It is common to see a “hole” in your gums after a wisdom tooth extraction; this is a normal part of the healing process. This visible space is where the tooth’s roots were located. This article explains the nature of this post-extraction space, how it heals, and provides guidance on caring for the site.
What the Hole Is
The “hole” observed after a wisdom tooth extraction is medically termed an extraction socket. This is the natural space left in the jawbone after the entire tooth, including its roots, has been removed. Approximately two-thirds of a tooth’s structure, specifically its roots, resides beneath the gum line, leaving an empty space where the tooth once anchored.
Immediately following extraction, this socket fills with blood, forming a crucial blood clot. This clot acts as a protective barrier, shielding the underlying bone and nerve endings. The socket’s size can vary; impacted or unerupted wisdom teeth extractions often create larger spaces. The presence of this visible space is a normal and expected outcome of the procedure.
How the Extraction Site Heals
The healing of an extraction socket unfolds in several stages, beginning immediately after tooth removal. A blood clot forms within the socket, protecting exposed bone and nerves and acting as a scaffold for new tissue growth. Over the first few days, this blood clot may appear whitish or yellowish as it solidifies and integrates with surrounding tissues.
Within days, granulation tissue starts to form over the socket. This new, soft tissue is rich in blood vessels and indicates healthy healing. While gum tissue may visibly close over the extraction site within one to two weeks, deeper bone healing takes considerably longer. New bone gradually forms within the socket, filling the space left by the extracted tooth, a process that can take several months, sometimes up to four months for larger extractions.
Caring for the Healing Socket
Proper care of the extraction site is important for promoting healthy healing and preventing complications like a dry socket, which occurs if the blood clot becomes dislodged. For the first 24 hours after surgery, it is important to avoid rinsing your mouth vigorously or spitting, as this can dislodge the protective blood clot. After this initial period, gentle rinsing with warm salt water (half a teaspoon of salt in 8 ounces of warm water) two to three times a day can help keep the area clean.
- Consume soft foods for the first three to five days, such as yogurt, smoothies, and mashed potatoes, gradually reintroducing solid foods as comfort allows.
- Avoid hard, crunchy, or chewy foods that could irritate the site or get stuck in the socket.
- Avoid using straws, as the suction created can dislodge the blood clot.
- Refrain from smoking or vaping, as these activities can restrict blood flow and impair healing.
- Gently clean around the extraction site when brushing, avoiding direct contact with the healing socket for the first day.
When to Contact Your Dentist
While some discomfort, swelling, and minor bleeding are normal after a wisdom tooth extraction, certain signs indicate a potential complication that requires professional dental attention. You should contact your dentist or oral surgeon if you experience severe pain that worsens after the first few days or does not improve with medication. Increasing swelling after the initial 48-72 hours, or new swelling in surrounding tissues, can also be a cause for concern.
Other warning signs include excessive bleeding that does not stop with pressure or continues beyond 24 hours, a foul odor or taste in your mouth, or pus draining from the extraction site. A fever higher than 102 degrees Fahrenheit (38.8 degrees Celsius) or a persistent low-grade fever, as well as difficulty breathing or swallowing, are also indicators that you should seek immediate dental evaluation. These symptoms could signal an infection or other healing complications, such as a dry socket.