Rinsing with Salt Water After Tooth Extraction

Wait at least 24 hours after extraction:

When your tooth is removed, blood fills the socket and clots, forming a protective covering over the bone and nerves beneath. This blood clot is essential for normal healing—it protects the underlying tissue, provides a matrix for new tissue to grow, and prevents bacteria from reaching the exposed bone.

During the first 24 hours, this clot is fragile. Rinsing, spitting, or any suction in your mouth can dislodge it. Once dislodged, you risk developing dry socket (alveolar osteitis), an extremely painful condition where the bone and nerves are exposed to air, food, and bacteria.

So for the first 24 hours: no rinsing, no spitting, no drinking through straws, and no vigorous mouth movements.

After 24 hours, start gentle rinsing:

Once a full day has passed, the clot has adhered more firmly and gentle rinsing becomes safe and beneficial. Begin salt water rinses 24 hours after your extraction, and continue them for about 1-2 weeks until your socket has healed over.

Aim to rinse 4-6 times daily, especially after eating, when food debris is most likely to be near the extraction site. Rinses before bed help reduce bacterial levels overnight.

The recipe:

Mix 1/2 teaspoon (about 2.5 grams) of table salt into 8 ounces (1 cup or about 240 ml) of warm water. Stir until the salt completely dissolves. This creates a solution that's isotonic or slightly hypertonic to your body's tissues—similar to or slightly saltier than your natural body fluids.

Why these proportions:

Too little salt won't have much effect. Too much salt can irritate tissues and cause discomfort. A half teaspoon per cup is the sweet spot—therapeutic without being irritating.

Water temperature matters:

Use warm water, not hot and not cold. Warm water is more comfortable on tender extraction sites and helps dissolve the salt completely. Hot water can irritate healing tissues or even burn them. Cold water isn't harmful, but it's less comfortable and may not dissolve salt as well.

Aim for a temperature that feels comfortably warm in your mouth—similar to a warm shower, not a hot bath.

Freshness:

Make a fresh solution each time you rinse, or at minimum, make a fresh batch daily. Prepared salt water left sitting around can potentially harbor bacteria over time. Since making the solution takes only seconds, fresh is best.

Can you use other salts?

Table salt (sodium chloride) is the standard and works perfectly. Sea salt works equally well. Avoid salts with additives like iodine (iodized salt is fine, but specialty iodine-heavy products aren't necessary). Epsom salt is different chemically (magnesium sulfate) and isn't recommended for oral use.

Gentle is the key word:

Take a mouthful of the warm salt water. Rather than swishing vigorously like you might with regular mouthwash, use a gentler approach. Tilt your head to let the solution flow naturally over the extraction site. Let it sit there for 30 seconds or so, gently moving your head from side to side if needed to ensure the solution reaches the area.

When you're done, let the water fall out of your mouth into the sink. Don't spit forcefully—the spitting action creates negative pressure that could dislodge the clot.

What NOT to do:

Avoid vigorous swishing that creates turbulent forces in your mouth. Don't spit forcefully—the suction-like pressure is dangerous to your clot. Don't use a water flosser or similar device near the extraction site—the water pressure can easily dislodge clots. Don't use mouthwash with alcohol during the first few days, as it can irritate the site and delay healing.

Dealing with food stuck near the site:

It's normal for food to get lodged near or in the socket. Gentle salt water rinses are the safest way to dislodge debris. If food doesn't come out with rinsing, don't pick at it with fingers, toothpicks, or other objects. Your dentist may have given you an irrigation syringe for stubborn debris—if so, follow their instructions for gentle use after the first few days.

Reducing bacteria:

Salt creates an environment that many bacteria find inhospitable. While it doesn't sterilize your mouth (and you wouldn't want it to—healthy oral bacteria are beneficial), it helps reduce harmful bacterial populations around the extraction site.

Decreasing inflammation and swelling:

The slightly hypertonic salt solution draws fluid out of swollen tissues through osmosis. This can help reduce inflammation and discomfort, particularly in the first few days after extraction.

Promoting tissue healing:

Studies suggest that salt water rinses may actually accelerate wound healing. The mechanism isn't entirely understood, but it may involve stimulating cells involved in tissue repair.

Safely removing debris:

After eating, food particles inevitably get near the extraction site. Salt water rinses gently flush away debris without the mechanical trauma of brushing directly on the healing socket. This helps prevent food from decomposing in the socket, which would cause bad taste, odor, and potentially infection.

How long to continue:

Continue salt water rinses for about 1-2 weeks, until the socket has mostly healed over with new gum tissue. You can continue longer if you find it helpful—there's no harm in gentle salt water rinses even after complete healing. After the first week or so, you can also begin carefully brushing closer to the site as it heals.