Updated: Oct 30
If you want to rinse with Listerine after a tooth extraction, you should wait at least 48 hours in order to minimize adverse effects from occurring. Rinsing too soon after your surgery can cause unintended side effects.
Despite its wonderful antiseptic benefits, Listerine isn't the preferred mouth rinse after an extraction. Most dentists (us included) actually recommend a simple salt water rinse.
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Waiting will prevent adverse effects
Rinsing with Listerine within 48 hours of an extraction or wisdom teeth removal, can develop undesired side effects. The two most notable adverse effects from rinsing with it can affect clotting and induce pain.
Rinsing too soon with it will affect the blood clotting process of your tooth socket. It will either prolong the time it takes to clot or dislodge the clot and make you keep bleeding.
Effects on clotting:
Impaired clotting. Studies have shown that intaking alcohol can increase the clotting time and decrease the clot firmness. That is from a mere 0.4 pH increase in acidity from neutral. Listerine contains 26.9% alcohol which is very acidic, much more than a beer. The delayed clotting is why you shouldn't drink alcohol after wisdom teeth removal.
Dislodged clot. You're not supposed to rinse with any solutions within the first 24 hours after your surgical tooth extraction. Vigorous rinsing may dislodge the blood clot that is trying to stabilize and that will cause you to keep on bleeding.
Therefore, if you want to use it as a mouth rinse, it would be safer to wait until after 48 hours have passed in order to minimize these adverse effects.
Due to the high alcohol content in Listerine (21.6% to 26.9%) it will burn when you rinse with it. In fact, the burning sensation will be more intense than usual because you're rinsing with it on an open wound.
You're in enough discomfort as it is from the surgery, do you really want to experience additional pain from using this? For this reason, we recommend a more gentle alternative like saline instead, which does not contain any alcohol nor is it acidic.
Note: You can mitigate the discomfort if you use the Zero Alcohol versions of Listerine. However, it'll still give you a slight tingle which is due to the essential oils in the ingredients.
Can it cause a dry socket?
Fortunately, even if you are non-compliant and insist on using Listerine before the 48 hour mark, you won't develop a dry socket. Studies have shown that the development of this condition is due to biological reasons and not mechanical ones.
Ultimately, if you rinse with it, the clot may come out and you'll experience persistent bleeding but what won't happen is a dry socket. The intraoral rinsing pressure is what can potentially dislodge the clot.
Risk factors for dry socket:
Smoking. Studies have shown that smokers are 3 times more likely to get it when compared with non-smokers.
Traumatic extraction. Difficult extractions increase the incidence.
Birth control. Studies have shown that the incidence of alveolar osteitis was significantly higher for those on birth control.
Middle of Menstrual cycle. Middle of a menstrual cycle can increase chances of getting it.
Had it before. If you've had alveolar osteitis in the past, you're more likely to get it once more.
Salt water rinse is a better alternative
The preferred mouth rinse to use after an extraction is plain salt water. That is the general consensus among dentists and oral surgeons. It is what you should be using for the entire first week after your procedure with the exception of the first 24 hours.
Benefits of saline rinse after an extraction:
Gentle. It doesn't cause any discomfort since it isn't alcoholic and doesn't burn.
Antiseptic. The salt will reduce inflammation, pain, and bacterial biofilm.
Dislodges stuck food. If you have food stuck in your tooth socket or wisdom tooth hole, rinsing with salt water can help remove it.
Inexpensive. Salt is readily available and certainly costs less than a brand name mouthwash.
How to make 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.
Listerine vs Salt water rinse
If you wait 48 hours after your extraction, you may use Listerine once more but we'll give you reasons as to why salt water is a better choice.
In our opinion, rinsing with saline is the clear winner here. In fact, that is precisely what we personally recommend to all of our patients after an extraction or wisdom tooth extraction.
You should definitely not use Listerine within the first 48 hours after your tooth removal because there are side effects. However, after that time period, you may rinse with it if you prefer.
Although the preferred and recommended mouthwash to use after an oral surgery procedure is actually just a simple salt water rinse. It is effective, easy to make, and inexpensive. You really can't go wrong with it.