Is it absolutely necessary to rinse with salt water after teeth extraction? makes me gag.

No: Its not necessary but it helps the healing process. Try using less salt and more water.

No.: The salt water rinse in my opinion is a very "old school" recommendation, although i know many highly educated dentists and oral surgeons continue to recommend this. The concept is to reduce bacteria by exposing them to a hypertonic environment, salt water. Unfortunately it also creates a hypertonic environment for the newly forming cells your body is building to heal the wound.