After a tooth extraction: bleeding, pain, when to eat and dry socket

1. Bite firmly on the gauze pad your dentist placed for 30–45 minutes, then remove it.
2. For the first 24 hours, do not spit, rinse or drink through a straw; these can dislodge the clot.
3. Hold something cold against your cheek on the extraction side for 15–20 minutes at a time, several times on the first day.
4. Taking the painkiller your dentist recommends before the numbness wears off makes pain easier to control.
5. Sleep with your head raised on an extra pillow.
6. Do not smoke for at least 48–72 hours.

You can eat once the numbness has gone (usually 2–3 hours). Eating while numb makes it easy to bite your lip or cheek without noticing.

Pink-tinged saliva is normal for the first 24 hours. If there is active bleeding, place a fresh gauze pad or a moistened black tea bag over the area and bite firmly for 30 minutes; the tannin in tea helps stop bleeding.

Swelling usually peaks on day 2 or 3 and then settles. After the first 24 hours, warm compresses are more soothing than cold. Bruising can appear after difficult or surgical extractions and fades within a week.

• Brush your teeth on the first evening, but avoid the extraction site.
• After 24 hours, gently bathe the area with warm salt water (half a teaspoon of salt in a glass of water) after meals, letting it sit rather than swishing hard.
• Stitches, if used, are removed after 7–10 days or dissolve on their own.
• Avoid heavy exercise for 24–48 hours.

Dry socket happens when the clot breaks down early and the bone in the socket is exposed. The typical sign is throbbing pain that gets worse, rather than better, 2–4 days after the extraction and spreads towards the ear. There may be a bad taste or smell and the socket looks empty.

It is more common in smokers, after lower wisdom tooth removal and after difficult extractions. Treatment is simple: your dentist cleans the socket and places a soothing dressing, and the pain usually eases markedly within a few days. Do not just wait it out; contact your dentist.

• Bleeding that continues for more than an hour despite pressure
• Swelling that increases after day 3, or a fever
• Difficulty swallowing or breathing (an emergency)
• Numbness of the lip, chin or tongue lasting more than 24 hours
• Signs of dry socket

For problems that start at night or at the weekend, see our emergency toothache guide. We cover what to do about the gap in implant or bridge?; if the gap is left for a long time, the jawbone gradually shrinks.