Tooth extraction is a common dental procedure, and understanding the gum’s healing process afterward can help alleviate concerns. The appearance of the gum changes significantly as it recovers, moving through several stages. Recognizing these normal changes is important for patients navigating their post-extraction care.
Expected Immediate Appearance
Immediately following a tooth extraction, within the first 24 hours, the gum around the extraction site will show specific characteristics. A blood clot forms in the empty socket, appearing as a dark crimson or maroon, jelly-like mass that should fully cover the extraction site. This clot protects the underlying bone and nerves, serving as the foundation for new tissue growth.
Slight bleeding is normal, and the gauze placed by the dentist helps absorb blood and encourage clot formation. Minor swelling and some redness around the extraction area are also common. The tissue surrounding the socket might appear whitish due to the trauma of the procedure.
Normal Healing Stages
As healing progresses, the gum’s appearance changes over the first few days to weeks. Within 24-48 hours, the blood clot solidifies, and swelling peaks before beginning to subside. Around day 2-3, new gum tissue begins to form around the edges of the socket, and discomfort should start to diminish.
By days 4-7, the blood clot may lighten to a pinkish, pale, or creamy white appearance as granulation tissue forms underneath it. This granulation tissue, composed of collagen, white blood cells, and blood vessels, protects the wound and provides a framework for new tissue growth. The socket gradually becomes smaller, and by day seven, gum tissue starts to cover the region.
Around one to two weeks post-extraction, the gums begin to seal off the socket, forming early gum tissue. The socket may appear pinker as new tissue continues to grow, and the socket will look nearly closed. By three to four weeks, the extraction site is largely filled with new gum tissue, though a slight indentation may remain. Complete gum healing, where the site integrates seamlessly with surrounding oral tissue, takes several weeks to a few months.
When to Seek Dental Advice
Certain visual cues indicate a problem requiring professional dental attention. If you experience excessive or prolonged bleeding beyond 24 hours, or if it increases after initially subsiding, contact your dentist. While some initial swelling is expected, increasing or severe swelling, especially if it spreads to your neck or jaw after the first 48-72 hours, indicates a concern.
Pus or discharge (yellow or white) from the extraction site clearly indicates infection. Extreme redness spreading beyond the immediate area, or if the site feels warm to the touch, can also signal an infection. A persistent foul odor or taste from the extraction site, even after rinsing, can also signal infection.
Another complication is a dry socket, which occurs when the blood clot either dislodges or fails to form. A dry socket appears as an empty tooth socket with exposed bone, which may look whitish or grayish instead of the dark blood clot. Severe, pulsating pain that radiates to the jaw or ear and appears two to four days after extraction is a primary symptom of dry socket. If you notice any of these deviations, promptly contacting your dentist is important for evaluation and appropriate treatment.