Do gums shrink after a tooth extraction? Yes, the gums and the underlying jawbone undergo a process of change and reduction following the removal of a tooth. This change is a natural biological event known as remodeling, where the body adapts to the new structure of the mouth. The process begins immediately after the procedure and impacts both the soft tissue (the gum itself) and the hard tissue (the jawbone).
The Initial Changes in Gum Tissue
The immediate phase after a tooth is removed focuses on the healing of the soft tissues (the gums, or gingiva). The body’s first response is to form a blood clot within the empty socket, which acts as a protective barrier for the underlying bone and nerve endings. Over the next one to two weeks, the gum tissue begins to regenerate and close over the site where the tooth once was.
This initial stage involves the soft tissue smoothing out and contracting to cover the wound. By three to four weeks post-extraction, the site is typically covered with new gum tissue, often leaving a slight indentation in the gum line. While this initial change closes the open wound, the deeper, more significant changes in the overall contour of the gum line are only just beginning, as the remodeling of the bone underneath takes much longer.
Understanding Alveolar Bone Loss
The most significant and long-lasting form of “gum shrinkage” is the resorption of the supporting jawbone, known as the alveolar ridge, not the gum tissue itself. The alveolar bone requires mechanical stimulation from chewing and biting forces transmitted through the tooth to maintain its density and dimension. Once the tooth is gone, this stimulation ceases, and the body recognizes the bone as functionally unnecessary.
This lack of stimulation triggers bone resorption, where specialized cells begin to break down and reabsorb the bone tissue. The loss is particularly pronounced in the first six months, with studies showing a horizontal reduction in ridge width that can range from 29% to over 60%. The bone typically shrinks in width first, followed by a reduction in height, making the jawbone narrower and shorter over time. This structural loss of the jawbone is the primary reason the gum line appears to shrink and recede over the extraction site.
Impact on Future Dental Work
The resulting loss of bone height and width creates significant challenges for replacing the missing tooth, affecting both function and appearance. When a dental bridge is placed over a shrunken area, the prosthetic tooth may not sit flush with the gum line, creating an unsightly gap. This space, sometimes called a “dark triangle,” can trap food and make proper hygiene difficult.
For patients who choose dentures or partials, the diminished bony ridge provides less support, leading to a poorer fit and instability. Dentures may require frequent adjustments because the underlying bone continues to resorb over the years. The lack of bone volume also complicates the placement of dental implants, which require a substantial foundation of healthy bone for stability. Insufficient bone often necessitates an additional bone grafting procedure before an implant can be successfully placed.
Minimizing Shrinkage After Extraction
Patients concerned about the loss of bone and gum contour have proactive options available immediately following the extraction. The most common preventative measure is a procedure called socket preservation, also known as alveolar ridge preservation. This technique is performed at the same time as the tooth removal, before the bone resorption process accelerates.
Socket preservation involves placing a bone graft material directly into the empty socket. This material, which can be synthetic or derived from other sources, acts as a scaffold to maintain the bone’s original volume and shape. The graft material slowly integrates with the body’s natural bone, minimizing the horizontal and vertical bone loss that would otherwise occur. Alternatively, placing a dental implant immediately into the fresh socket can also help preserve the bone structure, as the implant post provides the necessary stimulation to the jawbone.