Wisdom teeth removal is a common procedure. Experiencing some pain after extraction is a normal part of healing as the body repairs the surgical sites. Understanding what to anticipate regarding pain progression and how to effectively manage it can reduce anxiety and promote a smoother recovery.
Expected Pain Timeline
Pain after wisdom teeth removal typically follows a predictable timeline, with initial discomfort gradually subsiding. The first 24 to 48 hours usually mark the highest intensity of pain, often described as throbbing, accompanied by peak swelling and some bleeding. During this initial period, local anesthesia effects wear off, and the surgical area becomes more sensitive.
Pain should begin to decrease gradually from day three to five, and swelling often starts to subside. Most individuals can transition from a liquid diet to softer foods during this phase. By the one-week mark, significant improvement is expected, with acute pain largely resolved, though mild soreness might persist around the extraction sites. While soft tissue healing can take two weeks to a month, most patients report being largely pain-free around two weeks post-surgery. Complete bone healing can take up to six months.
Strategies for Pain Relief
Managing pain effectively after wisdom teeth removal involves medication and self-care practices. Over-the-counter pain relievers like ibuprofen (an NSAID) and acetaminophen are recommended to reduce pain and inflammation. These can be taken alternately every few hours for continuous relief. For more intense pain, a dentist or oral surgeon may prescribe stronger medications, including opioids, which should be used only as directed and for a short duration. Take pain medication with food to prevent stomach upset or nausea.
Applying cold compresses to the outside of the cheek helps during the first 24 to 48 hours post-surgery. This reduces swelling and can numb the area, offering quick relief. Apply cold packs for 15-20 minutes at a time, with equal breaks, to avoid skin damage. After 48 hours, warm compresses can help by promoting blood circulation and relaxing tense jaw muscles.
A soft diet is important to avoid irritating the surgical sites and dislodging the protective blood clot. For the first 24 hours, a liquid diet is recommended, transitioning to soft, non-chewy foods like mashed potatoes, yogurt, scrambled eggs, and blended soups for about a week. Avoid hot, spicy, or hard foods, and refrain from using straws, to prevent complications like dry socket.
Rest and elevation are also important for a smooth recovery. Plan to rest for at least three to five days, avoiding strenuous activities that could increase heart rate and potentially lead to increased bleeding, swelling, or pain. Keeping the head elevated with pillows, even during sleep, can help minimize swelling. Maintaining gentle oral hygiene, such as rinsing with warm salt water (half a teaspoon of salt in eight ounces of warm water) after the first 24 hours, can keep the area clean and promote healing without dislodging the blood clot. Gentle brushing can typically resume the day after surgery, carefully avoiding the surgical site.
When Pain Signals Concern
While some pain is expected after wisdom teeth removal, certain symptoms can indicate a complication requiring professional attention. Severe, throbbing pain that worsens after three to five days, particularly if it radiates to the ear, temple, or neck, could be a sign of dry socket. This condition occurs when the blood clot dislodges from the extraction site, exposing the underlying bone and nerves.
Increasing swelling, redness, or pus around the surgical site are signs of infection. Swelling that does not subside after three days or worsens, along with a persistent bad taste or odor in the mouth, often indicates bacterial activity or infection. A fever or chills also suggest the body is fighting an infection and warrant immediate contact with a dental professional.
Persistent numbness beyond the expected duration of local anesthetic effects, especially in the lower lip, chin, or tongue, may suggest nerve irritation or damage. While most nerve injuries are temporary, resolving within weeks to months, any lasting numbness should be evaluated. Additionally, serious symptoms like difficulty swallowing or breathing, or excessive bleeding that does not stop with pressure, require immediate medical attention. Knowing these warning signs allows for timely intervention, which can significantly impact recovery outcomes.