Persistent Lump After Wisdom Tooth Extraction: What to Do Next?

It has been two months since my wisdom tooth extraction, and there is still a lump?

Hello, Director Lin.
I had my lower right wisdom tooth extracted at the clinic on February 22.
After the extraction, my cheek was very swollen.
By March 18, the swelling had decreased but was still quite noticeable (the pain only occurs when I open my mouth wide).
During this time, I did not experience any fever, headache, or other symptoms.
On the same day, I took a referral to a medical center for drainage (but no drainage tube was placed; the doctor said the extraction looked very good on the X-ray, and I wondered why it was so swollen).
By March 31, the swelling had significantly reduced to a hard lump about the size of a one-dollar coin (it is very hard, and the skin still shows a faint red mark).
It does not hurt when I open my mouth wide or press on it.
Although it is not painful and does not interfere with my daily life (I just pretend it doesn't exist), I am still a bit worried because it has been 23 days since March 31, and it seems like it is not going away.
It feels like it has only slightly decreased in size, but not noticeably (it even seems like it might just be a psychological effect that it has shrunk).
So I would like to ask the doctor: 1) What should I do next? Should I return to the medical center for drainage again? Can medication help speed up the disappearance of the hard lump? 2) Is there anything I can do at home (such as warm compresses or massage) to help the lump dissolve faster? 3) Can you tell me what the hard lump might be? (pus, blood, or something similar) 4) My biggest concern is whether that hard lump will ever go away completely.
Thank you, Director.

Yang, 20~29 year old female. Ask Date: 2024/04/23

Dr. Lin Jiayong reply Dentistry

Hello, 1.
Medication can indeed have an anti-inflammatory effect.
2.
Alternating hot and cold compresses can improve circulation.
3.
It may be the process of bone remodeling.
4.
Observe for about six months; if it is still swollen by the end of August this year, it is recommended to consult an oral surgeon for further evaluation.

Reply Date: 2024/04/23

More Info

After wisdom tooth extraction, it is not uncommon for patients to experience swelling, discomfort, and the formation of lumps at the extraction site. In your case, it appears that you have developed a persistent lump that has not fully resolved even after several weeks. Let's address your concerns one by one.

1. Next Steps: Given that the lump has persisted for over three weeks without significant pain or other symptoms, it is advisable to follow up with your oral surgeon or dentist. They can perform a clinical examination and possibly imaging studies to determine the nature of the lump. If it is a hematoma (a localized collection of blood outside of blood vessels) or a seroma (a pocket of clear fluid), they may recommend drainage if necessary. Medications such as anti-inflammatory drugs may help reduce swelling and discomfort, but they will not directly cause the lump to disappear.

2. Home Remedies: While you should always consult with your healthcare provider before trying home remedies, some general practices may help. Gentle warm compresses applied to the area can promote blood flow and may assist in the healing process. However, avoid any vigorous massage or pressure on the lump, as this could exacerbate inflammation or cause further irritation.

3. Nature of the Lump: The lump you are feeling could be due to several factors. It may be a residual hematoma, which can occur after surgery if blood collects in the tissue. Alternatively, it could be a seroma, which is a collection of fluid that can develop post-operatively. In some cases, lumps can also be caused by scar tissue formation or even an infection that has resolved but left behind a residual lump. Your dentist or oral surgeon will be able to provide a more accurate diagnosis based on examination and imaging.

4. Concern About Permanence: It is natural to worry about whether the lump will ever go away. Many post-surgical lumps do resolve over time, especially if they are related to fluid accumulation or minor hematomas. However, if the lump is scar tissue, it may take longer to diminish, and in some cases, it may remain palpable but not cause any issues. Regular follow-up with your healthcare provider will help monitor the situation and determine if any intervention is necessary.

In summary, while it is understandable to be concerned about a persistent lump after wisdom tooth extraction, many such lumps are benign and resolve over time. It is crucial to maintain open communication with your healthcare provider, who can guide you through the healing process and address any complications if they arise. If you notice any changes in symptoms, such as increased pain, fever, or drainage, seek medical attention promptly.

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