Tooth extraction — your questions answered

It depends on two things: how involved the extraction was and what your work involves.

• Simple extraction, desk job: next day is usually fine. You may be able to work from home the same afternoon, though your lip will be numb for a few hours and calls will be awkward.
• Surgical or wisdom tooth extraction: expect swelling to peak on day two or three. Two to three days off is sensible.
• Physical work, gym or sport: avoid heavy lifting and strenuous exercise for at least 48 to 72 hours. Raised blood pressure from exertion can restart bleeding.

Our written aftercare asks you not to ride or drive yourself home after surgery, so arrange a lift or a cab rather than taking your two-wheeler through traffic with a mouthful of gauze. For surgical extractions, bring a companion.

If you work in one of Kharadi's IT parks, a late-evening slot can help: our Kharadi clinic is open until 11 PM, so you can have the extraction after work and rest overnight. Book online to reserve the time. For what to eat and how to care for the socket at your desk, see our tooth extraction page.

A little blood mixed with saliva looks like a lot, so it helps to know what is normal.

• First hour: bite firmly on the gauze pad. Our aftercare asks for exactly 45 minutes of steady pressure, without changing it to look.
• Rest of the day: slight oozing and pink-tinged saliva are expected.
• Next 24 hours: occasional streaks, especially after eating or on waking.

If it is still bleeding

1. Wipe away loose clots gently with clean gauze. Do not rinse or spit.
2. Fold a fresh gauze piece, or use a moist tea bag, over the socket and bite firmly for another 30 to 45 minutes.
3. Sit upright and rest; keep your head raised on pillows at night.
4. Avoid hot drinks, exercise, alcohol and smoking.

Call 8484 990 678 if bleeding is heavy, fills your mouth, or has not slowed after two rounds of pressure. Our Kharadi clinic is open until 11 PM. After hours, uncontrolled bleeding should be seen at a hospital emergency department; see our emergency dentist page. If you take blood thinners, mention this before the extraction so extra measures can be planned.

Keeping your mouth clean helps healing, but the socket itself needs to be left alone at first.

• First 24 hours: our aftercare asks for no brushing and no rinsing near the site. You can brush other teeth gently, keeping the brush away from the wound and letting toothpaste froth fall out rather than spitting hard.
• After 24 hours: start gentle warm salt-water rinses, especially after meals. Take a mouthful, tilt your head side to side, and let it fall into the basin.
• Days 2 to 7: brush the teeth next to the socket with a soft brush and small, slow strokes. Do not scrub the socket itself.
• Mouthwash: skip strong, alcohol-based mouthwash for the first week. Use a medicated rinse only if your dentist prescribes one.

Do not poke the socket with a toothpick, finger or tongue to remove food. If food sticks, a gentle salt-water rinse is enough. If stitches were placed, they are usually checked or removed at the follow-up about 8 days later. More aftercare tips are on our tooth extraction page.

Smoking harms a fresh socket in three ways:

• Suction: drawing on a cigarette or beedi creates negative pressure in the mouth that can dislodge the clot.
• Reduced blood supply: nicotine narrows blood vessels, so less oxygen and fewer healing cells reach the wound.
• Heat and chemicals: smoke irritates the tissue and raises infection risk.

Smokeless tobacco is no safer. Gutkha, kharra, mishri and tobacco with supari sit right against the healing gum and are a common reason for painful sockets in Pune.

What we ask

Our written instructions ask for no smoking, alcohol, tobacco or mishri for 48 hours before and 72 hours after surgery, and no tobacco or alcohol for 4 to 5 days afterwards. Longer is better. If you cannot stop, at least avoid the first 72 hours completely, and never smoke or chew near the side of the extraction.

Many people find an extraction a good moment to try quitting, since the first few days are already the hardest. If you use nicotine gum or patches, tell your dentist. Signs of dry socket and how to prevent it are explained on our page on alveolar osteitis.

A gap is not static. Several things happen after a tooth comes out:

1. Healing: the clot is replaced by gum within a few weeks and by new bone over three to six months.
2. Bone shrinkage: the ridge of bone where the tooth stood gets narrower and lower. The biggest change happens in the first months and continues slowly after that. This can make a future implant harder without a bone graft.
3. Drifting: the teeth on either side lean or slide into the space, opening small gaps elsewhere.
4. Over-eruption: the tooth in the opposite jaw has nothing to bite against and slowly grows down into the gap.
5. Bite and cleaning problems: tilted teeth trap food, are harder to clean, and are more prone to decay and gum disease. Many people start chewing only on the other side.

None of this happens overnight, and not every gap causes trouble. A removed wisdom tooth usually leaves no problem at all. But a missing first molar or front tooth is worth planning for. Our missing teeth page and replacement options explain what can be done and when.