After a tooth extraction, the appearance of the wound and the amount of facial swelling may change from day to day. Healing is best assessed by how your symptoms develop over time: after the first few days, you should generally notice gradual improvement.
How Long Is Swelling Normal?
Facial swelling is common, especially after surgical tooth removal or wisdom tooth surgery. Swelling is often most pronounced on the second or third day and then gradually begins to decrease.
Bruising may also develop and can take one to two weeks to disappear. You may temporarily find it more difficult to open your mouth. Do not try to force your jaw open.
How Should You Apply Cold to Your Face?
During the first day, short periods of external cooling may help reduce discomfort and swelling.
Wrap a cold pack or ice pack in a thin towel before placing it against your face. For example, apply it for around 10 minutes, followed by a 10–20 minute break.
Do not place ice directly on your skin and do not fall asleep with a cold pack on your face. When resting, keeping your head slightly elevated may also help.
There Is a White Layer on the Wound – Is It Pus?
Not necessarily.
A whitish or yellowish-white layer may develop on the surface of a healing extraction site. This can be a normal part of wound healing. Do not scrape it off or try to remove it with a toothbrush.
Infection cannot be diagnosed based on colour alone. However, increasing pain, fever, purulent discharge and worsening swelling occurring together may indicate a complication.
When Will the Extraction Site Close?
The surface of the wound may close within a few weeks, although larger extraction sockets can take longer.
The bone underneath continues to remodel for several months. A visible depression at the extraction site does not necessarily indicate a problem, and you should not try to fill the socket yourself.
The time it takes for dissolvable sutures to disappear depends on the type of material used. Non-dissolvable sutures are removed at the follow-up appointment arranged with you.
If a suture becomes loose, do not cut or pull it out yourself.
When Should You Contact Your Dentist?
Contact your dentist or oral surgeon if the swelling continues to increase after the third day, becomes worse again after initially improving, or is accompanied by fever or severe pain.
Persistent numbness should also be reported.
If you experience difficulty breathing, difficulty swallowing saliva, or rapidly spreading swelling of the neck, call 112 immediately.
After extraction of an upper molar, a connection with the maxillary sinus may rarely develop. If you notice fluid passing into your nose while drinking, contact your dentist or oral surgeon as soon as possible.
If an opening into the sinus has been confirmed or is suspected, do not blow your nose. Keep your mouth open when sneezing and follow the specific instructions given by your oral surgeon.
Professional references: AAOMS – Stages of Wound Healing After Oral Surgery ; Newcastle Hospitals – Surgical Removal of Teeth .
For related advice on recovery and symptoms, see essential tooth extraction aftercare and inflammation around a wisdom tooth .