A wisdom tooth extraction is a common procedure that removes the last set of molars, often performed to prevent crowding or infection. The surgery leaves a socket in the jawbone, and the subsequent healing process involves significant changes in the gum and bone tissue. Finding a lump or bump where the tooth once was can be startling, but the presence of a bump is extremely common and expected. Understanding these structural changes helps distinguish between a benign part of healing and a potential complication.
Expected Bumps During Standard Healing
Recovery from wisdom tooth removal involves tissue repair, often resulting in various lumps or irregularities. One frequent finding is a bone spur, also called a bone spicule or fragment. These are small, sharp pieces of alveolar bone fractured during extraction that begin to work their way out of the gum tissue as the site heals. Bone spurs feel hard and sharp to the touch. While they can be irritating to the tongue or cheek, they are typically a temporary part of the healing process and may be naturally expelled.
Another common occurrence is the development of granulation tissue, which serves as a protective scaffold for new tissue growth. This specialized tissue is rich in blood vessels and appears in the socket as the initial blood clot is replaced, typically forming within the first week after surgery. Granulation tissue can look bumpy, moist, and range in color from deep red to pink or white. Patients sometimes mistake this appearance for pus or a foreign object. Its soft texture is a positive sign, indicating the body is actively filling the empty socket.
Localized swelling, or edema, is a normal post-surgical reaction that can feel like a firm or rubbery lump in the cheek or jaw area. Swelling generally peaks within two to three days and should then gradually subside. Persistent swelling without other concerning symptoms is often a collection of fluid or a dense inflammatory response that takes longer to resolve. These expected types of bumps are typically manageable with standard post-operative care.
Signs That a Bump Indicates a Complication
While many lumps are benign, certain characteristics signal a complication, such as infection or a retained foreign body. An abscess or infection often presents as a soft, warm, and throbbing bump accompanied by worsening pain that does not improve after the first few days. Indicators of bacterial involvement include white or yellow pus draining from the socket, a foul odor, or a persistent bad taste in the mouth. Systemic symptoms, such as a fever above 100 degrees Fahrenheit or swollen glands in the neck or jaw, also suggest a serious infection requiring medical intervention.
A persistent, hard lump preventing the socket from fully closing may indicate residual root material or a retained foreign body. During a complex extraction, a small piece of the tooth’s root tip may fracture and be left behind. The body may respond by trying to push it out or walling it off, sometimes leading to a post-extraction granuloma, a lump formed by the body’s attempt to heal around the irritant. A rarer complication is the formation of a dentigerous or periapical cyst, which can grow slowly around retained tissue and may require subsequent surgical removal.
A hematoma, a collection of blood under the tissue, can feel like a firm mass in the cheek or jaw area. Unlike an abscess, a hematoma should not include fever or pus discharge, and it should gradually decrease in size over time as the body reabsorbs the blood. Swelling that continues to worsen after 48 hours or spreads significantly beyond the immediate surgical site is a concerning sign. Any persistent discharge, increasing discomfort, or new swelling several days after the procedure warrants professional attention to rule out a serious issue.
When to Seek Professional Evaluation
Patients should contact their oral surgeon or dentist immediately if they experience “red flag” symptoms that suggest an acute complication. These urgent criteria include:
- A fever that spikes above 100 degrees Fahrenheit.
- Uncontrolled bleeding continuing beyond 24 hours.
- Yellow or green pus draining from the extraction site.
- Severe difficulty swallowing or breathing.
- Pain that worsens significantly after the initial three to five days of recovery.
For bumps that are less acute but still concerning, a follow-up is recommended. If a sharp bone spur is still present and causing irritation to the tongue or cheek after four weeks, the surgeon may need to smooth or remove it. Similarly, any lump that remains unchanged or increases in size several weeks post-surgery should be examined. The dental professional typically uses an X-ray to determine the underlying cause of a persistent bump, allowing them to visualize any retained root fragments or bone issues beneath the gum line.