Tooth extraction is a common procedure, but the healing process requires careful monitoring. Following the procedure, the body initiates a recovery process to repair the surgical site. Understanding normal recovery is the first step in identifying complications, such as a bacterial infection. This knowledge allows you to seek professional care if healing deviates from the expected path.
Understanding Normal Recovery
The first few days following an extraction involve expected post-operative symptoms that are part of the body’s natural inflammatory response. Mild, manageable pain is normal, particularly within the first 72 hours, and is typically controlled with medication. Localized swelling around the extraction site usually peaks around the second or third day and then begins to subside.
Minor bleeding or oozing is common during the first 24 hours as the protective blood clot forms in the socket. This clot acts as the foundation for new tissue growth. Discomfort and swelling should progressively lessen, indicating that the soft tissues are healing. By the fourth or fifth day, most individuals feel comfortable returning to their regular daily activities.
Definitive Signs of Post-Extraction Infection
A post-extraction infection occurs when oral bacteria invade the socket, often after the protective blood clot has been compromised. The most telling sign is the presence of pus or a foul discharge from the surgical site. This discharge is typically yellow, white, or green, indicating an active bacterial process. A persistent bad taste or odor originating from the extraction site is another strong indicator.
Pain that intensifies rather than improves after the initial three to four days is a significant warning sign. Unlike normal healing, infection-related pain often feels throbbing and relentless. Swelling that increases or spreads beyond the initial 72 hours, or tissue that feels hot, suggests a spreading inflammatory response. Systemic symptoms like fever, generally defined as a body temperature above 100.4°F (38°C), or chills signal that the infection is advancing and requires immediate attention. Lymph nodes under the jaw or in the neck may also become tender and swollen as the body fights the bacteria.
Differentiating Infection from Dry Socket
Patients often confuse a bacterial infection with dry socket, or alveolar osteitis, but their causes and symptoms are different. Dry socket occurs when the blood clot dislodges or dissolves prematurely, leaving the underlying bone exposed. This typically happens three to five days after extraction and results in severe, sharp pain that often radiates to the ear, temple, or neck.
Dry socket is generally not a bacterial infection, meaning it lacks the hallmarks of fever, spreading swelling, or visible pus. While it can cause an unpleasant taste and odor, the site appears empty, sometimes with visible white bone, rather than exhibiting the thick, colored discharge characteristic of infection. The pain profile is also different; dry socket pain is an immediate, intense spike that does not follow the worsening trend seen with infection.
When to Contact Your Dentist Immediately
Certain symptoms require you to contact your dentist or oral surgeon without delay, as they may indicate a serious or rapidly progressing complication.
Urgent Symptoms Requiring Immediate Attention
Visible pus or any yellowish or greenish discharge from the socket warrants an immediate call for professional evaluation and likely antibiotic treatment. A high or persistent fever, especially if accompanied by chills or difficulty swallowing, suggests a systemic spread of infection. Uncontrolled or heavy bleeding that does not slow down after applying pressure with gauze for an extended period, or bleeding that restarts significantly after the first 24 hours, is also an urgent concern. Attempting to manage a suspected infection or dry socket at home can delay necessary treatment, so it is always safer to seek a professional diagnosis for any symptoms that are severe, worsening, or do not fit the expected pattern of normal recovery.