Wisdom tooth removal is a common surgical procedure. While most recoveries are straightforward, the process involves a temporary disruption of the body’s protective barriers. Normal discomfort, bleeding, and swelling are expected as the body begins the repair process. Understanding the difference between these anticipated healing symptoms and the signs of a bacterial infection is important for a safe recovery. This guidance helps you recognize indicators that signal a need for prompt professional attention.
Understanding the Standard Healing Process
Following a wisdom tooth extraction, recovery involves a predictable pattern of symptoms that should gradually lessen. The first 24 hours are marked by the formation of a blood clot within the socket, which is the foundation for new tissue growth. Mild bleeding or oozing is expected, typically controlled by gauze, and should diminish significantly within a day.
Pain and swelling generally peak around the second or third day after the procedure. Swelling often presents externally on the cheek as part of the body’s natural inflammatory response. Pain should be manageable with prescribed or over-the-counter medication. A reduction in symptoms by the fourth or fifth day is the strongest indicator that healing is progressing normally.
Definitive Symptoms of a Post-Extraction Infection
A bacterial infection presents with distinct symptoms that deviate from the normal healing trajectory. The most telling sign is pain that worsens significantly after the third to fifth day, rather than improving as expected. This escalating discomfort signals an active bacterial invasion of the tissues surrounding the extraction site.
A localized infection frequently results in pus, which appears as a thick, white, or yellowish discharge draining from the socket. This may be accompanied by a persistent, foul odor or an intensely bad taste in the mouth. Systemic signs indicate the infection is spreading, most notably a persistent fever of 100.4°F (38°C) or higher.
Swelling that continues to increase after the third day or begins to spread down the neck or across the face is a serious warning sign. This spreading inflammation suggests the body is struggling to contain the bacterial load. Difficulty swallowing or opening the mouth wide, known as trismus, can also be a symptom of an advanced infection.
Distinguishing Infection from Dry Socket
Many confuse a dry socket (alveolar osteitis) with a bacterial infection because both cause severe pain following extraction. The two conditions differ fundamentally in their cause and presence of systemic signs. A dry socket occurs when the protective blood clot is prematurely dislodged or fails to form, leaving the underlying bone exposed.
The pain from a dry socket is typically an extreme, throbbing ache that begins suddenly two to four days after surgery. This pain often radiates to the ear, temple, or neck. Crucially, a dry socket does not involve systemic symptoms like fever, and the hallmark sign of pus is absent. The socket often appears empty, sometimes allowing the white bone to be visible.
A true infection is caused by bacterial overgrowth and is characterized by pus and often a fever, indicating an active immunological fight. While both conditions can cause a bad taste and odor, dry socket is a localized issue of exposed nerve endings. Infection is a microbiological problem that carries a greater risk of spreading.
Protocol for Suspected Infection
If you observe definitive signs of a bacterial infection, such as pus, a spreading fever, or worsening pain, contact your oral surgeon or dentist immediately. Be specific about the symptoms, noting the temperature of any fever and the exact day the pain began to increase. Avoid waiting for symptoms to resolve, as untreated oral infections can spread to other parts of the head and neck.
Do not attempt to treat the suspected infection with leftover antibiotics or by aggressively probing the site. Continue gentle saltwater rinses to maintain cleanliness while awaiting professional advice. Treatment usually involves the dental professional cleaning the area and prescribing an appropriate course of antibiotics.