Facial swelling is a common and normal part of the healing process after a tooth extraction. This reaction is the body’s natural way of responding to the procedure, indicating it is working to repair the affected area.
Understanding Post-Extraction Swelling
Swelling after a tooth extraction is a natural inflammatory response to the trauma. When a tooth is removed, surrounding tissues like gums and bone experience a controlled injury. This triggers the immune system to send increased blood flow, fluid, and immune cells to the site, which helps protect against infection and initiates repair.
The accumulation of fluid and immune cells in the soft tissues causes visible puffiness, indicating the body is actively healing the wound. While normal, the extent of swelling varies with extraction complexity; for example, removing impacted wisdom teeth often results in more pronounced swelling due to increased tissue manipulation.
Managing Swelling at Home
Immediately after extraction, apply a cold compress to the outside of the cheek near the site for 15 to 20 minutes at a time, with 15 to 20-minute breaks, for the first 24 to 48 hours. The cold constricts blood vessels, reducing inflammation and numbing the area.
Elevating the head, especially while resting or sleeping, also helps minimize swelling. Use extra pillows to keep the head elevated above the heart, promoting fluid drainage. Over-the-counter pain relievers like ibuprofen may be recommended by a dentist for pain and inflammation. Follow dosage recommendations and avoid strenuous activities, smoking, or using straws, as these can disrupt the healing clot and worsen swelling.
Typical Swelling Timeline
Swelling typically begins within the first 24 hours after extraction, usually peaking between 24 and 72 hours post-procedure. For many patients, the second or third day is when swelling is most noticeable.
After peaking, swelling should gradually subside. Noticeable swelling diminishes within three to five days for most individuals. While the majority resolves within about a week, some mild puffiness might linger, especially after more complex procedures like wisdom tooth removal. Bruising around the extraction site can also occur and typically fades within one to two weeks.
When Swelling Signals a Problem
While some swelling is expected, certain signs can indicate a potential problem that requires immediate dental attention. Swelling that worsens or spreads after three to five days, instead of improving, is a concern. This could include swelling spreading down the neck or affecting vision, although this is less common. Severe or worsening pain that does not respond to medication is also a red flag.
Other warning signs include a fever, chills, or the presence of pus or a foul-smelling discharge from the extraction site. An unpleasant taste or persistent bad breath that is not alleviated by oral hygiene can also suggest an infection. Difficulty swallowing or breathing, or an inability to open the mouth normally, are serious symptoms that warrant immediate medical evaluation.