Aftercare after a Tooth Extraction, Day by Day

Why the first few days matter

Once a tooth is out, healing starts right away, and good after extraction care helps it along. A blood clot fills the socket, and over the next week or two soft gum tissue grows across the top. The bone underneath takes several months to fill in fully, but you won't feel that part.

Almost every aftercare tip comes back to one goal: keep that first clot in place. Your dentist will give you written instructions that fit your own extraction. Follow those first. The timeline below is a general guide for a simple extraction in a healthy adult.

Day 1: after extraction care in the first 24 hours

Your mouth will likely stay numb for a few hours. Be careful not to bite your cheek, lip or tongue, and wait until feeling returns before eating or drinking anything hot.

• Bite firmly on the gauze for about 30 to 60 minutes. If oozing continues, place a fresh, folded piece and bite again. A little pink saliva is normal for a day or so.
• Don't rinse, spit hard, use a straw or smoke. Each of these can loosen the clot.
• Rest with your head raised on an extra pillow. Skip the gym for the day.
• Hold a cold pack wrapped in a cloth against your cheek, 10 minutes on and 10 minutes off, to limit swelling.
• Choose soft, cool or lukewarm foods such as yogurt, applesauce, smoothies eaten with a spoon, or mashed potatoes.
• Brush your other teeth gently, but stay away from the socket tonight.

Days 2 and 3: swelling peaks, then settles

Swelling and stiffness are often at their worst around the second or third day, then begin to fade. Some people also notice a small bruise on the cheek. After the first 24 hours, switch from cold packs to a warm, damp cloth if your jaw feels tight.

Now you can start gentle salt water rinses. Stir about half a teaspoon of salt into a cup of warm water. Let it roll around your mouth, then let it fall out over the sink rather than spitting. Do this after meals and before bed. Keep eating soft foods such as scrambled eggs, pasta, soup that has cooled, and soft fish.

Day 4 after tooth extraction: what should you feel?

By day 4 after a tooth extraction, most people feel clearly better than they did on day two. Mild tenderness, a little stiffness and some sensitivity when chewing nearby are still common. You may be able to go back to most normal foods, chewing on the other side.

Day four is also the time to watch closely. If pain that was fading suddenly gets stronger, spreads toward your ear, or keeps you awake, call your dentist. That pattern can mean a dry socket, which we explain in our article on what dry socket is and how to spot it.

What a normal socket looks like after tooth extraction

Many people are surprised by how a healthy socket looks. In the first day it holds a dark red clot. Over the next few days the top can turn white, cream or yellowish. That is usually a layer of healing tissue, not pus. The edges of the gum look pink and slowly pull inward.

By about one to two weeks, the hole is smaller and covered by soft gum, though you may still feel a dip with your tongue. If you had stitches, they will either dissolve on their own or be removed at a follow-up visit, as your dentist tells you.

Days 5 to 14: getting back to normal

Through the second week, keep the socket clean and keep easing back into your routine. Brush gently around the area. Keep up warm salt water rinses until the gum has closed over, or for as long as your dentist suggests. Small bits of food may catch in the socket. A gentle rinse usually clears them. Avoid digging food out with a toothpick.

Go back to crunchy, sharp or very chewy foods such as chips, nuts and crusty bread slowly. If you smoke, waiting as long as you can, ideally until the socket has closed, helps the area heal well.

Pain relief and medicines

For most simple extractions, an over-the-counter pain reliever is enough. Your dentist will tell you which type suits you. Take it only as directed on the package or by your dentist, and don't take more than the label allows. Ask a pharmacist before mixing medicines, or if you have stomach, kidney, liver or bleeding problems, are pregnant, or take a blood thinner.

Don't place a tablet against the gum, since it can burn the tissue. If you were given a prescription, such as an antibiotic, take it exactly as prescribed and finish it unless told otherwise. Never use leftover antibiotics or someone else's.

Warning signs: when to call

Call your dentist if you notice any of the following. If you're in Aurora or nearby, you can reach Aurora Gateway Dental Care at 289-475-5497; if we're closed, follow the instructions on our line. Call 911 or go to the emergency department for swelling that makes it hard to breathe or swallow.

• Bleeding that is still heavy after an hour or more of firm pressure on gauze
• Pain that gets worse after day three instead of better
• Swelling that keeps growing after day three
• A fever, chills, pus or a foul taste that won't rinse away
• Numbness in the lip, chin or tongue that is still there the next day
• Trouble opening your mouth that lasts more than a week

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