Wisdom tooth extraction is a common dental procedure, often performed to address issues like impaction or crowding. Understanding the normal visual changes of the extraction site can help manage expectations and provide reassurance during recovery.
Immediate Post-Extraction Appearance
Immediately following a wisdom tooth extraction, the site shows distinct visual characteristics. A blood clot forms in the empty socket to protect underlying bone and nerves. This clot typically appears dark red or maroon, resembling a deep scab, and has a jelly-like consistency, fully covering the socket.
Sutures are often used to close the surgical site and hold gum tissue in place. These stitches may appear as dark threads, sometimes black or blue, neatly tucked into the gumline or slightly curled outward. Their purpose is to stabilize the area, reduce bleeding, and protect against infection.
Initial swelling and bruising are common. Swelling typically affects the cheek and jaw, peaking within 24 to 72 hours after the procedure. Bruising can appear as yellowish or purplish discoloration on the cheek or jaw, and may spread slightly from the immediate extraction site.
The gum tissue surrounding the extraction site may look inflamed or red, which is a normal healing response to surgical trauma. Light bleeding or oozing, especially pink-tinged saliva, is normal. However, heavy or continuous bright red bleeding is not typical after the initial hours.
Normal Healing Progression
As healing progresses, the extraction site undergoes predictable changes. Within the first few days (days 1-3), the dark red blood clot stabilizes, and its color may deepen. It remains solid within the socket, providing a protective barrier.
Around days 3-4, swelling begins to subside, and bruising starts to fade, transitioning from purplish tones to yellow or green as it resolves.
During this period, a white or grayish-white material may become visible over the healing socket. This is often granulation tissue, a normal sign of new tissue formation, not pus. This tissue works to fill the empty space.
By the first week (days 5-7), gum tissue starts to grow over the developing granulation tissue, and the socket opening visibly reduces in size. The granulation tissue may appear soft, moist, and slightly bumpy, ranging in color from reddish to pale pink or whitish. Stitches, if present, are either dissolving or ready for removal as the surface gum tissue starts to close.
Over the next few weeks, the soft tissue continues to mature, gradually filling the socket. By two weeks, the socket appears significantly smaller, with more complete gum tissue coverage. Bone regeneration begins beneath the gum surface, a process that continues for several months.
Signs of Abnormal Healing or Complications
Recognizing visual cues of abnormal healing or complications is important.
A dry socket (alveolar osteitis) occurs when the protective blood clot dislodges or fails to form properly. Visually, a dry socket appears as an empty, hollow socket where the dark blood clot should be. Exposed bone, which looks whitish or grayish, may be visible at the bottom of the socket.
Infection is another potential complication with distinct visual signs. Pus or discharge from the extraction site, often thick, yellowish, or greenish, indicates infection. Spreading redness of the gums and surrounding tissues beyond the immediate extraction area can also signal an infection. Swelling that increases after the initial 2-3 days or spreads to the face and neck is concerning, as normal swelling should begin to subside.
Persistent bleeding (fresh, bright red blood), especially if it continues heavily beyond 24-48 hours, is not normal and requires attention. While minor oozing or pink-tinged saliva is expected, continuous flow that quickly soaks through gauze suggests a problem with clotting. Any unusual or worsening discoloration that spreads, rather than fades, should prompt a call to a dental professional.
Long-Term Appearance and Full Recovery
Once the wisdom tooth extraction site has fully healed (typically after several weeks to a few months), its appearance normalizes. The socket will be completely closed by mature gum tissue. This new gum tissue will generally blend in with the surrounding oral tissues, matching in color and texture.
While the surface gum tissue heals relatively quickly, the underlying bone continues to remodel and fill the socket over several months. A slight indentation or depression may remain where the tooth was, even after full soft tissue coverage. This is a normal anatomical variation and does not indicate an issue with the healing process.