Day 4 marks a significant transition in the recovery process following wisdom teeth removal, moving beyond the acute phase of immediate post-operative care. The intense discomfort and limitations characteristic of the first three days should be noticeably easing by this point, confirming that healing is progressing as expected. Patients often begin to feel more functional and are ready to consider a wider range of activities and foods. This stage of recovery is defined by a shift from managing symptoms to actively encouraging soft tissue healing.
Typical Physical Recovery Milestones
Pain levels on Day 4 should be substantially reduced compared to the peak discomfort experienced on Day 2 or Day 3. The need for prescription pain medication should be decreasing, with many patients finding relief with only over-the-counter options. If your pain is suddenly worsening or feels intense and throbbing, this deviation from the expected improvement warrants professional attention.
Swelling, a natural inflammatory response to the surgery, typically peaks around 48 to 72 hours post-procedure and should now be visibly starting to subside. While some residual facial puffiness or minor bruising may still be present, the overall size should be decreasing daily. Continued application of moist heat externally can help the body reabsorb the fluid contributing to this residual swelling.
Some stiffness in the jaw, medically termed trismus, may persist, but your ability to open your mouth should be incrementally improving. Inside the mouth, the extraction sites are healing, and it is normal to see white or yellowish tissue covering the sockets. This is a layer of fibrin, a protein involved in clotting, and it represents healthy, protective granulation tissue, not a sign of infection.
Resuming Normal Activities and Diet
Day 4 is generally the time to cautiously expand your diet beyond the initial liquid and pureed foods, moving into soft solids. Acceptable options include well-cooked pasta, soft scrambled eggs, mashed bananas, and thoroughly steamed vegetables that require minimal chewing. The goal is to provide necessary nutrients for healing without putting excessive mechanical stress on the surgical sites.
You must continue to avoid anything crunchy, sharp, or sticky, such as nuts, chips, and seeds, which could irritate the healing gum tissue or become lodged in the socket. Similarly, very hot liquids or spicy foods can increase inflammation and should still be avoided for a few more days. It remains important to take small bites and chew gently, primarily using the front teeth and avoiding the back extraction sites.
Oral hygiene protocols can be maintained with slightly increased rigor, though gentleness is paramount. You should continue to brush your remaining teeth carefully, avoiding the surgical area directly, and resume the prescribed or saltwater rinses. When rinsing, simply tilt your head and let the liquid drain out rather than spitting forcefully, as the suction can dislodge the protective blood clot.
Physical activity can be gradually reintroduced, but only in the form of light, non-strenuous movement. Avoid intense exercise, heavy lifting, or activities that cause you to strain or significantly increase your blood pressure. Elevated blood pressure can restart minor bleeding and impede the clot formation necessary for proper healing. Any form of smoking or vaping must still be completely avoided, as the negative pressure and chemicals severely compromise the healing blood clot.
Recognizing Signs of Abnormal Healing
While Day 4 should bring improvement, it is also a time when complications, like alveolar osteitis (dry socket), may present. Dry socket involves the loss of the blood clot from the socket, leaving underlying bone and nerve endings exposed. The hallmark symptom is severe, throbbing pain that noticeably worsens between Day 3 and Day 5, often radiating up to the ear or down the neck, and is generally unresponsive to typical pain medication.
Signs of a localized infection differ from dry socket and require immediate attention from your surgeon. These symptoms include swelling that begins to increase again after Day 3, excessive redness around the socket, or the presence of thick, yellowish or white pus discharge. A persistent, foul taste or bad breath that cannot be resolved with gentle rinsing may also indicate a bacterial issue.
A low-grade fever is sometimes expected, but a temperature of 100.4°F (38°C) or higher, especially if accompanied by chills or general malaise, suggests the body is fighting a spreading infection. Minor oozing or pink-tinged saliva is normal, but if heavy bleeding persists or if you need to change gauze pads every hour for several hours, contact your oral surgeon immediately.