What should I do the first week after a bone graft?
Cited to 4 sources. Reviewed 2026-08-25.
The first week after a dental bone graft is about leaving the site completely alone. Do not rinse or spit early, do not use straws, do not smoke or vape, do not pull your lip out to look, and do not brush over the graft. Ice and keep your head elevated for the first 48 hours, eat cool soft food, and chew on the other side. Cleveland Clinic also advises avoiding alcohol for two weeks and heavy exercise for the first 48 hours. Initial healing takes about a week.
- No rinsing or spitting
- First 24 to 48 hours
- Ice and head elevated
- First 48 hours
- No heavy exercise
- First 48 hours
- No alcohol
- About 2 weeks
What to expect, step by step
Numbness for a few hours, then oozing and building swelling. Gauze pressure controls bleeding.
What to do: Bite firmly on gauze, ice 20 minutes on and 20 off, keep your head above your heart, cool liquids and spoon-soft food only. No rinsing, no spitting, no straws, no smoking, no alcohol, no exercise.
Swelling and bruising peak around 48 to 72 hours. This is the worst of it. Bruising can drift down the cheek or jaw with gravity.
What to do: Keep icing through 48 hours, keep the site untouched, brush every other tooth with a soft brush, stay on soft food, and keep chewing on the opposite side.
Swelling starting to fall and pain clearly easing. Gum edges beginning to close. You may notice a white or gray film at the site, which is usually the membrane or a normal healing layer.
What to do: Switch from ice to gentle warmth on the outside if your surgeon suggested it. Start approved salt water rinses, letting water fall out rather than spitting.
Cleveland Clinic describes the first round of healing as taking about a week. Most people are noticeably comfortable here.
What to do: Continue soft food and the no-brushing rule at the site until your surgeon clears it. Keep the follow-up appointment even if you feel completely fine.
The three pressures that move a graft
Almost every first-week restriction exists to stop one of three forces from shifting graft material before it stabilizes.
Suction. Straws, smoking, vaping and spitting all create negative pressure in your mouth, which can lift particles out from under the membrane. Cleveland Clinic advises against spitting or rinsing vigorously and against smoking or vaping after a bone graft.
Traction. Pulling your lip or cheek outward to inspect the site is the most underrated risk on this list. The gum was closed under tension, and stretching it is a direct route to tearing a stitch and opening the wound over the graft. Resist the urge to check, and use a mirror without touching if you must look.
Compression. Chewing over the site, poking with your tongue, brushing it, or using a water flosser all push directly on material that is not yet anchored.
The first week checklist
Print this or keep it on your phone. Follow your surgeon's own instruction sheet where it differs, since it accounts for the size and type of your graft.
- Bite on gauze with firm steady pressure for 15 to 30 minutes at a time until oozing stops
- Ice the outside of your face for the first 48 hours, roughly 20 minutes on and 20 minutes off
- Sleep with your head elevated on extra pillows for the first two to three nights
- No rinsing, swishing or spitting for the first 24 to 48 hours, or as long as your surgeon specified
- No straws, no smoking, no vaping, and no carbonated drinks
- No alcohol for about two weeks, and none at all while taking prescribed pain medication
- No heavy lifting or strenuous exercise for the first 48 hours
- Cool or lukewarm soft food only, chewed entirely on the opposite side
- Brush every tooth except the graft area with a soft brush from the first night
- Do not pull your lip or cheek out to look at the site
- Take medication exactly as your surgeon prescribed and finish any antibiotic course
- Keep the follow-up appointment even if everything feels normal
What is normal in week one
Swelling and bruising are expected and peak around 48 to 72 hours. Cleveland Clinic describes tenderness, swelling and bruising as normal side effects that subside within one to two weeks. Bruising on the cheek, jawline or even down the neck is a gravity effect, not a complication.
A few gritty particles that look like grains of sand or salt escaping the site is also normal. Cleveland Clinic notes small bone fragments like this are expected and only significant fragment loss warrants a call.
A white, gray or creamy patch over the site is usually the barrier membrane or the normal fibrin layer that forms over any wound in the mouth, not pus. Some odor while you cannot brush one spot is also common. A foul taste that keeps coming back after rinsing is not.
Call your dentist or oral surgeon if
- Bleeding that restarts and does not stop after 30 to 45 minutes of firm gauze pressure
- Pain or swelling that gets worse after the first week instead of better
- Fever of 101 degrees Fahrenheit or higher
- Pus or drainage from the graft site
- Losing a large amount of graft material rather than a few grains
- The stitches opening and leaving the graft or membrane widely exposed
- Numbness in the lip, chin or tongue that persists well past the day of surgery
- Difficulty swallowing or breathing, or swelling spreading toward the eye or neck, which needs emergency care immediately
Related questions
When can I start salt water rinses?
Usually after the first 24 to 48 hours, but only when your surgeon says so. When you do, hold the water, tilt your head and let it fall out over the sink instead of spitting.
Can I sleep on the side I had surgery on?
It is better not to for the first few nights. Keep your head elevated and try to stay off that side so pressure and swelling stay down.
How much swelling is too much?
Swelling that peaks at 48 to 72 hours and then declines is normal, however large it looks. Swelling that grows again after day three, or that spreads toward your eye or neck, needs to be seen.
Can I go back to work the next day?
Many people with a small socket graft do desk work the next day. Skip anything physically strenuous for the first 48 hours, since exertion raises blood pressure at the site.
Sources
- Dental Bone Graft: Process, Purpose & Healing (Cleveland Clinic)
- Tooth Extraction: Surgery & Healing (Cleveland Clinic)
- Smoking and surgery (MedlinePlus (NIH))
- Dry socket - Symptoms and causes (Mayo Clinic)
Reviewed against the sources above on 2026-08-25. General information only, not dental advice. Your own provider's aftercare instructions come first.
Keep reading
Stay on cool soft foods for the first few days after a dental bone graft, then work back toward normal food over one to two weeks while chewing entirely on the other side. Yogurt, smoothies eaten with a spoon, scrambled eggs, mashed potatoes, soup that has cooled and soft pasta are all fine. Skip straws, hot liquids, seeds, nuts, chips, and anything that fragments and could lodge in the site. Cleveland Clinic also advises no alcohol for about two weeks.
Brush the rest of your mouth normally starting the night of surgery, but keep the brush completely off the graft site until your surgeon clears it. Cleveland Clinic's guidance for surgical sites is to avoid brushing directly over the area until your dentist says it is safe while brushing and flossing everywhere else as usual. In practice that clearance usually comes somewhere between one and two weeks, at the visit where your stitches are checked or removed.
Yes, a small number of granules coming out is normal and expected. Cleveland Clinic describes tiny bone fragments that look like grains of sand or salt working loose in the first days, and that does not mean the graft has failed. Surgeons pack extra material precisely because some is lost. What is not normal is losing a large amount, seeing a visible dip appear in the site, or having granules keep pouring out past the first week. Call your surgeon in those cases.
A dental bone graft heals on two separate clocks. The gum tissue over the graft settles within about one to two weeks, which is when tenderness, swelling and bruising fade. The bone underneath takes far longer: at least three months for a small socket graft, and up to about 12 months for a large ridge augmentation or block graft. Your surgeon confirms bone maturation with an x-ray, not by how you feel.