Wisdom tooth removal is a common oral surgery procedure. Following the surgery, the body initiates a healing process at the extraction site, which requires careful monitoring. Understanding the difference between expected recovery and the signs of a bacterial infection is important for a smooth return to normal function. This guide explains the typical post-operative experience and the specific indicators that suggest a complication has arisen.
Understanding Normal Recovery Symptoms
Pain and swelling are expected outcomes of the surgical trauma following wisdom tooth removal. These symptoms are typically managed effectively with prescribed or over-the-counter medication. Swelling generally reaches its maximum extent around 48 to 72 hours after the procedure and should gradually begin to subside afterward.
The surgical site may exhibit slight oozing of blood, often appearing as pink-tinged saliva, which is normal for the first 24 hours. Many patients also experience temporary stiffness in the jaw muscles, known as trismus, which can make opening the mouth or chewing difficult. Healthy recovery is indicated when all these symptoms—pain, swelling, and stiffness—improve progressively day by day after the initial peak.
Normal healing involves the formation of a blood clot in the socket, which may be covered by a white or yellowish film of fibrin tissue. This layer is not pus and should not be a cause for concern unless accompanied by other signs of infection. If discomfort or swelling continues to lessen after the third day, the healing process is likely proceeding without bacterial interference.
Clear Indicators of Post-Extraction Infection
A bacterial infection presents with distinct signs that worsen over time, contrasting sharply with the gradual improvement of normal recovery. The most definitive indicator is purulent discharge, which is thick, opaque fluid appearing yellow, white, or green. This pus often originates directly from the socket and may be accompanied by a persistent, noticeably foul taste or odor that cannot be resolved with rinsing or brushing.
Pain that increases in intensity after the third or fourth post-operative day is concerning. Unlike the dull ache of healing, infectious pain is often described as severe, throbbing, and refractory to pain medication that previously provided relief. This worsening pain suggests that bacteria are causing inflammation in the bone and surrounding tissues.
Systemic symptoms indicate that the body is fighting a spreading infection beyond the immediate socket. These signs include a low-grade fever, typically above 100.4°F (38°C), or feeling generally unwell with chills. The lymph nodes under the jaw or in the neck may also become tender and noticeably swollen.
Facial swelling that continues to increase or spreads further down the neck after the initial 72-hour period is concerning. Infectious swelling may feel warm to the touch and can sometimes make swallowing or breathing difficult, requiring immediate medical attention. Any stiffness in the jaw that worsens instead of improving should also be evaluated.
Action Plan and Professional Treatment
If infection is suspected, contact the oral surgeon or dentist immediately. Do not wait for symptoms to resolve or attempt treatment with only home remedies. When calling, be prepared to describe the specific symptoms, including the color of any discharge, the exact temperature if a fever is present, and the level of pain.
Professional treatment typically begins with a clinical examination of the extraction site, often followed by X-rays to assess the underlying bone. The surgeon will thoroughly clean the infected socket, a process called debridement, flushing out trapped debris, bacteria, and accumulated pus. This cleaning removes the source of contamination and promotes a clean environment for healing.
The prescription of antibiotics, such as Amoxicillin, targets common oral bacteria. If a patient has a penicillin allergy, alternatives like Clindamycin may be prescribed. If an abscess (a localized pocket of pus) has formed, the surgeon may need to gently drain it to relieve pressure and facilitate healing. Patients must complete the entire course of antibiotics as prescribed to ensure the infection is fully eradicated and prevent recurrence.