Lump in the Cheek After Wisdom Teeth Removal: Should You Worry?

Most Common Causes of a Lump or Swelling After Wisdom Teeth Removal

If you've noticed a lump or any form of swelling after your wisdom teeth removal, don't panic—it's completely expected during the healing process.

Most of the time, these symptoms are temporary and part of the body's natural response to surgery. They should resolve themselves within a week or two.

However, if the lump is getting bigger or worse over time, then it's worth talking to your dentist.

Here are the most likely causes of a lump in the cheeks after wisdom teeth extraction:

1. Chances Are, It’s Post-Surgical Edema

One of the most common reasons for lump or swelling after surgery is edema. It’s a natural reaction and happens after almost any kind of surgery.

Following wisdom tooth removal, the blood vessels in the area expand to bring in essential cells and nutrients to help with healing. This process leads to redness, warmth, tenderness, and noticeable swelling around the surgical site. The swelling can spread to other facial areas like your cheeks, lips, chin, and even under the jaw.

How bad the swelling looks can vary from person to person. Some people barely notice it, while others may feel like their entire mouth is puffed up.



Typically, edema starts within the first 24 hours after the procedure, reaches its peak around 48-72 hours, and gradually fades within 7-10 days post-surgery.

Tips to Reduce Edema

Here are some tips to reduce edema after wisdom tooth removal:

• Ice Application in the First 24 Hours: Apply ice to the affected area for 20 minutes every hour during the initial 24 hours. To prevent skin damage, always wrap the ice in a cloth or towel. Avoid prolonged use beyond the first day, as excessive cold can narrow blood vessels too much and slow healing.


• Transition to Warm Compresses after 24 Hours: Once the initial 24-hour period has passed, switch from ice to warm, moist compresses. This helps to relax and relieve pressure in the swollen area.


• Adjust Sleeping Posture: For the first two nights post-surgery, keep your head slightly elevated while sleeping. This positioning helps minimize facial edema.

2. Hematoma: When Bleeding Goes the Wrong Way

If you're noticing skin discoloration after your wisdom teeth removal, it's usually bruising—a temporary and totally harmless pooling of blood that has leaked into the deep soft tissues.

In some cases, blood can collect in one area under the skin, forming a spongy, rubbery lump called a Hematoma. It often looks bluish but can also appear black, green, or yellow as it heals.

While it can look alarming, hematoma is usually temporary and should resolve on its own within 5 to 10 days.

Speeding Up Hematoma Removal

The good news is that hematomas naturally fade away as the body absorbs and eliminates the pooled blood. To speed up the removal process, follow the same recommendations provided for edema. Apply cold compresses during the initial 24 hours, then switch to warm compresses over the next few days.”

3. The Lump May Point to an Infection

While complications following wisdom teeth extraction are rare, it's crucial to recognize the telltale signs of infection. This will let you act quickly to prevent it from spreading further.

Infection can appear as a lump or localized swelling in the cheek or near the extraction site.

When an infection develops, it usually starts in the wound inside the bony socket. Common signs include a socket filled with white or gray material, pus (a clear-yellow fluid) oozing from the area, throbbing pain, and bad breath.

If left untreated, the infection can spread—either to the bone beneath or, more commonly, to the surrounding soft tissues of the face, such as the cheeks, lips, or the area under the tongue. When the infection spreads into these tissues, it leads to a condition called Cellulitis.

If the cheek area is involved, the first signs are usually increased redness, widespread swelling, warmth, and pain. You might also find it difficult to eat or fully open your mouth.

As the infection progresses, pus may build up and form a more defined lump. At this point, the symptoms often become more intense.

If the infection persists, it can become chronic. The accumulated pus may harden, forming a firm, purplish lump. Sometimes, it can find a way to drain through the skin by creating a small tunnel called a fistula.



Factors that increase the risk of infection after wisdom tooth removal:

• Longer and more complex procedures: The more time it takes to remove the tooth and the more bone that’s removed, the higher the risk of infection after surgery.


• Lower vs. upper wisdom teeth: Lower wisdom teeth typically carry a higher risk of complications than upper ones. This is because the lower jaw has less blood flow, which can slow the healing process and increase the risk of pain and infection.


• Something stuck in the wound: If a foreign object or bone fragment becomes trapped in the wound, it can lead to infection. Similarly, eating hard or crunchy foods too soon after the procedure can cause food to get stuck in the socket, leading to potential issues.

Infection vs. Normal Healing

It can be difficult to tell the difference between the early stages of an infection and the normal healing process, as both can cause swelling, redness, and pain. However, there are red flags you should watch out for:

1. The wound is filled with a gray or black substance.


2. Pus is oozing from or near the extraction site.


3. A lingering bad taste or persistent bad breath.


4. Systemic signs like fever, fatigue, and swollen lymph nodes under the jaw.


5. Symptoms intensifying over time rather than improving.

How is Infection After Wisdom Tooth Removal Treated?

If you suspect an infection, visit your dentist or surgeon as soon as possible to prevent it from progressing.

Infections following wisdom tooth extraction are typically treated with antibiotics, often combined with anti-inflammatories and painkillers. In cases where the infection has led to a lump or lesion on the face, your dentist or surgeon may need to make a small incision to drain the accumulated pus.

Preventing Infections

The best way to deal with an infection after a wisdom tooth extraction is to prevent it in the first place. Follow prescribed antibiotics before and after the procedure as directed. Never stop halfway, even if you feel better before completion.

Additionally, from the second day on, start rinsing with warm salt water to reduce swelling and bacteria load in your mouth.

4. Swollen Lymph Nodes

Lymph nodes are small lumps, scattered throughout the body and usually too tiny to feel. They consist of immune white blood cells that help watch over the body and fight off things like bacteria, viruses, and cancer cells.

When an infection is detected, white cells multiply rapidly, causing the lymph nodes to increase in volume, becoming palpable and noticeable. In the case of an infection following wisdom tooth extraction, the nearby lymph glands, especially those below the lower jaw along the jawline, become activated. You'll also notice the following signs:

1. The growth is bean-shaped and has clear borders.


2. The size is about half an inch.


3. The growth is soft and moves when lightly pressed.


4. Swollen lymph nodes associated with infection are often painful.

What to Do About Swollen Lymph Nodes?

Swollen lymph nodes often indicate the onset of an infection. If you experience this, it's important to contact your dentist or surgeon, especially if it's accompanied by pus, fever, fatigue, or difficulty opening your mouth. Once the infection is treated, your lymph nodes will return to their normal size.

The Lump May Actually Arise From the Jawbone (though rare)

If the wound or socket becomes infected, the infection follows the path of least resistance, usually the soft facial tissues. However, in rare cases, it can spread deeper into the underlying bone—a condition known as Osteomyelitis.

At first, the buildup of fluid and inflammation inside the bone causes hard, painful swelling near the extraction site.

If left untreated for 2 to 3 days, pus may accumulate, worsening the symptoms and leading to fever, fatigue, and a general feeling of illness. The skin and gums around the area often become red, swollen, and tender.

When the pus eventually drains from the bone into the mouth, it might bring temporary relief—but this doesn’t resolve the root of the infection. Without proper treatment, the infection can persist and damage a significant part of the jawbone.

Cyst formation is another potential complication arising from the jawbone and manifesting as a hard mass or lump.



Unlike other complications, a cyst's growth is not an overnight process. It takes months or even years to become noticeable. Usually painless and progressing slowly, a cyst can reach a significant size, deforming the jawbone and face.

A Lump After Wisdom Teeth Removal is Often Temporary

Again, the lump or swelling you're noticing in the first two weeks after surgery is likely normal and temporary. It's often the result of natural healing responses like edema, bruising, or blood pooling—all common after a surgical procedure.

So rather than constantly checking the surgical area, focus on getting rest and closely following your dentist’s post-op instructions.

While these symptoms should naturally improve and regress over time, if they persist longer than two weeks or worsen, don't hesitate to contact your dentist or surgeon. They're in the best position to tell what’s normal and what might be a problem for you.

When Should You Be Concerned?

Complications following wisdom tooth extraction are rare. Still, it's important to watch out for specific signs that may indicate potential infection or other serious complications.

Swelling or lump formation associated with pus leakage, fever, fatigue, swollen lymph nodes, throbbing pain, difficulty breathing and opening the mouth indicate a spreading infection. In such cases, prompt treatment is essential to prevent the infection from advancing.

In extremely rare cases, another potential complication that shows up as swelling is called subcutaneous emphysema. It occurs when air infiltrates the wound and diffuses under the skin of the face and neck.

Subcutaneous emphysema appears suddenly, or a few hours after the procedure, as a large swelling and, when touched, makes a weird sound. It’s mostly harmless and temporary, but in rare cases, air can move into vital areas such as the heart and lungs.

To reduce the risk of these problems, avoid coughing, smoking, or blowing forcefully during the first few days after surgery. This not only helps prevent emphysema, but also keeps the blood clot in place. The blood clot that forms right after surgery is very important for healing because it stops bleeding and protects the wound while new tissue grows.