blood test and breathe in my mouth is going to go away any time soon or do u have to go see my dentist
So I got a tooth extracted last Wednesday… well today I was brushing my teeth and accidentally bumped my toothbrush kinda hard into the area my tooth was taken from and it started bleeding.. is there anything to worry about?
Bumping an extraction site (or any surgical site in the mouth) is never a good idea as it will probably hurt a bit! But as long as the bleeding stops you shouldn’t have too much to worry about. More delicate oral surgical procedures such as bone grafting, gum grafting and dental implant procedures are at higher risk from trauma from eating and brushing. If it’s an extraction site and the bleeding stops and there is no pain it’s probably fine. If it’s a different type of oral surgical procedure, or there is persistent pain or bleeding then best to call your dentist.
I brushed my teeth the night of a tooth extraction- my sheet from my dentist said just to be careful now after reading this I am a bit worried- is the infection going to come back or will that cause dry socket?
No need to be overly concerned Mary. Brushing an extraction site once won’t necessarily cause a dry socket. In general it is safer to avoid the area for the first few days to avoid disturbing the clot. There are many factors that could contribute to the development of a dry socket: lower teeth more frequently, females more often than males, smoking, use of birth control pills. We don’t fully understand all of the causes of dry socket, and even the existence of multiple risk factors doesn’t always lead to a dry socket. Hopefully everything healed up uneventfully.
I had one lower wisdom tooth removed about 5 days ago, i am a medical marijuana patient, and have put off smoking. I have read so many different answers on how long to really wait, my doctor told me 24 hours, everything online says 72. Should i be okay to smoke with out harming the location?