Almost everything that goes well or badly after an extraction comes down to one thing: the blood clot that forms in the socket. It is the scaffold the new tissue grows into. Protect it and healing is usually uneventful. Dislodge it and you get a dry socket, which is genuinely unpleasant and entirely avoidable in most cases.
The first few hours
- Bite firmly on the gauze for the period you were told, usually 30 to 60 minutes. Firm, steady pressure, not chewing on it.
- If bleeding continues, replace with fresh clean gauze or a damp tea bag, and bite for another 30 minutes. The tannins in black tea help the clot form. Some oozing for several hours is normal; a slow trickle mixed with saliva looks far more dramatic than it is.
- Rest with your head elevated. Lying flat increases pressure and bleeding.
- Ice on the outside of the face, twenty minutes on and twenty off, for the first several hours. This does more for swelling than anything you do later.
- Do not drive if you have been sedated, and follow the instructions you were given.
What not to do for 48 hours
This is the list that matters.
- Do not rinse, spit or swill. Let saliva fall from your mouth rather than spitting. Rinsing is the most common way people dislodge the clot.
- Do not use a straw. The suction pulls directly on the socket.
- Do not smoke or vape. Both the suction and the chemistry impair clot formation. Smoking is the single largest risk factor for dry socket.
- Do not drink alcohol, which interferes with clotting and with healing.
- Avoid hot food and drink on the first day, which can dissolve the clot.
- No strenuous exercise for a few days. Raised blood pressure restarts bleeding.
- Do not poke the socket with your tongue, a finger or anything else.
Eating
Soft, cool and unchallenging for the first day or two: yoghurt, smoothies eaten with a spoon rather than a straw, mashed potato, scrambled egg, soup once it has cooled. Chew on the opposite side. Avoid anything with small hard fragments such as seeds, nuts, rice and crusty bread, which lodge in the socket. Build back to normal food as comfort allows, usually over three to five days.
Keep fluids up. Dehydration makes everything feel worse.
From day two onward
- Start gentle warm salt water rinses after 24 hours: half a teaspoon of salt in a cup of warm water, held and tipped gently rather than swilled, several times a day and after meals.
- Brush your other teeth normally from the first night, avoiding the socket itself for a few days.
- Expect swelling to peak on day two or three, not day one. It then settles over the following few days.
- Take pain relief as directed on the packet or as prescribed. Taking it before the anaesthetic fully wears off works better than waiting for pain to establish.
- Some stiffness and difficulty opening is normal after a surgical extraction and eases over a week.
Dry socket: what it is and how to spot it
A dry socket occurs when the clot is lost or breaks down before the tissue has healed, leaving bone exposed. The pattern is distinctive: pain that was improving suddenly worsens around day three to five, often radiating to the ear or temple, with a bad taste and an empty-looking socket. Over-the-counter pain relief tends not to touch it.
It is treatable. The dentist irrigates the socket and places a medicated dressing, which usually relieves the pain quickly. It is not an infection in the usual sense and does not typically need antibiotics. Do not wait it out.
When to contact the practice
- Bleeding that has not settled after several hours of firm pressure.
- Pain that increases from day three rather than improving.
- Swelling that worsens after day three, or spreads.
- Fever, or feeling generally unwell.
- Numbness in the lip, chin or tongue persisting well beyond the expected duration of anaesthetic.
- Difficulty swallowing or breathing, which is a hospital matter.
Thinking ahead about the gap
Once healing is complete, the question of whether to replace the tooth is worth addressing rather than leaving by default, because neighbouring teeth drift and bone resorbs over time. For a back molar with a stable bite, monitoring may be entirely reasonable. For anything visible or load-bearing, the options are set out in implant, bridge or denture for a missing tooth.
What it costs
Tooth extraction at Civic Gentle Dental Care, including wisdom teeth, ranges from $275 to $600 depending on complexity. An emergency examination starts from $70 to $110 with x-rays at $52 each as needed. Current fees are on our price list, with more on tooth extraction and wisdom teeth removal.
Common questions
How long until the socket closes over?
The gum surface typically closes within one to two weeks. The bone underneath continues filling in over several months.
Can I brush my teeth that night?
Yes, brush your other teeth as normal. Avoid the socket itself and do not rinse vigorously.
When can I exercise again?
Light activity after two to three days, strenuous exercise after about a week, or as advised.
Is it normal to taste blood for a day or two?
Yes. Minor oozing mixed with saliva is expected in the first 24 hours and can leave a metallic taste.
Booking an appointment in Canberra City
Civic Gentle Dental Care is a dentist in Canberra City at Suite 8, Level 3/161 London Circuit, a short walk from the Canberra Centre. To arrange an appointment, call (02) 6247 0224 or send us a message through our contact page.
This article is general information only and is not a substitute for individual dental advice. Whether a treatment is suitable for you, and what it will involve, can only be determined after an examination by a dentist. Any prices mentioned are estimates drawn from our current price guide and are not a quote.