After Tooth Extraction: What to Watch For

Your tooth has been removed. Your mouth now needs a few days to heal. On this page we explain what to do, which things are normal, and when to call us.

Please read all of it. If anything worries you, even something small, call us. There is no such thing as calling for nothing.

Note: This page gives general information. If your dentist told you something different, follow what your dentist told you.

Know Which Type of Extraction You Had

Not every tooth extraction is the same. Healing time and what you will feel depend on which tooth was removed. If you are not sure which of the three types below applies to you, call us and ask.

These times are averages. Yours may be a little shorter or a little longer. That does not mean something is wrong.

Rules for Every Extraction

The following applies after any tooth extraction. The harder the extraction was, the more carefully you need to follow these.

These Are Normal, Do Not Worry

These are the things our patients worry about most. All of them are part of normal healing.

• You may see a dark red, almost black jelly in the socket. What you are looking at is the blood clot covering the wound. It is not rotten tissue and it is not an infection. It is exactly what should be there, and it means healing has started. Do not try to clean it away.
• After a few days the area may look white or yellowish. New tissue forms over the clot and creates a layer of this colour. Most of our patients think it is pus and panic. It is not. It is your new gum in its earliest form.
• Your saliva may look pink on the first day. A small amount of blood mixed into a lot of saliva looks like heavy bleeding. Real bleeding fills your mouth quickly and soaks the gauze bright red. That is the difference.
• You may have a metallic taste in your mouth. That is the taste of blood. It clears up on its own within a few days.
• You may notice a slight bad smell or taste for a few days. Bits of debris left in the healing area cause it. Salt water rinses take care of it. If the smell is strong and you also have a fever or increasing pain, that is a different situation, so call us.
• Swelling is at its worst on day 2 or 3. Most patients expect swelling to shrink a little every day. In fact it builds up first, peaks around day 2 or 3, and then goes down. So if you are more swollen on the second day than the first, you are not getting worse.
• You may get bruising on your cheek or jaw. Blood leaking from tiny vessels under the skin turns purple, then green, then yellow. It fades on its own within a week or two.
• You may not be able to open your mouth fully. Your jaw muscles were held open during the procedure and have tightened up. With back teeth especially, your mouth opens less for a few days. It sorts itself out after day 3 or 4.
• You may feel a small hard edge in the socket. As the gum shrinks back, the edge of the bone underneath can become noticeable. Usually the gum grows over it and it disappears. If it feels sharp, come in and we will smooth it.
• Your tongue will keep going to the gap. That happens because you have noticed the change in your mouth. But do not press on it, suck on it or poke at it. You can pull the clot out that way.
• If you have stitches, the thread may loosen or the end may get longer. Stitches loosen as the gum heals. The dissolving type falls out by itself within 7 to 10 days. If one is bothering you, do not cut it with scissors. Call us and we will deal with it.

Notes for Your Type of Extraction

After a Simple Extraction

• You can go back to work or school the next day. With simple extractions there is mild tenderness for the first 2 or 3 days and the rest is usually comfortable. If your job is physical, take the first day easy.
• Without stitches, food can get into the socket. This is not dangerous, but we do not want it sitting there. After 48 hours, hold salt water in your mouth and let it fall out to clean the area. Never push a toothpick, a needle or a brush tip into the socket.

After a Wisdom Tooth Extraction

• Do not skip the ice in the first two days. The back of the jaw is surrounded by muscle, so it swells more. Twenty minutes of ice on the outside of your cheek followed by twenty minutes off makes a real difference to the swelling. Wrap the ice in a cloth and never put it straight onto your skin.
• After day 3, stop the ice and switch to warm compresses. Cold stops swelling from building up in the first two days. From the third day, warmth increases blood flow and helps clear the swelling that has already collected. Cold first, warmth after. Do not do it the other way round.
• Chew on the other side for at least a week. Pressure on the extraction side damages the clot and slows healing. Make a habit of putting food on the opposite side of your mouth.

After an Impacted Tooth Extraction

• Plan to take the first 2 days off. This is a bigger wound and your body is spending energy on healing it. Feeling tired is normal. Resting speeds the healing up.
• Leave your stitches alone. Playing with them with your tongue or checking them with your finger loosens them and opens the wound. Dissolving stitches fall out by themselves. If yours are the other kind, we will remove them at your appointment, and having stitches out does not hurt.
• From day 4, open and close your mouth gently. Muscles stiffen when they stay still for a few days. Opening and closing as far as you comfortably can, a few times a day, brings your jaw back to normal faster. Never force it into pain.
• After a lower impacted tooth, your lip or tongue may feel numb. The anaesthetic wears off within a few hours. If numbness is still there the next day, we need to know about it. It is not something to panic about, but do call us.
• If you have trouble breathing or swallowing, do not wait. This is very rare, but it can mean the swelling is spreading towards the neck and it needs treating immediately. Call the clinic, and if you cannot reach us, go straight to the nearest hospital emergency department.

About Your Medication

• Not every patient is given antibiotics. Antibiotics are only prescribed when they are needed. If you were not given any, nothing has been left out. Your dentist decided they were not necessary in your case. Taking antibiotics you do not need does no good and can do harm. If antibiotics are not on your prescription, please do not buy them yourself at a pharmacy.
• If you were given antibiotics, finish the whole course. Stopping early because you feel better lets the surviving bacteria multiply again, and the infection becomes harder to treat. Keep going until the last tablet, even if your symptoms are gone.
• Take your painkiller before the pain starts. If you take the first dose while the anaesthetic is still working, the pain never gets a chance to build. A painkiller taken after pain has set in works much less well. Stick to the intervals you were given and do not increase the dose on your own.
• Do not stop your regular medication. Carry on as normal with medication for blood pressure, diabetes, your heart or blood thinning, unless your dentist has told you otherwise. If you take a blood thinner and have not told us, call us now so we can keep an eye on the bleeding.
• Do not use aspirin as a painkiller. Aspirin thins the blood and can increase oozing from the socket. Use the painkiller your dentist recommended. If you are unsure about a tablet, call us before you take it.

What to Do If the Bleeding Does Not Stop

1. Fold a clean piece of gauze into a roll. A clean handkerchief will do if you have no gauze.
2. Place it directly over the socket. Not inside your cheek and not between your teeth, but right on the wound.
3. Bite down firmly for 30 minutes. Do not talk and do not take it out to check.
4. Repeat with a fresh piece for another 30 minutes if you need to.
5. Stay sitting up while you do this. Do not lie down.
6. If it still has not stopped, call us.

A damp black tea bag works the same way if you bite on it for 30 minutes. The tannin in tea helps the blood to clot.

If You Are Travelling Home

Many of our patients come to Istanbul from abroad. Tell us your flight date before you leave the clinic so we can tell you when it is safe to fly. Pack a few pieces of gauze, your painkillers and some salt in your hand luggage. Save our phone number and our WhatsApp before you travel, because we can still help you after you have flown home.

Why These Rules Matter So Much

• The clot is the wound's own lid. When a tooth comes out, a hole is left in the bone. A blood clot fills that hole and covers the bone and nerve endings underneath. New gum and new bone grow on top of that clot. If the clot comes out, the hole is left bare, severe pain begins and healing drags on for weeks. This is called dry socket. Most of the rules on this page exist to protect one thing: that clot.
• Spitting and drinking through a straw pull the clot out. Spitting and sucking both create suction inside your mouth. That suction lifts a clot that has not settled yet. This is why we ask you to swallow your saliva on the first day, or tilt your head and let it run into the sink, instead of spitting.
• Smoking harms you in two separate ways. First, the suction when you draw on a cigarette disturbs the clot. Second, nicotine narrows the blood vessels and cuts the blood supply to the wound. A wound with no blood supply cannot heal. Put the two together and your chance of that very painful healing problem goes up sharply. You need at least a week away from cigarettes, and absolutely none in the first three days.
• Heat can restart the bleeding. Hot food, hot drinks, hot showers and steam rooms widen the blood vessels. Wider vessels bring more blood, and the fresh clot can break down. Cold does the opposite by narrowing the vessels, which reduces both bleeding and swelling. Stay on the cold side for the first day.
• Rinsing washes the lid off the wound. Swishing water around is strong enough to flush the clot out. That is why we ask for no rinsing at all in the first 48 hours, and after that only holding salt water in your mouth and letting it fall out. The aim is a clean area with an untouched clot.
• You still need to brush your other teeth. Plenty of patients stop brushing altogether out of fear. In reality, the bacteria building up in the mouth are the real risk to the extraction site. Brush all your other teeth normally and simply keep off the socket. A clean mouth heals faster.
• Bending and lifting raise the pressure in your head. When you bend forward or lift something heavy, your blood pressure rises and the socket can start oozing again. Stay away from heavy work on the first day and keep your head raised on a pillow at night.
• Leaving the gap empty causes problems later. Once a tooth is gone, the jawbone in that spot is no longer being used and slowly shrinks. The tooth in the opposite jaw grows down into the gap and the neighbouring teeth tip towards it. This is why it is worth talking to your dentist about what goes in the space. We will go through dental implants, bridges and dentures with you. The earlier you plan it, the simpler the treatment is.

In Short

• First 2 hours: bite on the gauze, no eating, no drinking, no spitting, no smoking.
• First 24 hours: no heat, no straws, no rinsing, no cigarettes. Use ice, eat soft food, rest.
• Days 2 to 7: clean gently with salt water, brush your teeth, leave the socket alone.
• Swelling peaks on day 2 or 3, then goes down. That is normal.
• Pain should ease a little every day. If it is increasing, call us.

You can find our other aftercare guides on the Patient Guides page. If an implant is planned, it is worth reading After Dental Implant Surgery as well. You can book your check-up through online appointment, and you can reach us on +90 212 823 79 72 with anything at all that is on your mind.