A tooth extraction, the removal of a tooth from the socket in the jawbone, often causes concern about how the space heals. The extraction site may look unsettling immediately after the procedure, but the body has a predictable process for recovery. Understanding the normal visual changes helps monitor healing and reduces anxiety. The immediate formation of a blood clot is the first step, setting the stage for gum tissue to regenerate and cover the empty space.
Visual Expectations in the First 24 Hours
The most noticeable feature in the first 24 hours is the blood clot, which acts as a protective barrier and the foundation for new tissue growth. This clot should appear as a dark red or deep purple mass, often described as a jelly-like substance, filling the entire socket up to the level of the surrounding gum tissue. Protecting this clot is the primary goal during the initial recovery period because it prevents the underlying bone and nerves from being exposed.
The gum tissue directly surrounding the extraction site may display signs of trauma from the procedure, appearing darker than the rest of the mouth. This tissue can look bruised, showing shades of dark red or even purple, which is a normal response to the manipulation of the gums. Minor swelling on the cheek or jawline near the site is expected, typically peaking around the 24-hour mark as the body initiates its healing response.
Mild, controlled bleeding or oozing is common and can cause the clot to look wet or slightly red-tinged, but this should be manageable with gauze pressure and gradually diminish. The presence of this dark, stable clot is the most positive visual sign that initial healing is proceeding correctly. If sutures were used to close the gum edges, these threads will also be visible, usually dark in color and positioned across the top of the socket.
The Normal Healing Timeline
After the first day, the extraction site begins a transition that can often cause confusion, as the appearance of the clot starts to change. Around day two or three, the dark red blood clot begins to be replaced by new tissue known as granulation tissue. This tissue is made up of collagen, blood vessels, and white blood cells, and it visually presents as a grayish-white or yellowish film covering the socket.
This grayish-white tissue is not pus or a sign of infection, but rather a healthy sign of the body actively repairing the wound. Concurrently, the swelling in the surrounding gum and facial tissues should start to subside significantly. The dark bruising and redness around the socket will begin to fade, with the gum tissue gradually returning to its normal pink color.
The socket will appear to close in a slow, continuous process, as the gum tissue grows inward from the edges over the granulation tissue. For smaller extraction sites, the entire hole may be covered by new gum tissue within about seven to ten days. Larger extraction sites, such as those from molars, may take longer, but a noticeable reduction in the size of the open socket should be visible by the one-week mark.
Identifying Signs of Complications
Two primary complications, dry socket and infection, have distinct visual and symptomatic indicators that signal a need for professional attention. A dry socket, formally known as alveolar osteitis, occurs when the protective blood clot is lost or fails to form, exposing the underlying bone. Visually, this results in a gaping, empty socket where the dark clot should be, often revealing a gray or whitish-yellow surface of exposed bone.
The pain associated with a dry socket is far more severe than normal post-operative discomfort, often starting around two to four days after the extraction and radiating toward the ear, temple, or neck. Unlike normal healing where pain lessens, dry socket pain intensifies and will not be resolved by typical pain medication. A persistent foul odor and bad taste frequently accompany the condition.
An infection presents with a different set of visual cues, primarily involving inflammation that spreads beyond the immediate extraction site. Signs of infection include excessive and increasing redness and swelling of the surrounding gum and facial tissues several days after the procedure. The most definitive visual sign of infection is the presence of yellow or green discharge, or pus, coming from the socket.
This discharge, often accompanied by a persistent foul taste or bad breath, indicates a bacterial presence in the wound. Unlike the normal grayish-white granulation tissue, pus is thicker. If you observe spreading redness, swelling that worsens after the third day, or any visible pus, contacting your dentist is necessary for evaluation and treatment.