Tooth Extraction Aftercare – Problems And Their Management

Tooth extraction aftercare

Tooth extraction aftercare is essential for the healing of the extraction site. The extent of tissue damage during the extraction determines the post-extraction pain and its associated symptoms.

During the routine extractions, teeth are separated from the bone with the hand instruments such as elevators and forceps. These extractions are less traumatic and show quick healing in young and healthy patients.

factors that delay healing after extraction

Healing may be impeded if a patient has a pre-existing condition like diabetes or high blood pressure, etc. The odds of complications in these patients are four times as compared to a healthy person. Old age, reduced immune system or extensive tissue damage during the procedure, for instance, surgical extractions also delays the healing.

Surgical extractions come with the worst post-operative symptoms. Surgical extractions involve cutting the bone with a motorized saw or drill and damage to soft tissues.

Dentists sought to surgically remove a tooth when the wisdom tooth hidden in the bone (impacted tooth) becomes infected, a fragile tooth or tooth has curved or twisted roots and it cannot be removed in one piece without cutting the bone.

The knowledge about the complications of extraction and following the post-extraction instructions may prevent the occurrence of untoward consequences after the procedure.

Tooth extraction aftercare on day 1

local anesthesia

Before the extraction, a local anesthetic injection is given at the site or remote to the site of extraction. The injection aims to numb the area and make the whole procedure painless.

The effect of anesthesia weans in a couple of hours. Therefore, avoid biting and chewing on anything until you get your sensations back.

To stop bleeding – the most important tooth extraction aftercare

The most important thing after the tooth removal is to stop the bleeding and allow a blood clot to form.

If a blood clot doesn’t form or becomes dislodged, dry socket results. Moreover, the risk of post-operative bleeding is high in patients who take asprin (Aspro and Astrix), clopidogrel (Plavix) or warfarin (Coumadin or Jantoven).

Several measures favor the clot formation:
• Biting on the gauze or cotton pad for 30-60 minutes following the procedure.
• Do not spit, rinse, suck using a straw, smoke, or drink carbonated or alcoholic beverages for at least 24 hours.
• Passively empty your mouth when required.
Do not smoke for at least 72 hours after the surgery because smoking delays healing.
• Do not cough or sneeze. Take your medication after the surgery for a couple of days.
• Take some rest and elevate your head. Try to avoid any strenuous activity.


Patients experience mild to moderate degree of pain based on the injury to the tissues. You may also experince pain on swallowing and earache on the side of surgery. Surgical extraction, and impacted wisdom tooth removal present with the worse pain.

Take the pain medication as prescribed by the dentist to relieve the pain. For pain relief non-steroidal antiinflammatory painkillers (tylenol, advil or aleve) are given.

In moderate to severe pain dentists often prescribe opioid painkillers (Percocet). However, Opioids cause drowsiness and therefore one must not drive an automobile after the surgery.

A non-pharmacological tooth extraction aftercare is to keep a warm wheat pack around the neck, or a cold pack wrapped in a towel on the affected jaw to ease the pain. Donot apply heat to your jaws, it will dislodge the clot and delay the healing.


he dentist prescribes antibiotics for severe infection or abcesses. Complete a 5 to 7 days course of antibiotics and do not discontinue the treatment in the middle even if the signs and symptoms resolve.

Tooth extraction aftercare on day 2

Initiate your oral hygiene practices on day 2:

• Brush gently and avoid any plaque buildup at the site of surgery.
• Soothe your mouth with warm salt water gargles and rinse at least 3-4 times a day.
• Start rinsing your mouth with a mouthwash within 24 hours after the surgery. Mix a teaspoon of mouthwash (Chlorhexidine 1%) in warm water and gently swish it around the mouth and let it empty passively.

You will most likely experience one or more of the following symptoms on day 2:


Impacted wisdom tooth removal or a surgical extraction presents some swelling and difficulty opening your mouth. However, in atraumatic simple extractions swelling is hardly noticeable.

Swelling peaks about 36-48 hours after the procedure and begins to resolve after 3-4 days. You may have trouble opening your mouth, but it becomes easier as swelling reduces and the wound heals.

Apply cold compresses to the affected area for 15-20 minutes, remove for 20-minutes then repeat. Call the office if there is no change in swelling after 4-5 days of extraction.


Bleeding from the site of extraction occurs in first 12-24 hours. There is no need to worry as the bleeding discharge is a mixture of blood and saliva.

If you experience excessive bleeding, apply firm pressure with 1-2cm folded moist cotton pad or a damp tea bag on the affected area for 30-60 minutes and keep your head elevated. Do not use a dry cotton pad, it will dislodge the clot.

Call the office if the bleeding does not subside.

Nutrition – diet-related tooth extraction aftercare gives energy to heal fast

• Drink plenty of fluids.
• Avoid carbonated and alcoholic beverages.
A soft diet and nutritious protein-rich diet help get you back on your feet fast. Yogurt, milkshakes (without straw), soups, fish, chicken, and eggs are packed with nutrition and are easy to swallow.
• Salt and some black pepper in food are fine but make sure to avoid spicy food. It is normal to have some discomfort while chewing and difficulty opening wide.


In surgical extractions or large wounds, the dentist closes the wound with stitches. Do not touch them. The stitches remain in place for 7-10 days and are removed at the next appointment. On the contrary, some stitches dissovle on their own in 3-7 days and do not require removal.

After a week or two, the extraction area heals but a hole remains where the tooth was present.

The hole probably takes 3-4 months to fill with a new bone and bridged by gums. However, if food particles become lodged in the hole rinse your mouth with a mouthwash or gently brush to free them.


The most important tooth extraction aftercare is to stop the bleeding and allow a blood clot to form.

Use of pain killers, antibiotics, and cold and hot packs help relieve the pain and swelling following the extraction.

Avoid sucking on a straw, smoking, and spiting to prevent a blood clot to dislodge and cause dry socket.

Following proper care after the extraction reduces the post-extraction complications and allows quick healing.

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