Updated: Oct 19
Accidentally rinsing your mouth after an extraction can potentially dislodge the blood clot from the socket which results in continued bleeding. Although sometimes you can get lucky and it doesn't resume bleeding.
Worry not, we're here to guide you through this crisis from your accidental blunder. To be crystal clear, everything we say here will also apply to wisdom teeth.
Consequences of rinsing after tooth extraction
If you accidentally rinse your mouth after the extraction such as with Listerine or even plain water, one of two things can happen.
Outcomes from rinsing after extraction:
Bleeding worsens. You notice the tooth socket start to bleed more. The amount and intensity of the bleeding is increasing.
Nothing happens. Surprisingly, absolutely nothing happened after rinsing your mouth. You were expecting something bad to occur but nothing ever did.
Rinsing may increase risk of bleeding
The worse outcome from rinsing too soon after the surgical extraction of a tooth may lead to more bleeding. The intraoral pressure that from vigorous rinsing can potentially dislodge the blood clot which is still in the process of stabilizing.
During the first few hours after the procedure, the clot that forms is not mature and it's fairly unstable. For the clot to stabilize, it takes about 24 hours after your procedure before it can withstand rinsing pressure.
If you rinse before the blood clot has stabilized, it will come out and that is when you start bleeding again. For this reason, we recommend abstaining from rinsing until the day after.
The clotting process (hemostasis) explained:
Blood vessel constriction. Within 30 minutes of an extraction, vascular spasms ensue which leads to vasoconstriction. Constriction leads to decreased bleeding.
Platelet plug formation. The platelets arrive and adhere to one another and form a temporary platelet plug. This can momentarily stop the bleeding but it's not very stable.
Activate coagulation cascade. The cascade leads to activation of platelets which strengthens them.
Fibrin clot formation. The final step of the coagulation cascade leads to fibrin deposition. The blood clot stabilization happens during this stage.
Can it cause a dry socket?
Contrary to popular belief, rinsing after an extraction does not cause a dry socket (alveolar osteitis). Although it is unknown as to what causes the condition, what we do know is that it is a biological process and not mechanically induced. That is why activities which may forcefully dislodge the blood clot (rinsing) do not lead to it.
Why rinsing did worsen the bleeding
Sometimes you can get lucky and the rinsing did not make the bleeding worse. Perhaps the blood clot has stabilized just enough to withstand the intraoral pressure.
Alternatively, maybe you only rinsed lightly so the pressure wasn't enough to dislodge the clot. Disappointment or a sigh of relief? Consider yourself lucky but, don't do that again because you may not be so fortunate next time!
How to deal with the aftermath
What you should do afterwards to correct your mistake of rinsing after an extraction would depend on what happened. Is it bleeding or is it not bleeding?
We've created a decision tree diagram to help you determine what you should do.
To be crystal clear, these instructions are valid for all teeth including your wisdom teeth.
If the extraction socket has resumed bleeding, you must bite on gauze again.
Take two pieces of gauze.
Fold them in half twice.
Place gauze over extraction socket.
Bite down with firm pressure.
Remove after 30 minutes.
Repeat steps #1-5 until it stops bleeding.
If you've run out of gauze, you can use a wet black tea bag as a substitute. The tannins in it have hemostatic properties which actually makes it more effective for stopping the bleeding.
Wet the black tea bag.
Place it over extraction site.
Bite with firm pressure.
Switch out to a new one every 30 minutes.
Please don't accidentally rinse again after you've stopped the bleeding.
It's not bleeding
If the socket isn't bleeding then consider yourself lucky because you don't need to do anything. Just make sure that you don't do it again because it may not turn out as favorably the next time you rinse.
As a reminder, you're also not supposed to spit, drink through a straw, nor smoke. All of those three create the same effect as rinsing. They generate a lot of intraoral pressure that can potentially dislodge the unstable blood clot.
When can I rinse again?
It is safe to rinse your mouth the next day or 24 hours after the tooth extraction. By that time the blood clot should've stabilized enough to withstand the rinsing pressure.
In fact, once you're able to rinse again, you should do it as vigorously and frequently as possible with salt water. There are many benefits to doing so.
Prevents food from getting stuck in the extraction hole.
Keeps the area clean of food, debris, and bacteria.
Patients who accidentally rinse after their extraction are not uncommon. After all they've had a long day that was both physically and mentally traumatizing. They did have a tooth surgically removed so can you blame them if they forgot in the heat of the moment?
The good news is that you can redeem yourself by correcting your mistakes. Usually by resuming the use of gauze will mitigate the bleeding which may occur from rinsing. You were supposed to have been biting on gauze for about 3 hours but now you have to redo it again.
You're most likely going to have to bite on gauze or tea bags for an additional 3 hours.
Essentially you'd have been putting pressure on the socket for a grand total of 6 hours... But hey, it was your fault and now you have to deal with it!