Swelling is a common and expected aspect of healing after wisdom teeth removal. This natural response occurs as the body sends increased blood and fluids to the surgical site, initiating the repair process. While some swelling around the cheeks, jaw, and sometimes the neck is normal, effective management strategies can enhance comfort and support a smoother healing journey.
Initial Swelling Control
Managing swelling effectively begins immediately after wisdom teeth removal, primarily within the first 24 to 48 hours. During this initial phase, applying cold compresses or ice packs is highly beneficial. Patients should wrap an ice pack or a bag of frozen peas in a cloth and apply it to the outside of the cheek over the surgical area. This application should be done in intervals, typically 15 to 20 minutes on and 15 to 20 minutes off, repeated frequently while awake. The cold helps constrict blood vessels, which reduces inflammation and minimizes bruising in the affected tissues.
Elevating the head plays a significant role in controlling initial swelling. Patients should keep their head elevated above the heart, even while resting or sleeping. This can be achieved by using two or three extra pillows to create a gentle incline. Head elevation helps prevent blood from pooling in the surgical area, which can otherwise increase swelling and discomfort.
Continued Care for Swelling
Beyond the initial 24 to 48 hours, the approach to managing swelling typically transitions to promote circulation and ease stiffness. After cold therapy, moist heat can be introduced through warm compresses. A warm, damp towel or a heating pad set on a low temperature can be applied to the cheek for 20 minutes on and 20 minutes off. This warmth increases blood flow to the area, assisting in the removal of inflammatory byproducts and promoting muscle relaxation, which can alleviate jaw stiffness.
Dietary adjustments and hydration are important for healing and swelling reduction. Consuming a soft diet, including foods such as yogurt, mashed potatoes, soups, and smoothies, prevents irritation to the surgical site. Staying well-hydrated by drinking plenty of water, juice, or broth is equally important, as it aids the body’s natural healing processes. Patients should avoid using straws, as the suction can dislodge the protective blood clot in the extraction site, potentially leading to complications.
Medications play a role in managing swelling and discomfort during recovery. Over-the-counter anti-inflammatory medications like ibuprofen or acetaminophen can help reduce both pain and inflammation. If prescribed, stronger pain relievers should be taken as directed, often with food to minimize stomach upset. Certain activities should be avoided to prevent worsening swelling or dislodging the blood clot, including vigorous rinsing, smoking, and strenuous physical exertion. Gentle jaw exercises, if advised by the oral surgeon, can help maintain jaw mobility and reduce stiffness.
Identifying Concerning Swelling
While some swelling is normal, certain signs indicate it might be abnormal and require medical attention. Swelling typically peaks around the second or third day after surgery and should gradually begin to subside thereafter. If the swelling worsens significantly after this period, or if it does not show signs of improvement by day four, it warrants contacting the oral surgeon.
Additional symptoms with swelling indicate a potential complication. These include the swelling spreading to the neck or throat, or if it causes difficulty breathing or swallowing. A fever, especially one exceeding 100.4°F (38°C), or the presence of pus or unusual discharge from the extraction site, are signs of infection. Severe, uncontrollable pain not relieved by medication, a persistent bad taste or odor in the mouth, or difficulty opening the mouth are also concerning symptoms. Any of these signs should prompt immediate communication with the oral surgeon.