When does the anesthesia for a wisdom tooth wear off?
“How much will it hurt when the anesthesia wears off? Can I go to work tomorrow?” This is the question I get most often before an extraction. Anesthesia usually wears off within 2–3 hours. For lower wisdom teeth, the anesthetic is given near the main nerve trunk, so the lips and tongue can stay numb for up to 4–5 hours. If you take the prescribed painkiller before it wears off, the pain afterward is considerably less.
While you are numb, you will not notice if you bite your lip or the inside of your cheek. Put off eating until feeling returns, and avoid hot drinks as well.
How many days do pain and swelling last?
| Timing | What usually happens |
|---|---|
| Same day | Throbbing as the anesthesia wears off. Blood mixed in saliva |
| Days 1–3 | Pain is strongest. Swelling peaks on day 2–3. Mouth does not open as wide |
| Days 4–7 | Pain and swelling noticeably decrease. A bruise under the jaw may turn yellow |
| Around 1 week | Stitches are removed. Most normal meals are possible |
| 2–4 weeks | The gum covers the extraction site. The hole where food gets stuck gradually becomes shallower |
| 3–6 months | The bone beneath the extraction site fills in |
Upper wisdom teeth often pass more quickly than this, while lower impacted wisdom teeth that required trimming bone and removing the tooth in sections may have pain and swelling for a few more days. Look at whether it is better than yesterday rather than at what day it is.
How can I reduce pain and swelling?
- Be sure to bite on the gauze for as long as instructed. This stops the bleeding and lets the blood clot settle in place.
- For the first two days, apply a cold compress to the outside of the cheek. Repeat holding it for 15–20 minutes and then resting briefly. Once the swelling starts to go down, a warm compress feels more comfortable.
- Take painkillers on schedule, before the pain builds up. If you were given antibiotics, finish the full course even if you feel better.
- Raising your head slightly when sleeping reduces swelling.
- Straws, spitting hard, rinsing hard, and smoking can dislodge the blood clot. Avoid them for a few days.
I have summarized separately when you can start eating, brushing, and exercising in Brushing, eating, and exercise after wisdom tooth extraction.
When should I come back to the clinic?
| Symptom | What we suspect |
|---|---|
| On day 2–4 the pain actually gets stronger and spreads to the ear or temple | Dry socket |
| After 3 days the swelling keeps growing and there is fever | Infection |
| Blood keeps pooling even after biting firmly on gauze for more than 30 minutes | Bleeding |
| Sensation in the lip, chin, or tongue is still dull the day after the anesthesia wore off | Nerve irritation |
| The mouth opens less and less, or swallowing is difficult | Deep infection |
A trace of blood in your saliva is normal for a day or two. I have put how to tell dry socket from ordinary extraction pain in a table in Dry socket symptoms.
How we do it at Wonjin Dental
On the day of extraction, we explain when to take painkillers, how long to use cold compresses, and when the stitches will be removed. If you contact us because it hurts, I first ask, “Is it better than yesterday?” and if it is not getting better, I tell you to come in rather than waiting for the stitch-removal day. Whether to remove a wisdom tooth and how it is removed are covered in Wisdom tooth extraction: does it have to come out?
Frequently asked questions
Can I go to work the day after wisdom tooth extraction?
Many people go to work the next day after an upper wisdom tooth or an easy extraction. With a lower impacted wisdom tooth, swelling is greatest on day 2–3, so if you have plans to meet a lot of people, it is easier to schedule it just before a weekend.
Food keeps getting stuck in the extraction site.
For a few weeks before the gum covers it, food gets stuck in the hole. From about a week after, rinse gently with water after meals, and do not dig it out with a toothpick. If it keeps hurting or smells, show it to us.
I have a bruise. Is that okay?
After a lower wisdom tooth is removed, bruising can appear on the cheek or under the jaw. It changes from purple to yellow and fades within 1–2 weeks. If swelling and fever grow along with it, we will see you again.
When can I drink alcohol?
Avoid it at least until the stitches are removed. Alcohol increases bleeding and swelling, and it does not go well with painkillers and antibiotics.