The emphasis is on rinsing during the second day because on the day of the surgery, you're not supposed to rinse, spit, or drink through a straw.
Benefits of a salt water rinse
Despite it's simplicity, a salt water rinse is the most effective mouthwash to use after a tooth extraction. The vast majority of its benefits are derived from the salt in the rinse.
Accelerates wound healing. Studies have shown that using salt can increase the effectiveness in wound healing. It helps the wounds heal faster by closing up quicker.
Decreases dry socket risk. Rinsing with salt water can decrease the incidence of dry socket. Those who rinsed with it had a 2.5% chance of getting it vs 25% chance for those who did not.
Antimicrobial properties. Studies have shown that salt has antibacterial properties. People have been preserving their foods in salt for centuries. This was of course before the invention of the refrigerator.
Cleanses the wound. Vigorously rinsing with a saline mouthwash can dislodge and prevent food from getting stuck in the tooth socket. It also removes debris and plaque that may be around the surgical site.
Non-irritating rinse. Unlike the alcohol based mouthwashes, salt water is gentle enough to not aggravate the extraction site. The acidic rinses will hurt and burn because you're rinsing on an open wound. Same concept as putting rubbing alcohol on a cut. You don't want to cause yourself pain.
Inexpensive and readily available. Everyone has salt at home and it doesn't cost very much. That is a win on the financial front as well.
Due to all of the reasons stated above, it is the preferred rinse to use by all dentists and oral surgeons after an extraction.
It can help prevent dry socket
We would like to just give additional emphasis on the fact that rinsing with salt water can decrease the incidence of dry socket. That is a big deal because the condition is extremely painful and there is no cure. We've had patients tell us that it hurts more than before they had their tooth removed. That is how bad it is.
If the simple act of rinsing with a cup of water and some salt can decrease the chances of it happening, you should do it. Hopefully that is enough of a motivator for you to be compliant with this post-operative recommendation.
How to do it
There is no need to buy saline because you can make your own. All you need is a cup, water, and some salt. It's dirt cheap to boot.
How to make and use a salt water rinse:
Add a teaspoon of salt to a cup of water.
Stir the saline mixture lightly.
Rinse vigorously for 2 minutes by swishing around.
Spit out and repeat after every meal.
Although we say to do it after every meal, you can in fact rinse with it as frequently as you want. There is no such thing as over-doing it when it comes to this mouthwash. The alcoholic mouthwashes may have a limitation but not with salt water.
How to make it more effective
When making the rinse, you can use as much or as little salt was you wish. However it works the best and is most effective when the water is saturated with salt. That means you do have to put a very generous amount in it.
How to tell when it is saturated: Essentially you keep adding salt and stirring it. When it becomes saturated, it will no longer incorporate and there will be salt remaining at the bottle of the glass. If you see salt at the bottom of the cup while stirring, it has become saturated.
Will all that salt give me high blood pressure?
You may be concerned that using so much salt may give you hypertension. Fortunately it should not because you won't be ingesting any of it. After rinsing you should spit it all back out so that you don't swallow any of the salt.
When should I start rinsing?
Despite all of it's benefits, you should start rinsing with salt water on the day after your tooth extraction. You should not and do not want to rinse with anything on the day of your surgery and that includes plain water.
Accidentally rinsing on the day of your tooth removal may result in prolonged bleeding from the socket. The rinsing pressure can dislodge the not yet stable blood clot that is trying to form. If the clot comes out you will resume bleeding once more.
Therefore it is hazardous to actually rinse with salt water on the first day. You should wait for the day after which is when the blood clot has stabilized and matured enough to withstand rinsing pressure. You don't have to worry about the clot coming off if you start on the second day.
How long to rinse for
You should do your best to rinse with salt water for at least a week after your extraction. That is the most critical period for healing. After a week has passed you should notice that the socket hole should've shrunk significantly in size.
It is no longer necessary after 7 days to rinse with it anymore. However if you want to continue using it as a replacement for your mouthwash, you may feel free to do so. You don't need to have a tooth taken out in order to rinse with it. It is gentle enough to be used as an everyday rinse. You can even replace your traditional mouthwash with it if you'd like.
Tip: If you ever get gum inflammation or some type of mouth injury, rinsing with salt water is always the preferred mouthwash to use.
A rinse with salt is the preferred mouthwash after your extraction. Although if you wanted to use something else you may but they won't be as effective.
Plain water. While not as effective, rinsing without salt can still help. Although you do lose the beneficial properties of salt.
Coconut oil. Oil pulling is an option but it is more costly and it may be uncomfortable. Your jaw muscles are most likely tired from the surgery and oil pulling for 20 minutes may be a bit too much.
Does it work for wisdom tooth extractions?
Yes, salt water rinsing applies to extractions for all teeth and that includes the removal of wisdom teeth. It doesn't matter if you're taking out one wisdom tooth or all four at once. You can still use this rinse for all of them.
As a matter of fact, it is probably even more important that you rinse with it frequently if you get all of the third molars taken out at once. More wisdom teeth holes means more chances for an infection to happen. You better rinse as often as you can if that is your situation.
Consequence of not using a mouth rinse
You may be wondering if it is even necessary to do all of this but we're here to tell you otherwise. The chances for complications and side effects may increase.
Food getting stuck. An open hole where the tooth used to be can trap a lot of food. Rinsing vigorously is one way of getting debris out of it.
Dry socket. There is a decrease in incidence for this condition when rinsing with salt.
Bad breath. The frequent rinsing helps to keep the teeth clean and free of bacteria/plaque. That helps to reduce bad breath.
Infection. If you don't keep the surgical site clean it can get infected.
One of the most important things which you can do for your extraction aftercare is rinse with salt water. It will help decrease complications and speed up your recovery.
Just remember that you're not supposed to rinse with it on the day of the surgery. You should start on the day afterwards which is when the blood clot has stabilized.