Wisdom Teeth
Swelling around wisdom teeth comes in two very different forms. Swelling after wisdom teeth removal is expected: it usually appears the day after surgery, peaks around day 2 or 3, and then steadily improves over the following days. Swelling before removal is different. A swollen gum or cheek around a wisdom tooth that has not been removed usually points to an infection or irritation, such as pericoronitis, and should be assessed by a dentist or oral surgeon.
Key takeaways
- After surgery, swelling builds for 2 to 3 days, then fades. It is normal for the cheeks, around the mouth and sometimes near the eyes to be swollen.
- Use ice on your cheeks for the first 24 hours only, 20 minutes on and 20 minutes off, unless your surgeon tells you otherwise.
- Bruising on the cheek or jaw can appear a few days after surgery and is usually harmless.
- Swelling that increases after day 3, comes with fever, pus or a bad taste, or makes it hard to swallow or breathe needs a call to the office or emergency care.
- Swelling around a wisdom tooth that has not been removed is a reason to be examined, not to wait.
Swelling After Wisdom Teeth Removal: What Is Normal?
Surgery irritates the tissues around the teeth, and the body responds with inflammation. That inflammation is what you see as swelling. It is part of healing, and it is usually proportional to how much surgery was involved. Removing four impacted wisdom teeth normally causes more swelling than removing a single tooth that was fully through the gum.
A typical pattern looks like this:
| When | What you may notice |
|---|---|
| Day of surgery | Little swelling yet; numbness from the anesthetic, mild oozing |
| Day 1 | Swelling begins to appear in the cheeks and along the jaw |
| Days 2 to 3 | Swelling and jaw stiffness are at their worst; bruising may appear |
| Days 4 to 7 | Swelling steadily goes down; the jaw loosens up |
| After one week | Little visible swelling; some firmness or tenderness may linger around the sockets |
Everyone heals at their own pace. If your swelling and stiffness are still there after a few days, that is usually not a cause for alarm as long as it is not getting worse, but you should always follow the written instructions from your surgeon and call if you are unsure. For a full day-by-day picture, see our wisdom teeth recovery timeline.
How To Keep Swelling Down After Surgery
Swelling cannot be completely prevented, but these steps can limit it.
- Start ice right away. Apply an ice pack to your cheeks on the side of the surgery, 20 minutes on and 20 minutes off, for the first 24 hours. Ice beyond 24 hours does not help and may increase discomfort and slow healing.
- Keep your head elevated when resting, including at night. Use an extra pillow.
- Take medications as directed. Follow the written instructions given by your surgeon about pain medication and any other prescriptions.
- Eat soft, cool foods and drink plenty of fluids. See our guide on what to eat after wisdom teeth removal.
- Rest, and avoid strenuous activity for the first days. Exercise can raise blood pressure and increase swelling and bleeding.
- Avoid smoking and vaping. They slow healing and raise the risk of dry socket. See smoking after tooth extraction.
- Follow your instructions for rinsing. Most patients begin gentle warm salt-water rinses the day after surgery. Do not rinse or spit forcefully in the first 24 hours.
Your own written instructions take priority over any general guide. Our wisdom teeth aftercare instructions explain what we ask patients to do.
Bruising And Jaw Stiffness Are Common Too
It surprises many people to see a yellow, purple or green bruise on the cheek or jaw two to four days after surgery. This happens when a small amount of blood from the surgical site spreads under the skin, and it fades over days. Jaw stiffness, where it is hard to open your mouth fully, is also common after wisdom teeth removal because the chewing muscles are sore. Gentle opening and closing and soft foods help it settle.
When Is Swelling After Surgery Not Normal?
Call the office if:
- Swelling gets bigger after day 3 instead of improving, or goes down and then comes back
- Pain gets worse after it had been improving
- You have a fever, chills, pus, or a persistent foul taste or smell
- You are unable to open your mouth more than a little after the first few days
- The swelling is hard, hot and spreading
- You have an allergic reaction to a medication, such as a rash or itching
Worsening pain with an empty-looking socket several days after surgery can be a sign of dry socket, which needs treatment but is different from infection.
Go to the nearest emergency department or call 911 if you have trouble breathing or swallowing, swelling spreading toward the eye or down the neck, or a high fever with rapidly spreading swelling.
Swelling Around A Wisdom Tooth That Has Not Been Removed
If your gum or cheek is swollen around a wisdom tooth, the most likely explanation is irritation or infection. The most common cause is pericoronitis, where a flap of gum over a partly erupted tooth traps food and bacteria. Other causes include decay, an abscess, or an infected cyst. Swelling like this can come with pain, a bad taste, jaw stiffness and fever.
Mild swelling may ease with gentle cleaning and warm salt-water rinses, but it usually means the tooth is a problem that needs to be assessed. Read our guides to infected wisdom teeth and pericoronitis, and see a dentist or oral surgeon if the swelling is spreading, you cannot open your mouth, or you have a fever. Swelling on one side of the face with severe pain should be examined promptly.
Why Is Only One Side Of My Face Swollen?
After surgery, swelling is often uneven. It depends on which teeth were removed, how complex the surgery was, and which side you slept on. A little difference between the sides is common. If you did not have surgery and only one side is swollen, there is likely a problem on that side, such as an infected tooth or abscess, and you should be examined.
Swelling And Wisdom Teeth Care In Waterloo Region
Our office at 96 Union Street East, near Uptown Waterloo, removes wisdom teeth for patients from Waterloo, Kitchener, Cambridge, Guelph and Stratford. Before you leave, our nursing staff reviews your written instructions with you. If you have concerns about swelling, call +1 (519)-743-7811 during opening hours. If you have heavy bleeding, trouble breathing or swallowing, or rapidly spreading swelling, call the office or go to the nearest emergency department. If you are planning surgery, see our wisdom teeth removal page.
Sources
- National Institute for Health and Care Excellence. Guidance on the extraction of wisdom teeth (TA1). 2000.
- Wisdom tooth removal aftercare instructions and post-operative instructions, Dental Specialty Group Waterloo.
FAQ
How Long Does Wisdom Teeth Swelling Last?
After surgery, swelling usually peaks around day 2 or 3 and then goes down over the next several days. Most people feel much better within a week, though mild firmness can last a little longer. Swelling that increases after day 3 should be checked.
Should I Use Ice Or Heat For Wisdom Teeth Swelling?
Our instructions are to use ice on the cheeks for the first 24 hours only, 20 minutes on and 20 minutes off. Using ice beyond 24 hours may increase discomfort and slow healing. Follow the instructions your own surgeon gives you.
Is It Normal For My Cheek To Be Swollen And Bruised After Wisdom Teeth Removal?
Yes. Swelling of the cheeks and around the mouth, and bruising that appears a few days later, are common. They usually fade within a week or so. Call the office if the swelling worsens after day 3 or you develop a fever.
Why Is My Wisdom Tooth Gum Swollen When I Have Not Had Surgery?
A swollen gum around a wisdom tooth that is still in place usually means irritation or infection, most often pericoronitis. It needs to be examined. See a dentist or oral surgeon, and seek urgent care if you have trouble swallowing or breathing or swelling is spreading.
Does Swelling Mean I Have An Infection After Surgery?
Not necessarily. Some swelling is a normal part of healing. Signs of infection include swelling that increases after day 3, fever, pus, a bad taste, and pain that is getting worse. If you have these, call the office.
Can Swelling Make It Hard To Open My Mouth?
Yes. Jaw stiffness is common for several days because the chewing muscles are sore and swollen. It should gradually improve. If you cannot open your mouth more than a little after the first few days, or it is getting worse, call the office.
This article is general patient education and does not replace an examination, diagnosis, or the written instructions from your own surgeon or dentist. If you have heavy bleeding, trouble breathing or swallowing, or rapidly spreading swelling, call the office or go to the nearest emergency department.