Day five following wisdom teeth extraction represents a significant milestone in the healing process. Patients are typically transitioning out of the most acute discomfort experienced during the initial 72 hours post-surgery. Substantial improvement should be noticeable, but patients must remain diligent with their care routine to ensure complete recovery.
Normal Physical Symptoms and Pain Levels
By day five, patients should observe a noticeable decrease in post-operative discomfort compared to the second and third days. Pain medication usage often decreases, with many individuals finding relief using only over-the-counter anti-inflammatories. The intense, throbbing sensation should have resolved, replaced by a manageable, dull ache or general tenderness. If the pain is worsening instead of improving, it may indicate a complication requiring immediate attention.
Facial swelling, or edema, should be visibly resolving by this point, having typically peaked around day three. Any remaining puffiness is usually minor and localized closest to the jawline. Applying moist heat to the cheeks can further reduce remaining swelling and help alleviate muscle stiffness in the jaw, known as trismus. This stiffness, which can limit the mouth’s opening, is a normal surgical response and gradually resolves as the muscles relax.
The appearance of the extraction site may look different now that the initial blood clot has matured. A protective layer known as granulation tissue, which can appear whitish or gray, forms over the healing socket and should not be disturbed. If sutures were placed, they may begin to feel loose or start dissolving naturally, depending on the material used.
Advancing Your Diet and Oral Care Routine
Day five allows for a cautious progression in dietary choices, moving beyond strictly liquid and pureed foods. Patients can begin introducing chewable soft foods, such as well-cooked pasta, soft scrambled eggs, or steamed vegetables. Protein sources like soft fish, mashed beans, or pulled poultry aid in tissue repair. Foods that are crunchy, sharp, or contain small grains like seeds or nuts must still be strictly avoided, as they can become lodged in the socket and disrupt the healing clot.
Maintaining a clean mouth is paramount at this stage, and a gentle oral hygiene routine should be fully established. Regular brushing of the teeth away from the surgical site can be resumed with a soft-bristled brush. Patients should use extreme caution or avoid direct contact with the extraction areas altogether to prevent dislodging the protective clot.
Salt water rinsing is an important mechanism for keeping the sockets clean without causing trauma. A warm saline solution should be allowed to pool over the extraction site, then gently drained or allowed to fall out, rather than being forcefully swished or spat. This gentle action helps flush out accumulated food debris without creating negative pressure that could compromise the blood clot.
Light, non-strenuous movements are generally acceptable on day five. However, patients should still avoid activities that significantly increase heart rate or blood pressure, such as heavy lifting or intense exercise. Strenuous activity directs blood flow to the head and jaw, potentially increasing pressure at the surgical site and risking the disruption of the blood clot.
Identifying Signs of Delayed Healing
While most patients feel significantly better by day five, this period is when complications, such as alveolar osteitis or “dry socket,” may become most evident. Dry socket occurs when the protective blood clot is lost or fails to form, leaving the underlying bone and nerve endings exposed. The hallmark symptom is severe, intense throbbing pain that worsens significantly on day five, often radiating up to the ear, temple, or neck, and is generally unresponsive to standard pain medication.
If you look into the socket and see exposed bone instead of a dark, healing blood clot, or if you notice a persistent foul odor or bad taste, this strongly suggests dry socket. The risk period for this condition typically peaks between three and five days post-extraction. While painful, dry socket requires prompt treatment from the oral surgeon to clean the site and place a medicated dressing.
Other signs of delayed healing include symptoms associated with a developing infection. These signs include swelling that begins to increase again after initially peaking and subsiding, the presence of pus discharging from the socket, or a sustained fever. Any sudden, unexpected increase in pain, bleeding, or swelling after day three warrants an immediate call to the oral surgeon.