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Managing Swelling After Wisdom Teeth Removal

Updated: Nov 8

The amount of swelling after wisdom teeth removal will vary depending on how many teeth were extracted and how impacted they are. Of course, the more impacted and more teeth that you're taking out, the more swelling you should expect. Although If you're only removing a single tooth, there may not be much swelling.


impacted wisdom tooth
impacted wisdom tooth

We'll tell you some ways on how to decrease the swelling along with what to look out for.


What to expect

The majority of the swelling should occur within the first 2-3 days of the wisdom teeth extraction. Some people swell up on the day of the surgery while others don't see it until the day after. This is also the same time period for when pain peaks.


fresh wisdom tooth extraction socket
fresh wisdom tooth extraction socket

Those 2-3 days should be the worst of it because after that, the swelling should gradually decrease with each successive day. Typically by the end of the week is when you can expect most of the swelling to have dissipated.


What else to expect in addition to swelling:

  • Pain. Some discomfort is to be expected, the pain will typically peak around the same time as the swelling, 2-3 days.

  • Bruising. There may be a bruise near the surgical site on your face.

  • Trismus. You may find it difficult to open your mouth completely due to the swelling.

  • Inflammation. The surgical site will be inflamed, this induces healing.

  • Bleeding. The socket will be oozing out blood but you can stop it by using gauze.

FYI, whitening toothpaste cannot get rid of the facial bruising.


How to reduce swelling after wisdom teeth removal

You don't have to muscle through the discomfort because there are things that you can do to reduce some of the swelling. Below are some tips to help alleviate it.


Tips to reduce swelling:

  • Take a NSAID. Ibuprofen is commonly prescribed after wisdom teeth surgery because it is an NSAID (non-steroidal anti-inflammatory drug). What it does is help reduce the inflammation and that consequently helps with tempering the facial swelling.

  • Cold compress. For the first 48 hours you should be using a cold compress. You can alternate with 15 minutes on and 15 minutes off to prevent frost bite.

  • Warm compress. After 48 hours you should switch to a warm compress because it can expedite the healing by bringing more blood (nutrients) to the area.

  • Salt water rinse. You should be rinsing with salt water after your extraction to keep the area clean and prevent food from getting stuck in the wisdom tooth hole. It also helps decrease the chances for a dry socket as well.

  • Elevate your head. When you go to sleep, you can elevate your head with an extra pillow which helps to minimize the amount of blood going to your head.

  • Minimize chewing and speaking. Give the area a rest by chewing on the opposite side. You should also try not to move your mouth too much with excessive talking.


Cold vs warm compress

The recommendation by Hopkins Medicine is to use a cold compress for the first 48 hours. After that you should switch to a hot compress in order to maximize your recovery. Prior to 48 hours you should not use a hot compress because it can be detrimental.


Cold compress reduces swelling

The primary mechanism via how cold compresses help with swelling is through applying pressure with it. The pressure helps to keep the swelling and inflammation down. What the cold does is help numb the area to help alleviate pain. It can also slow down the flow of blood as well.


It is important to note that using cold compress is only effective for the first 24-48 hours. After that point, it won't have much of a benefit. You can easily purchase one at any local supermarket or pharmacy. If you can't find one you can make your own.


How to make your own cold compress:

  1. Wrap some ice cubes in a paper towel.

  2. Place them in a ziplock bag.

  3. Apply the compress to the affected side of your face.


Hot compress helps with recovery

The heat from a hot compress helps to stimulate blood flow. In order for the area to heal and get sufficient nutrients, the heat will accelerate the flow of blood to the area.


It is important to note that you should NOT use this within the first 48 hours of your wisdom tooth removal. During that time the most important thing to do is to get the socket to stop bleeding. Using heat will stimulate blood flow to the area and may make the bleeding worse. In other words, please do not use heat during the first two days.


When is the swelling abnormal?

The bulk of the post-surgical swelling from removing your wisdom teeth should occur within the first 2-3 days. After that, you should notice a marked improvement in how your face looks with each day thereafter.


If you notice the swelling not decreasing or improving after the third day, it is an indication that a complication may have occurred.


Signs of abnormal swelling:

  • Residual infection. Maybe all of the abscess or infection associated with the extracted third molar didn't not clear out.

  • You didn't take your antibiotics. If you were given antibiotics you should've been taking them.

  • New infection. Maybe new bacteria infected the wisdom teeth stitches or the extraction socket. A tell-tale sign would be pus oozing out of the area.


Amoxicillin
Amoxicillin

What to do

If there is no improvement in the swelling after the 3rd/4th day you should definitely contact your dentist. They will need to figure out what is wrong and then proceed from there. The area may need to be cleaned out once more and you might need different antibiotics.


Takeaway

Pain, bleeding, and swelling is to be expected after a surgical procedure like wisdom teeth removal. You can manage it at home by using a cold compress, taking NSAIDs, along with the other tips which we mentioned above. Those are all a part of the normal wisdom teeth aftercare.

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About the author: Dr David Chen, DDS

Hello, I'm Dr Chen and I'm an actively practicing dentist in Long Island City, NY. I graduated from Columbia University College of Dental Medicine in 2016 but prior to going to dental school I was already working in the dental field. It's been more than a decade since I first got to know dentistry and let me tell you, time flies by quickly. Since then I've developed a fondness for writing, which is how this all got started!

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Medical Disclaimer:

This blog is purely meant for information purposes and should not be used as medical advice. Each situation in your mouth is unique and complex. It is not possible to give advice nor diagnose any oral conditions based on text nor virtual consultations. The best thing to do is to go in person to see your dentist for an examination and consultation so that you can receive the best care possible.

The purpose of all of this oral health information is to encourage you to see your dentist and to inform you of what you may expect during your visit. Due to the unfortunate nature of dentistry, there isn't really any true home remedies that will get rid of dental problems. Roughly 99.99% of them require in-person intervention by a healthcare professional.

Hint: That is the reason why you can't eliminate seeing dentists in your life!

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