Wisdom teeth removal recovery: soreness, what to eat and dry socket, day by day

Recovery timeline: what is normal when

Wisdom teeth soreness follows a fairly predictable curve. The first 24 hours are about protecting the blood clot in the socket. Days two and three are usually the sorest, with swelling peaking around then. By day four or five most people are eating more normally, and by a week the sockets are closed over enough that the worst is behind you. Full healing of the bone underneath takes weeks, but you will not feel it.

How long you need off depends on how the teeth came out. Medibank’s guidance is about two to three days off work after a chair removal of one or two straightforward teeth, and up to a week after all four under general anaesthetic in hospital, with facial swelling for up to five days. Finder puts typical recovery at four to seven days, with some people taking up to two weeks. If you are planning a trip or an exam, give yourself the longer end.

Two things are worth knowing in advance. Pain that improves and then suddenly gets much worse around day three is not normal and may be a dry socket (see below). And after a general anaesthetic you should not drive for 48 hours, so arrange a lift home and for the next day.

The first 24 hours

Everything in the first day is about the blood clot. It forms in the empty socket within an hour or so and acts as the scaffold for healing. Lose it and you expose bone and nerve endings, which is what makes a dry socket so painful. Victoria’s Better Health Channel advice is to bite firmly on the gauze pad as instructed, avoid excessive rinsing, and not to spit, suck through a straw or smoke, because all of those create suction or pressure that can dislodge the clot.

• Bleeding: a little oozing that tints your saliva pink for the first day is normal. If the socket is actively bleeding, fold a clean piece of gauze or a damp tea bag, bite firmly for 20 to 30 minutes and stay upright. Call the practice if it has not slowed after an hour of firm pressure.
• Swelling: a cold pack wrapped in a cloth, 20 minutes on and 20 minutes off, on the cheek over the site for the first day or two. Sleeping with your head raised on an extra pillow helps.
• Pain relief: take whatever your dentist or surgeon prescribed or recommended, and take the first dose before the local anaesthetic wears off rather than waiting for the pain to arrive. Ask a pharmacist, doctor or dentist about what suits you; this guide does not give doses.
• Rest: no gym, no heavy lifting and no alcohol for the first day or two. Raised blood pressure makes sockets bleed.

Do not rinse at all on day one. From 24 hours, start gentle warm salt-water rinses (about half a teaspoon of salt in a cup of warm water) after meals, letting the water fall out of your mouth rather than spitting.

What to eat after wisdom teeth removal

Soft, cool and not too sweet is the rule for the first few days. You want food that needs no chewing on the extraction side and will not leave crumbs in the socket. Nothing hot for the first day, because heat increases bleeding and you may not feel a burn while you are numb.

From about day three or four, move on to soft solids: scrambled eggs, soft pasta, flaky fish, well-cooked rice, soft bread without crusts. Chew on the opposite side. Avoid anything crunchy, seedy or sticky (chips, nuts, popcorn, seeded bread, toffee) for at least a week, and go easy on very spicy or acidic food, which stings an open socket. Drink plenty of water, but from a glass, not a straw.

If you had all four out under general anaesthetic, you may feel nauseous for the first day. Start with clear fluids, then move to cool smooth food as you feel able. Avoid alcohol while you are taking any prescribed pain medicine.

Managing wisdom teeth pain and swelling

Expect the pain to be worst on days two and three and then ease steadily. Follow the pain relief plan your dentist or oral surgeon gave you, keep up the cold packs for 48 hours and then switch to warm compresses if your jaw is stiff. Stiffness and difficulty opening wide (trismus) is common after lower wisdom teeth and usually settles within a week; gentle opening exercises help once the surgeon says it is safe.

Bruising on the cheek or jawline can appear a few days after surgery and is harmless. Numbness of the lip, chin or tongue that lasts beyond the anaesthetic wearing off should be reported to your surgeon; it is usually temporary but needs to be tracked. Bad breath for a few days is normal while the socket heals, especially once you cannot brush properly nearby; salt-water rinses help.

Keep brushing your other teeth from the first evening, using a soft brush and keeping well away from the sockets. From day three you can brush closer, gently. Your dentist may prescribe an antibacterial mouthwash; use it as directed rather than as a replacement for rinsing with salt water.

Dry socket: the complication to watch for

Dry socket (alveolar osteitis) happens when the blood clot is lost or never forms properly, leaving bone and nerve exposed. Healthdirect puts the rate at about one in 20 extractions, and it is more common after lower wisdom teeth, difficult extractions and in people who smoke or take the oral contraceptive pill. It typically starts one to three days after the extraction, though it can begin a few days later.

The giveaway is pain that was settling and then becomes severe and throbbing, often radiating to the ear or eye on the same side, with a bad taste or smell and sometimes visible bone or greyish tissue in the socket where the clot should be. It is miserable, but it is treatable: a dentist or oral surgeon will flush out debris, place a medicated dressing in the socket and advise on rinses and pain relief. The dressing usually brings relief within hours and may need changing every few days.

To reduce your risk: do not smoke (ideally for at least 48 hours and preferably longer), do not use straws or spit, rinse gently and only after 24 hours, follow the aftercare sheet and ask your dentist about medicated rinses or a socket gel if you have had a dry socket before. See a registered dentist promptly if you think you have one; it will not get better quickly on its own.

When to call the dentist or go to emergency

Most recoveries are uneventful. Contact the practice that treated you, or an after-hours dentist, if you have:

• bleeding that will not slow after an hour of firm pressure on gauze
• pain that worsens sharply after day two or three, or is not controlled by your prescribed pain relief
• swelling that keeps increasing after day three, or spreads to your neck or eye
• fever, pus from the socket, or a foul taste that salt-water rinses do not clear
• difficulty swallowing or opening your mouth that is getting worse rather than better
• numbness in your lip, chin or tongue that persists

Go to a hospital emergency department if you have trouble breathing or swallowing, swelling that is closing your throat, or heavy bleeding you cannot control. Our emergency dentist guide explains how to find after-hours care in each capital city.

What to have at home before surgery

You will not want to go to the shops on day one, so stock up beforehand: gauze or clean cotton pads, a gel ice pack or two, a soft-bristled toothbrush, table salt, plenty of smooth food (yoghurt, soup, smoothie ingredients, mashed potato, custard), and whatever pain relief your dentist has recommended or prescribed. A pharmacy can put most of this together in one trip.

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For what the procedure itself involves and what it costs, see our wisdom teeth removal guide and wisdom teeth removal cost. If you are weeks out and still sore, or something does not feel right, see a registered dentist rather than waiting it out.

Common questions