When a wisdom tooth is removed, the surgical site can cause anxiety, as the appearance inside the mouth is often unfamiliar. Understanding the normal visual progression of healing helps alleviate worry during the recovery period. This guide provides a clear visual breakdown of what a healthy wisdom tooth extraction site should look like at different stages. The appearance changes rapidly, moving from an open wound to a stable, protected healing site, leading to full soft tissue closure within a few weeks.
What the Site Looks Like Right Away
The most important visual feature immediately following extraction is the blood clot, which must form correctly to begin healing. This clot appears as a dark red or maroon, jelly-like mass that completely fills the socket, acting as a biological bandage. Its presence protects the underlying bone and nerve endings from the oral environment.
Sutures, or stitches, are normal and are used to hold the gum tissue flaps together and minimize the open wound size. These sutures may be white, blue, or black, and their ends might stick out slightly. Most oral surgeons use dissolvable sutures, which break down on their own within one to two weeks, eliminating the need for a removal appointment.
During the first 24 to 48 hours, the surrounding gum tissue may look swollen and reddened due to the trauma of the surgery. Minor oozing or pink-tinged saliva is expected initially, but active, heavy bleeding should subside quickly. Swelling usually peaks around the second or third day post-surgery, with bruising on the cheek or jaw appearing as blue or yellow discoloration before fading.
Visual Changes During Standard Recovery
The visual transformation begins around Day 3, marking the transition from clot formation to tissue repair. The initial blood clot starts to mature and shrink, often changing from bright red to a darker, almost black or brown color as blood components break down. This darkening is a normal part of the maturation process.
A common and healthy visual change is the appearance of a whitish or yellowish film over the socket. This is not pus, but a layer of fibrin, a protein that forms a protective, soft layer of early granulation tissue. This granulation tissue is a pink, pebbly layer that gradually replaces the blood clot, serving as a scaffold for new gum and bone growth.
By the end of the first week, the gum tissue will visibly start to close over the hole, making the socket appear shallower. If dissolvable sutures were used, small pieces may begin to fall out around Day 5 to 7. This is expected and indicates the wound edges are stable enough to heal. Complete soft tissue closure, where the gum has fully sealed the opening, typically occurs within two to three weeks, though the underlying bone continues to fill in over several months.
Concerning Appearances That Require Action
While the healing site can appear unusual, two specific visual signs indicate a complication requiring immediate attention from the oral surgeon. The first major complication, known as a dry socket, occurs when the protective blood clot is dislodged or fails to form, exposing the bone underneath. Visually, a dry socket appears as an empty hole, where the dark clot is missing, often revealing a gray, white, or yellowish-white piece of bone at the base of the socket.
This exposed bone looks dry and appears sunken compared to a healthy site filled with a dark clot or granulation tissue. While the visual emptiness is a sign, the accompanying severe, throbbing pain that radiates to the ear or neck and is unrelieved by medication is the most definitive symptom. Pain from a dry socket typically begins two to four days after the extraction, after the initial post-operative discomfort should have been subsiding.
The second major complication is an infection, which has distinct visual markers that differentiate it from normal healing. The most concerning sign is the presence of thick, opaque discharge, which may be yellow, green, or whitish pus. This discharge is often accompanied by a persistent, foul taste or smell that cannot be remedied by rinsing.
Infection also causes localized redness that spreads outward from the extraction site and swelling that worsens after the third day, rather than improving. Any localized, firm swelling that increases in size past the peak of Day 2-3, especially when paired with a fever, indicates a bacterial invasion. Noticing any of these specific visual cues—a pus-like discharge, spreading redness, or a visibly empty socket—warrants prompt contact with your dental care provider.