Wisdom teeth removal is a common dental procedure, often due to impaction, decay, or overcrowding. Understanding the healing process following this surgery can help individuals recognize normal progression and identify any potential issues.
Initial Appearance After Surgery
Immediately after wisdom tooth removal, the extraction site will have gauze placed over it to absorb blood and encourage clot formation. Some bleeding or oozing is normal during the first 24 to 48 hours, often appearing as blood-tinged saliva. A dark-colored blood clot, resembling a scab, should form within the socket, acting as a protective barrier for the underlying bone and nerves.
Swelling around the cheeks and jaw is common, usually peaking around 2 to 3 days post-surgery. Bruising of the gums or skin near the extraction site may be present. Applying ice packs externally can help reduce swelling in the initial 24 hours.
Timeline of Normal Healing
The healing process of a wisdom tooth extraction site progresses through several stages. Within the first 24 hours, a blood clot forms in the socket, protecting the bone and nerve tissue and initiating healing. Swelling and discomfort peak within the first 1 to 3 days, then gradually begin to subside.
Around day 3 to 7, a soft, moist tissue called granulation tissue begins to form in the empty socket. This tissue, composed of new blood vessels, collagen, and white blood cells, can appear reddish, whitish, or pale pink, and may have a bumpy or granular texture. It serves to protect the wound, provide a framework for new tissue, and gradually fill the socket. By 7 to 10 days, the blood clot should be fully formed and stable, and any stitches, if placed, will dissolve or be removed. The hole left by the extraction should begin to close, though complete closure can take 2 to 3 weeks or even several months for underlying bone remodeling.
Indications of Potential Complications
While most wisdom tooth extractions heal without issues, certain visual signs can indicate complications. One such complication is a dry socket, also known as alveolar osteitis, which occurs when the blood clot dislodges or fails to form properly, leaving the underlying bone and nerves exposed. Visually, a dry socket appears as an empty hole where the tooth was, often with a whitish or grayish layer of exposed bone at the bottom, and may be accompanied by a foul odor.
An infection at the extraction site may present with distinct visual cues. This can include increasing redness around the site, the presence of pus or discharge, and severe swelling that worsens instead of improving. Pus often appears as a white or yellow collection, sometimes resembling a pimple on the gums. A persistent bad taste in the mouth or foul breath can also signal bacterial presence and infection.
Excessive bleeding is another concern. While some light oozing is normal for up to 48 hours, continuous heavy bleeding that saturates gauze quickly or bright red blood that does not subside with pressure is a sign of a problem. If bleeding restarts after having stopped, or if it is so heavy that it makes talking, eating, or breathing difficult, it warrants attention.
When to Contact Your Dentist
Contact your dentist or oral surgeon if you experience any of the following:
Severe pain that worsens or does not improve with medication, especially if it extends to your ear, eye, or neck.
Signs of infection, such as increasing redness, severe swelling, or any pus or unusual discharge from the extraction site.
Persistent bad breath or a foul taste in your mouth that doesn’t resolve with oral hygiene.
Heavy bleeding that continues for more than 24 hours or is uncontrollable.
Exposed bone in the socket.