Wisdom teeth, or third molars, are the final set of teeth to develop, typically erupting in the late teens or early twenties. They are frequently removed because they become impacted—trapped beneath the gum line or jawbone—or because they cause crowding and damage to neighboring teeth. Understanding the normal visual progression of the extracted tooth and the surgical site can significantly ease post-operative concerns.
The Appearance of the Extracted Tooth
The extracted wisdom tooth is highly variable, reflecting its complicated growth path within the jaw. The crown, or white chewing surface, generally looks like a normal molar, though it may be stained or show signs of decay if it was difficult to clean. The most significant visual differences occur in the root structure beneath the crown.
Unlike other teeth with predictable root patterns, wisdom tooth roots are known for their anatomical unpredictability. They may be fused into a single, cone-like mass, or they might be splayed, separating into two, three, or even four distinct roots. The roots often exhibit dilaceration, meaning they are sharply curved or hooked. This curvature sometimes necessitates the surgeon fragmenting the tooth into smaller pieces for safe removal. Fragments of bone or soft pink gum tissue may also remain attached to the tooth.
What the Extraction Site Looks Like Immediately After Surgery
Immediately following the extraction, the surgical site appears as an open, dark cavity where the tooth once resided. This socket is the primary site of healing and is usually covered by a dark red or maroon mass of blood. This blood clot is necessary, acting as a biological bandage to protect the underlying bone and nerve endings.
The surgeon often places sutures, or stitches, across the opening to help close the gum tissue and stabilize the clot. These threads may be black, blue, or white, and are often dissolvable, disappearing on their own over the next week or two. The site will likely be covered with a gauze pad, which may be saturated with a mixture of saliva and dark, watery blood, a normal sign of initial hemostasis.
Monitoring the Healing Socket
The socket’s appearance changes noticeably as it progresses through the initial stages of repair over the first week. By the 24-hour mark, the dark blood clot should be stable and fill the cavity, although minor pinkish oozing may persist. The surrounding gum tissue will likely appear red and slightly swollen.
Around three to five days post-surgery, the dark blood clot begins to transform as the body replaces it with new tissue. This initial healing tissue, known as granulation tissue, can look greyish, white, or yellowish, and may cover the dark clot. This change is often mistaken for pus or infection, but it is a healthy sign of fibrin and new cell growth filling the void. The socket opening will visibly shrink as the gum tissue walls begin to pull inward.
Visual Signs Requiring Immediate Attention
Certain visual cues at the surgical site can indicate a complication, requiring prompt contact with the oral surgeon. The most distinct sign of a dry socket, or alveolar osteitis, is the loss of the protective blood clot. This leaves the socket looking empty, revealing the underlying jawbone, which has a distinct whitish or yellowish appearance deep in the hole.
Signs of infection include a worsening presentation after the first few days, such as spreading redness that extends beyond the immediate gum line. The most concerning indicator is the presence of thick, opaque discharge, which can be yellowish-green pus draining from the socket opening. Uncontrolled post-operative hemorrhage is another sign requiring immediate attention, appearing as bright red blood that flows continuously and saturates multiple gauze pads quickly, rather than the expected dark, slow ooze.