Wisdom teeth removal is a common surgical procedure, and apprehension about recovery is normal. Monitoring the surgical site is natural, and understanding healthy progression reduces anxiety. The extraction site changes dramatically, reflecting the body’s predictable healing process. Knowing the visual benchmarks of a healthy socket helps differentiate normal recovery from complications.
The First 24 Hours
The surgical site’s appearance is dominated by the formation of the blood clot, the foundational first step of healing. This clot is a dark, maroon, or deep red mass that should completely fill the socket. It acts as a protective bandage, shielding the underlying bone and nerve endings.
This initial clot often has a jelly-like consistency and is anchored firmly within the socket walls. Minor bleeding or oozing is expected, causing the saliva to appear pink or red. The clot ensures hemostasis—the cessation of blood flow—which is necessary before tissue regeneration begins.
Swelling around the surgical site and cheek is a normal inflammatory response to the procedure. This swelling typically begins shortly after surgery and may increase over the first 24 to 48 hours, often peaking around the second or third day. The surrounding gum tissue will naturally appear red and slightly puffy.
The dark color of the clot signals proper formation and stability. Protecting this clot is paramount, which is why aggressive rinsing or sucking motions are restricted during this initial 24-hour period. This stable clot provides the necessary scaffold for new cells.
Week One: Visual Progression of the Healing Site
As the first week progresses, the extraction site transitions from a dark red clot to lighter colors. By day three or four, the blood clot surface may appear brown, grayish, or yellowish-white, which is a sign of healthy maturation.
This lighter color indicates the formation of granulation tissue, which replaces the blood clot. This tissue is composed of new blood vessels and connective tissue, serving as a framework for future gum and bone growth. It may appear bumpy, gelatinous, or like a white or pale pink film covering the socket opening.
Many mistake this whitish or grayish tissue for pus or food debris, but it is a positive sign that the socket is healing from the bottom up. As the week continues, initial swelling should decrease, and redness will fade, returning closer to the normal pink color of the mouth.
By the end of the first week, the socket may be covered by this thin layer of pale granulation tissue. The deep hole will appear to be gradually filling in, and tenderness will lessen considerably. This progression demonstrates a successful recovery.
When Appearance Signals a Problem
While normal healing involves predictable changes, certain appearances signal a complication. One distinct sign of a dry socket (alveolar osteitis) is the absence of the dark, protective blood clot. The socket will look empty and hollow, rather than filled.
In dry socket cases, the underlying bone may be visible as a pale, white, or gray surface inside the socket. This exposed bone is highly sensitive to air and fluid, causing severe pain. The walls of the socket may also appear dry and clean.
Indicators of a post-operative infection contrast sharply with normal healing tissue. An infection is marked by thick, opaque discharge, known as pus, which can be yellow or green. This discharge may also be accompanied by a persistent foul odor or a bad taste.
While some inflammation is normal, an infection causes redness and swelling that worsens and spreads after the third day. If the gum tissue becomes increasingly hot or swelling extends significantly into the face or neck, contact your oral surgeon immediately.