A tooth extraction leaves a temporary void in the mouth that requires a period of healing and recovery. Understanding the visual changes that occur in the extraction site is important for knowing that the healing process is progressing normally. The body’s response begins with the formation of a protective blood clot. Observing the socket’s appearance from the first hour to the first week can provide reassurance that the area is mending as expected. This visual guide explains what the socket should look like at various stages and how to distinguish healthy recovery from potential complications.
The Appearance Immediately After Surgery
The first 24 hours following a tooth extraction are characterized by the formation of a blood clot. This clot is a dark crimson or maroon, gelatinous mass that fills the socket, acting as a protective barrier over the underlying bone and nerve endings. This clot must remain in place, as it is the foundation for all subsequent healing. Some minor oozing or light bleeding is normal during these initial hours, often appearing as a pinkish tint in the saliva. The gum tissue immediately surrounding the site may appear red and somewhat swollen, which is a typical inflammatory response to the surgery. Additionally, the nearby cheek or jaw may exhibit localized swelling, which usually peaks around 48 to 72 hours after the procedure.
Normal Visual Signs During the First Week
From day two through day seven, the extraction site undergoes a visual transformation as the body begins to replace the blood clot with new tissue. The initial dark clot begins to change color, often developing a lighter, grayish or yellowish film on its surface. This pale appearance is not pus, but rather a normal part of the healing process called fibrin and early granulation tissue. Granulation tissue is the initial scaffolding of new cells that will eventually become gum tissue, and it may look soft, white, or creamy-yellow as it fills the socket from the bottom up. This is a positive sign that the wound is closing and should not be mistaken for an infection, especially if discomfort is gradually improving. The overall size of the socket opening will also appear to shrink noticeably by the end of the first week as the surrounding gum tissue starts to close over the area.
What Does an Extraction Complication Look Like?
A common complication, known as dry socket, occurs when the protective blood clot is dislodged or dissolves prematurely, typically a few days after the extraction. Visually, a dry socket appears as an empty, dark hole where the clot should be, often revealing the white or grayish bone of the jaw at the base of the socket. The socket will appear “dry,” lacking the dark, jelly-like plug that indicates normal healing. Signs of an infection, which usually appear after the first few days, include thick, yellowish or greenish discharge (pus) oozing from the site, severe, spreading redness, and tissue that feels warm to the touch. Swelling that significantly increases or spreads after the initial 48 to 72 hours, rather than subsiding, is another visual indicator that a bacterial infection may be present and requires immediate dental attention.