Why Is My Jaw Still Swollen Two Weeks After Wisdom Tooth Extraction?

Swelling of the jaw after wisdom tooth extraction?

Hello Doctor: Two weeks ago, I had my lower right wisdom tooth extracted.
After returning home, the right side of my face became very swollen.
A few days later, the bleeding decreased, and I have been consistently taking anti-inflammatory medication and antibiotics.
However, after two weeks, my lower right jaw is still very swollen, and there is a dark area on the skin that looks like a bruise.
I have been applying warm compresses during this time, but the swelling has not gone down.
I would like to ask the doctor why this is happening.
Since I had my wisdom tooth removed from the right side, why is the swelling located in my lower right jaw and has not subsided? Which specialist should I see?

shih, 20~29 year old female. Ask Date: 2020/02/18

Dr. Huang Tingfang reply Dentistry

Dear Ms.
Shi,
Hello! As mentioned, your wisdom tooth appears to be impacted deeper, and there is a larger hematoma (a dark area on the skin resembling a bruise).
Please continue with warm compresses.
It is important to keep your mouth clean and brush your teeth thoroughly.
Take care! Wishing you all the best and a smooth recovery!
Sincerely,
Dr.
Huang Ting-Fang, Dentistry

Reply Date: 2020/02/18

More Info

After wisdom tooth extraction, it is not uncommon to experience swelling, bruising, and discomfort in the affected area. The swelling you are experiencing two weeks post-extraction can be attributed to several factors, and it is essential to understand these to address your concerns effectively.

Firstly, the extraction of a wisdom tooth, especially if it was impacted or required surgical intervention, can lead to significant trauma to the surrounding tissues. This trauma can cause inflammation, which is a natural part of the healing process. Swelling typically peaks within the first 48 to 72 hours post-surgery and should gradually subside. However, in some cases, swelling can persist longer, especially if there was extensive manipulation of the tissues during the extraction.

The presence of a bruise or dark discoloration on the skin, as you described, is likely a result of blood pooling under the skin due to the trauma from the extraction. This is known as a hematoma and can take time to resolve. The body will gradually reabsorb the blood, and the discoloration should fade over time. However, if the swelling and bruising do not improve or worsen, it may indicate a complication.

One potential complication is an infection. Even with antibiotics, infections can occur if bacteria enter the extraction site. Signs of infection may include increased swelling, redness, warmth in the area, and possibly fever. If you notice any of these symptoms, it is crucial to seek medical attention promptly.

Another possibility is the development of a dry socket (alveolar osteitis), which occurs when the blood clot at the extraction site becomes dislodged or dissolves before the wound has healed. This condition can lead to severe pain and prolonged swelling. While dry socket typically presents with pain rather than just swelling, it is still a concern to consider.

Given that you have been experiencing persistent swelling and bruising for two weeks, it is advisable to follow up with your oral surgeon or dentist. They can assess the extraction site, check for signs of infection, and determine if further treatment is necessary. If you are unable to see your original dentist, consider visiting an oral and maxillofacial surgeon or a dental specialist who can provide a thorough evaluation.

In the meantime, continue to manage your symptoms with gentle care. Applying ice packs intermittently can help reduce swelling, and maintaining good oral hygiene is essential to prevent infection. Avoiding strenuous activities and following your dentist's post-operative care instructions will also aid in your recovery.

In summary, while some swelling and bruising are expected after wisdom tooth extraction, prolonged symptoms warrant further investigation. It is crucial to communicate openly with your healthcare provider about your concerns and any changes in your symptoms. Early intervention can help prevent complications and ensure a smoother recovery process.

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