After a tooth extraction: protecting the wound and knowing when to get help
Originally published
After a tooth is removed, a blood clot forms in the socket and helps protect the healing area. Looking after it reduces the risk of complications, but healing cannot be rushed or guaranteed within a fixed number of days.
This is general advice for adults. Follow the instructions from the team that treated you, particularly after complex surgery, sedation or a general anaesthetic, or if you take medicines that affect bleeding.
Protect the socket during the first day
Keep the pressure pack in place for the time your dental team advises. For the first 24 hours, avoid rinsing, forceful spitting and touching the socket with your tongue or fingers. Do not poke the wound or try to clean it with the corner of a tissue. Avoid drinking through a straw.
Follow your team’s advice on when to eat and drink. While your mouth is numb, take care not to bite your lip or tongue, and avoid hot food and drinks. Choose soft food and keep hydrated as advised.
Rest and avoid strenuous exercise for at least the first day, or longer if instructed. Avoid alcohol for at least 24 hours. Do not smoke for at least 48 hours; longer is better for healing. Avoid vaping too, and ask the team for support if this is difficult.
Cleaning and discomfort
Keep the rest of your mouth clean without disturbing the wound. After 24 hours, resume careful brushing around the area and use gentle warm salt-water rinses if advised. Do not swish vigorously or direct a water flosser into the socket.
Pain and swelling can increase during the first two or three days before settling. Recovery varies with the procedure, and the socket may take weeks to close. Do not assume worsening pain is normal just because healing is incomplete.
Paracetamol or ibuprofen may help if suitable for you. Follow the packet or your clinician’s instructions, and check with a pharmacist if you are unsure about other medicines or health conditions. Do not start aspirin for extraction pain because it can increase bleeding. If aspirin or an anticoagulant is already prescribed, do not stop it yourself: follow the treating clinician’s advice.
Antibiotics are not needed after every extraction. Take them only if prescribed and follow the instructions given.
What if bleeding starts again?
Some blood-stained saliva can occur. If the socket is actively bleeding, sit upright and bite firmly on a piece of gauze or a clean folded cotton cloth placed over it. Do not use a paper tissue or loose cotton wool.
Keep steady pressure for 30 minutes without repeatedly lifting the pad to check. If necessary, repeat once. Contact your dental team or NHS 111 if bleeding continues despite pressure, and seek help sooner if it is heavy or you feel unwell. Heavy bleeding that will not stop needs emergency assessment at A&E; call 999 if you feel faint or seriously unwell. Do not wait through repeated home attempts in that situation.
When to contact the dentist
Get prompt dental advice if pain becomes severe or increases after initially improving, particularly with an unpleasant taste or smell. A dry socket can cause substantial pain a few days after an extraction and needs assessment; it is not something to scrape or pack yourself.
Fever, increasing swelling, discharge, or a persistent sharp edge also need advice. Do not try to remove a suspected bone fragment. Severe mouth or neck swelling affecting breathing or swallowing is an emergency: call 999 or go to A&E.
After removal of an upper back tooth, the team may give additional precautions concerning the nearby sinus. Follow those specific instructions and contact them if anything is unclear, rather than trying to suppress a sneeze or test the socket yourself.
Contact us if you have concerns about your recovery. Outside normal hours, NHS 111 can help you find urgent dental care; use emergency services for the severe symptoms described above.