Tooth extraction healing - How long does it take?

Once your extraction process has been completed, you'll no doubt want to know how long it will take for your tooth's socket to heal.

We've broken our coverage of this subject into the following categories:
     A)  The initial 24 hours after a tooth extraction.
     B)   Weeks 1 & 2.
     C)   Weeks 3 & 4.
     D)   Bone tissue healing.

We also explain on this page how a person's extraction-site healing can affect the timing of their future dental treatment (replacing their missing tooth).

A) The initial 24 hours following your tooth extraction.

What will you notice?

As far as seeing changes, during the first 24 hours after your surgery you really won't be able to visualize all that much in terms of actual extraction-site tissue healing. You should, however, notice that the bleeding from your wound has stopped and the level of discomfort associated with it has started to subside.

You'll probably find that the region immediately adjacent to the tooth's empty socket is tender when touched and feels irregular and different to your tongue.

It's also possible (especially in the case of a relatively involved or difficult extraction) that you'll find some degree of swelling has formed, both in the tissues that surround your extraction site and possibly your face too. If so, this swelling should peak within the next 24 hours and then start to subside.

Restrictions on activities.

Routine extractions.

Most patients are probably best served by just going on home after their tooth extraction and just taking it easy. This allows you some privacy and adjustment time during that period while your anesthetic is wearing off and bleeding is coming to an end. It also gives you opportunity to get in sync with your dentist's all-important postoperative instructions.

Returning to non-strenuous, routine activities (going to an office job, attending class, shopping) the next day should present no problem. If you have more aggressive or involved activities in mind (including during the next several days) you should clear them with your dentist.

For the easiest and most routine extractions, you may be able to return to non-strenuous activities even the same day of your extraction (possibly after a short period recuperation). You'll need to ask your dentist for their opinion on this matter.

Difficult or involved extractions.

In the case of relatively involved or difficult extractions, or cases where some method of patient sedation has been used, your dentist may feel strongly that you must limit your activities during this initial 24 hour period.

It's important to follow their recommendation, your safety may be involved. And remember, the way you take care (or don't take care) of your extraction site during this initial period will set the stage for the healing process that follows.

B) Extraction site healing - Weeks 1 and 2.

What will you notice?

During the first two weeks after your surgery, you should notice that the gum tissue that surrounds your extraction site has completed a significant amount of repair. (As a point of reference, it's usually considered that enough gum tissue healing has taken place by days 7 through 10 that stitches can be removed.)

Especially toward the end of this time frame, you should find that your extraction area really isn't much of a problem or bother. However, the total amount of healing that's been able to take place will be influenced by the initial size of the wound.

At their surface, the sockets of very small diameter, single-rooted teeth may appear mostly healed. The same goes for baby teeth. Wider and deeper wounds left by larger, multi-rooted teeth will require a greater amount of time to fill in. So, in these instances, the contours of the gum may still show quite an indentation in the area of the tooth's socket.

Restrictions on activities.

It is important to understand that the tissue that initially forms during the healing process is quite vascular (contains a large number of blood vessels). So, if you inadvertently traumatize it (like with food or while brushing), you can expect it to bleed easily. You can also expect this newly formed tissue to be tender when accidentally touched or prodded.

C) Extraction site healing - Weeks 3 and 4.

What will you notice?

By the end of the 3rd to 4th weeks after your tooth extraction, most of the soft tissue healing will have taken place.

You'll probably still be able to see at least a slight indentation in your jawbone that corresponds with the tooth's original socket. Where large teeth have been removed (or a lot of bone was removed during the extraction process), a relatively significant indentation may still remain. It may persist, even for some months.

Restrictions on activities.

You may notice that the new gum tissue that has formed has some tenderness, like when jabbed by hard foods. But this trauma is not likely to result in bleeding.

D) Bone tissue healing.

When you have a tooth 'pulled,' it's the healing of your jaw's bone tissue that takes the greatest amount of time. In general, it takes on the order of 6 to 8 months for new bone to substantially fill in the tooth's empty socket space.

What will you notice?

During the initial weeks of the healing process it will be easy for you to see and feel a pronounced 'hole' in your jawbone that corresponds with the extracted tooth's socket. (For this reason, especially large or deep sockets may require "irrigation" to keep them clean during the early weeks of healing.)

In general, tooth sockets tend to both fill in and smooth over. And it's common for some of the bone's original height to be lost during this process (the bone in the region of the extracted tooth ends up looking somewhat sunken).

The amount of time it takes for complete healing, as well as the final shape of the healed bone ridge, will depend on the size of the original wound. Larger wounds will take longer to heal and will result in a greater degree of bone contour changes.

Tooth socket bundle bone.

Restrictions on activities.

Don't expect that you'll be incapacitated, or even inconvenienced, during this 6 to 8 month time period required for bone healing. For the most part, the events that take place will be little noticed by you.

FYI: Bundle Bone

If your dentist takes an x-ray right after you've had your tooth pulled, it will show a whitish outline surrounding your tooth's socket (see our graphic).

This is called "bundle bone" and it is that layer in which the fibers that anchored your tooth in place (its periodontal ligament) were embedded.

Over time, as healing takes place and new bone is deposited in the socket, this layer will slowly resorb. After about 18 months or so, it will have totally disappeared.

Treatment timing - Making plans to replace your missing tooth.

The fact that it takes as long as 6 to 8 months for the bulk of the jawbone healing process to take place doesn't mean that you have to wait that long until your tooth's space can be filled in using some type of dental restoration or appliance.

Wait periods.

It's true that with many types of restorations (dental bridges, partial dentures, some dental implants) there typically is a healing 'wait' period that must be adhered to for best results. (Probably on the order of 1 to just a few months.)

But even if this wait period is needed, there should be some type of temporary dental prosthesis that your dentist can place for you to wear until that point in time when your jawbone's healing has advanced enough that a permanent one can be made.

 All FYI's ► 

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