Wisdom tooth extraction is a common dental procedure involving the removal of one or more permanent adult teeth at the back of your mouth. While it addresses issues like impaction or overcrowding, pain and discomfort are normal during healing. Understanding the typical progression of this discomfort can help manage expectations and reduce anxiety during recovery.
Typical Pain Timeline After Extraction
The most intense pain occurs within the first 24 to 48 hours following wisdom tooth extraction as local anesthesia wears off. During this time, throbbing pain, swelling, and some bleeding are common. Swelling usually peaks around 24 to 72 hours after surgery, contributing to discomfort and jaw stiffness.
Pain should gradually decrease over the next few days, with significant improvement noticed within three to seven days. While the worst of the pain subsides, mild soreness or tenderness may linger for up to two weeks, especially after more complex extractions. This is normal as tissues heal and gums close over the extraction sites.
Factors That Can Prolong Discomfort
Several factors can extend the duration or intensity of pain after wisdom tooth extraction. One common complication is dry socket, also known as alveolar osteitis. This occurs when the protective blood clot at the extraction site dislodges or dissolves prematurely, exposing the underlying bone and nerves. This condition causes severe pain that worsens two to three days after the procedure, rather than improving.
Infection is another reason for prolonged discomfort, indicated by symptoms like fever, pus discharge, or increasing pain and swelling. Nerve irritation can also occur if the inferior alveolar or lingual nerves, located near the wisdom teeth, are affected during surgery. This can lead to numbness, tingling, or a burning sensation in the lips, chin, or tongue, which usually resolves within weeks to months but can sometimes persist.
Managing Post-Extraction Pain
Pain management is important for recovery. Over-the-counter pain relievers like ibuprofen or acetaminophen are recommended as a first-line approach, sometimes combined or alternated for better pain control. Your dentist may also prescribe stronger medications if needed. Taking pain medication with food can help prevent stomach upset.
Applying ice packs to the outside of the cheek for 15-20 minutes at a time during the first 24-48 hours can reduce swelling and pain. A soft food diet is recommended for the first few days to avoid irritating the surgical site, such as yogurt, soup, and mashed potatoes. Gentle rinsing with warm salt water the day after surgery helps keep the area clean and reduces infection risk, but vigorous rinsing or using straws should be avoided to prevent dislodging the blood clot.
When to Consult Your Dentist
While some discomfort is expected, certain signs indicate a complication requiring professional attention. Contact your dentist or oral surgeon if you experience severe pain that worsens or does not improve after the first few days, as this could signal a dry socket or infection.
Other warning signs include excessive, unstopping bleeding, swelling that intensifies after three days, or a fever higher than 102 degrees Fahrenheit. Pus or a foul taste in your mouth suggests infection. Difficulty swallowing or breathing, or persistent numbness in the lips, tongue, or chin, also warrant immediate evaluation.