How to Heal Your Gums After a Tooth Extraction

After a tooth is extracted, it leaves a wound in the gums and jawbone. If not properly cared for, this wound may lead to severe complications and discomfort. Knowing how to take preventative steps before and after the extraction will ensure the healing process goes smoothly.

Apply pressure with the gauze. After your extraction, the dentist will place a gauze pad over the wound to control bleeding. Bite down firmly on the gauze to apply pressure and stop the bleeding. If bleeding continues, you may need to adjust the gauze to align with the wound.

• Avoid talking as it may loosen the gauze and slow the clotting process.
• If the gauze becomes soaked, you can replace it with a new one; however, avoid changing it excessively, and do not spit as it can hinder clotting.
• Do not touch the extraction site with your tongue or fingers, and avoid sneezing, blowing your nose, or coughing during this time. Increased pressure can cause the wound to bleed again. Keep your hands away from the area to prevent it from warming up.
• Remove the gauze after 30-45 minutes and check in the mirror to see if the bleeding has stopped.

Take pain relievers. Only use pain medications prescribed by your dentist. If no prescription is given, you may use over-the-counter painkillers. Also, be sure to take the antibiotics as prescribed by your dentist.

• Take your first dose of pain medication as soon as possible, before the anesthesia wears off. It is essential to follow the prescribed dosage of painkillers and antibiotics as instructed by your dentist.

Use an ice pack. Apply an ice pack to the outside of your face, near the area where the tooth was extracted. The cold helps to stop bleeding and reduce swelling by constricting blood vessels. Apply the ice for 10-20 minutes, then take a 30-minute break. Always wrap the ice pack in a cloth or towel to avoid direct contact with your skin. You can use the ice pack during the first 24-48 hours after the extraction. After 48 hours, swelling will subside, and ice will no longer be effective for pain relief.

• If you don't have an ice pack, you can use a plastic bag filled with crushed or cubed ice.
• Avoid placing your hand on the extraction site as it could heat the area and interfere with healing.

Use a tea bag. Tea contains tannic acid, which helps to form a blood clot by constricting blood vessels. A tea bag can help stop the bleeding. If the bleeding continues for an hour after the extraction, place a moist tea bag on the extraction site and bite down gently to apply pressure. Hold it there for 20-30 minutes. Drinking cold tea may also help, but applying the tea bag directly to the wound will be more effective.

Rinse with warm salt water. Start rinsing your mouth with warm salt water the morning after your tooth extraction. You can prepare the rinse by dissolving one teaspoon of salt in a cup (240 ml) of warm water. Gently swish the solution around your mouth without applying too much pressure. Move your tongue back and forth from one side to the other, then gently spit the water out to avoid disturbing the blood clot.

• Rinse with salt water 4-5 times a day for several days after the extraction, especially after eating and before bedtime.

Get plenty of rest. Adequate rest will help stabilize your blood pressure, aiding in blood clot formation and gum healing. Avoid any physical activities for at least 24 hours after the extraction, and keep your head elevated while lying down to prevent blood or saliva from causing choking.

• Try using two pillows to prop up your head, and avoid lying on the side of the extraction to prevent blood from pooling due to increased temperature.
• Avoid bending over or lifting heavy objects.
• Always sit up straight.

Brush your teeth. After 24 hours post-extraction, gently brush both your teeth and tongue, but avoid brushing near the extraction site. Instead, rinse with salt water gently as described earlier to avoid disturbing the blood clot. Repeat this process for the next 3-4 days.

• You may continue flossing and using mouthwash as usual, but avoid flossing near the extraction area. Use an antibacterial mouthwash or one prescribed by your dentist to eliminate bacteria and prevent infection.

Apply chlorhexidine gel. The day after your tooth extraction, you can apply chlorhexidine gel to the wound to speed up healing. This will also help prevent bacteria from entering the wound and reduce pain and discomfort.

• Do not apply the gel directly to the empty tooth socket. Only apply it around the gum area of the extraction site.

Warm compress after 24-48 hours. Applying a warm compress will promote blood circulation, accelerate the healing process, reduce swelling, and ease discomfort. 36 hours after the extraction, use a warm, damp cloth on your face over the affected area, alternating between 20 minutes of compression and 20 minutes of rest.

Pay attention to your diet. Wait until the anesthesia has worn off before attempting to eat. Start with soft foods and chew on the healthy side of your mouth. You may also prefer cold, soft foods like ice cream to soothe pain and provide nourishment. Avoid hard, crunchy, or hot foods, and refrain from using a straw as it could dislodge the blood clot.

• Eat regularly and do not skip meals.
• Opt for cold or cool foods, but never warm or hot foods.
• Consume soft, slightly cold foods such as ice cream, smoothies, pudding, jelly, yogurt, and soup. These are especially beneficial right after the extraction, as they help alleviate discomfort. Ensure you avoid overly cold or hard foods, and do not chew on the side where the tooth was extracted. Foods that require heavy chewing (like cereal, nuts, popcorn, etc.) could cause pain and further injury to the wound. Gradually shift your diet from liquids to soft foods, then to solid foods after a few days.
• Avoid using a straw. Drinking through a straw creates suction in the mouth, which may lead to bleeding. Take small sips or drink using a spoon instead.
• Steer clear of spicy, sticky foods, hot drinks, and items containing caffeine, alcohol, or sugary drinks.
• Avoid smoking or drinking alcohol for at least 24 hours after the extraction.

Expect swelling. Your gums and mouth will swell as a natural reaction to the tooth extraction, and it may also be painful. This is normal and should subside within 2-3 days. During this time, you can use an ice pack on your cheek to alleviate pain, reduce swelling, and minimize inflammation.

Expect bleeding. After the tooth extraction, small blood vessels within your gums and bone will bleed. The bleeding won't be excessive or uncontrolled, but in some cases, the dentist may stitch the wound to speed up healing. Post-surgical gauze will be placed between your teeth, but not directly on the wound. Be sure to ask your surgeon for guidance and adjustments to the gauze if necessary.

Do not disturb the blood clot. The blood clot will form within the first 1-2 days, and it is crucial not to touch or dislodge it. This clot is an essential step in the healing process, and disturbing or removing it can lead to delayed healing, infection, and pain.

Expect epithelial tissue formation. In the 10 days following the extraction, the gum cells will multiply rapidly to form a layer of epithelial tissue that fills the gap left by the removed tooth. It's essential not to interfere with this natural process while the wound is healing.

Understand bone deposition. After the epithelial tissue forms, bone-forming cells in the bone marrow will be stimulated. This process typically begins along the walls of the extracted tooth socket and gradually moves inward. The gap left by the extracted tooth will eventually close up completely. Bone deposition to close the socket can take up to a year, but the gums will cover the socket within two weeks, and there is no cause for concern as it will fully heal.

Inform your oral surgeon about your medical history. It's essential to let your dentist know about any medications you are currently taking, as these could complicate the surgery or cause issues during or after the procedure.

• Diabetic patients may experience slower healing after dental procedures due to prolonged bleeding. To aid in faster recovery after tooth extraction, ensure your blood sugar levels are kept as close to normal as possible and inform your dentist about your diabetes condition and recent blood sugar test results. The dentist will assess whether your blood sugar level is safe for the procedure.
• Patients with high blood pressure should be aware that some blood pressure medications might cause gums to bleed. It's important to inform your dentist about any blood pressure medications you're taking or have recently taken, as discontinuing the medication before the surgery may prevent complications.
• Patients on blood thinners or anticoagulants like warfarin or heparin should notify their dentist before the procedure, as these medications interfere with blood clotting.
• Patients taking birth control pills containing estrogen should inform their dentist, as these medications may cause clotting issues.
• Some long-term medications may cause dry mouth, increasing the risk of infection after tooth extraction. Speak with your doctor about your medications before the surgery, and also consult them if you plan to change the type or dosage of any medication you're taking.

Understand that smoking can cause complications. Smoking is a major contributor to gum disease. Additionally, the action of smoking can dislodge the blood clot necessary for proper healing. Tobacco can also irritate the sensitive wound and slow down recovery.

• If you're a smoker, consider quitting before your tooth extraction.
• If quitting isn't an option, refrain from smoking for at least 48 hours after surgery. Patients who have the habit of chewing or 'packing' tobacco should avoid smoking for at least 7 days.

Consult with your general physician. Informing your general physician about the upcoming surgery before the tooth extraction can help you avoid potential issues related to medications you're taking or any underlying health conditions you may have.

• If you experience any unusual pain a week after the tooth extraction, consult your dentist.
• Avoid drinking coffee for at least 6 hours after the extraction, as it may reduce the effectiveness of the anesthetic.
• If the pain intensifies after 2 days, seek immediate dental attention, as this could be a sign of dry socket.
• Some mild bleeding and discoloration of saliva may occur within the first 12-24 hours after extraction. If the bleeding is heavy and persistent for 3-4 hours after the procedure, contact your dentist immediately.
• If you notice sharp bone fragments, known as bone sequestra, left behind after the surgery, notify your dentist. While bone regrowth is normal, broken dead bone fragments from the extraction site can cause pain and need to be removed. Contact your dentist or oral surgeon if you suspect leftover bone fragments.