What to Expect — This Is More Involved Than a Simple Extraction
Wisdom tooth removal — especially when the tooth is impacted (partially buried under the gum or bone) — is a surgical procedure. Recovery takes longer than a routine extraction. Being prepared helps.
Swelling: Expect noticeable swelling, usually peaking on day 2 or 3. It will then gradually reduce over 5–7 days. Swelling on the outside of your cheek and jaw is completely normal.
Bruising: You may develop bruising on your cheek or neck over days 2–4. This is normal and will fade over 1–2 weeks.
Restricted mouth opening: Your jaw muscles may feel stiff and sore — this is called trismus. It usually improves within a week.
Stitches: If your dentist or surgeon placed stitches, these are usually dissolvable and will disappear within 7–14 days on their own. You may also have a follow-up appointment booked to check healing.
Bleeding: Some oozing is normal for the first few hours. Significant bleeding should stop with pressure (see below).
Pain Management
Pain after wisdom tooth removal is often more significant than after a simple extraction. Starting pain relief promptly makes a real difference.
Take painkillers before the local anaesthetic wears off — do not wait until pain starts.
Ibuprofen 400mg three times daily with food, combined with paracetamol 1g up to four times daily (alternating every 3–4 hours), provides good pain control for most people. Only take ibuprofen if it is safe for you to do so (avoid if you take blood-thinning medications, have stomach problems, or are pregnant).
If your dentist prescribed stronger painkillers or antibiotics, take them exactly as directed. Complete the full course of antibiotics.
If you have been prescribed opioid-containing painkillers (such as codeine or co-codamol), do not drive, operate machinery, or drink alcohol while taking them — this is a legal requirement.
Apply a cold compress (frozen peas in a cloth) to your cheek for 10–15 minutes at a time during the first 24 hours to reduce swelling.
Pain should gradually improve each day. If it worsens after day 3, contact your dentist — this may indicate dry socket or infection.
Controlling Bleeding
Some bleeding or oozing after wisdom tooth removal is expected. Here is how to manage it:
Your dentist will have placed a gauze pad over the socket. Bite down firmly for at least 30 minutes without checking or moving it.
If bleeding continues, replace the gauze with a fresh pad (or a clean folded cloth) and bite firmly for another 30 minutes.
A damp tea bag can also be used — the tannic acid in tea helps blood clot.
Sit upright — lying flat increases blood pressure in the head and can worsen bleeding.
Avoid spitting, rinsing, or talking more than necessary for the first few hours.
If heavy bleeding continues after 1–2 hours of pressure, contact your dentist or call NHS 111.
Eating, Drinking, and Oral Hygiene
Your diet will need to be soft for longer than after a simple extraction.
Diet:
Stick to soft foods for the first 3–5 days: yoghurt, soup, mashed potato, scrambled eggs, soft pasta, smoothies.
Avoid hard, crunchy, chewy, or sticky foods for at least 7–10 days.
Avoid very hot food and drinks for the first 24 hours.
Do not use a straw for at least 48 hours — the suction can dislodge the blood clot and cause dry socket.
Avoid alcohol for 24–48 hours and while taking antibiotics or strong painkillers.
Oral hygiene:
Do not rinse your mouth for the first 24 hours.
From day 2 onwards, gently rinse with warm salty water (half a teaspoon of salt in a glass of warm water) after every meal and before bed. Continue for 7–10 days.
Brush your teeth gently, avoiding the surgical site for the first couple of days, then gradually reintroduce brushing near the area as it heals.
Smoking: Do not smoke for at least 72 hours — ideally for a week. Smoking is the biggest risk factor for dry socket and infection after wisdom tooth removal.
Dry Socket — Know the Signs
Dry socket is the most common complication after wisdom tooth removal, affecting roughly 1 in 10 people (and more if you smoke). It happens when the blood clot in the socket is lost too early.
Signs include:
Pain that starts to worsen after day 2–3 rather than improving
A throbbing ache that may radiate to your ear or along your jaw
Visible empty socket with exposed bone
Unpleasant taste or bad breath
Dry socket is treatable — your dentist can dress the socket to relieve pain. Contact your dentist promptly if you suspect dry socket. Do not wait, as the pain can become severe.
When to Seek Help Urgently
Contact your dentist or call NHS 111 if you experience:
Bleeding that does not stop after 30–60 minutes of firm pressure
Increasing pain after day 3 (possible dry socket or infection)
Swelling that is getting worse after day 3, or spreading towards your neck
A temperature above 38°C / 100.4°F
Pus or an unpleasant discharge from the site
Difficulty opening your mouth that is worsening rather than improving
Persistent numbness or tingling in your lip, chin, or tongue (beyond 8 hours after surgery)
Go to A&E immediately if you have difficulty breathing or swallowing, or if swelling is spreading rapidly to your neck or throat. This is rare but can be serious.
This leaflet is for general information only and does not replace professional dental advice. Your dentist will discuss your individual circumstances and any risks specific to you. Treatment outcomes vary between patients depending on individual circumstances.
When to Seek Urgent Help
Contact your dentist immediately if bleeding will not stop after 30 minutes of firm pressure, if pain is severe and not controlled by painkillers, if swelling is spreading to your neck or throat, or if you have a temperature above 38°C. Difficulty breathing or swallowing is a medical emergency — call 999 or go to A&E immediately.
References
Aligned with guidance from: SDCEP, NICE, FGDP(UK).