Tooth extraction healing. - How long does it take? / What can you expect? / Precautions and restrictions. / Pictures.

- An overview of the time line and stages of post-extraction healing.

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

We've broken our discussion of this subject into the following time frames following your extraction:


Size does matter.

Generally speaking, the degree of healing progress that takes place at each of the above stages is the same for any extraction.

But obviously larger, more involved wounds (like those resulting from surgical wisdom tooth removal) will take longer to fully resolve.

Taking time off.

This page also discusses the issue of how long you may need to limit your activities or take time off from work or school after having your tooth removed.

An x-ray a tooth socket after having its tooth pulled.

X-ray of tooth socket.

Future dental work.

In the case where the tooth that's been pulled will be replaced, we explain how extraction site healing affects the timing of future dental.

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 healing.

Tooth sockets immediately after the extraction process.

Tooth socket, immediately after extraction.

Blood clots have begun to form.

You should, however, notice that:

Additionally ...

  • 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 first 24 hours and then start to subside.

Restrictions on activities. / How much time will you need to take off?

a) With routine extractions.

Most patients are probably best served by just going on home after their tooth extraction and taking it easy.

This allows you some privacy and adjustment time during that period while your anesthetic is wearing off and your site's 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.

b) With 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 the 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.

Taking time off. / Sick leave. - What studies have shown.

Here are some examples of what researchers have reported about the amount of time off patients typically require after having wisdom teeth taken out (a level of surgery that is frequently more involved than just a routine tooth extraction).

Lopes (1995)

This paper followed the healing outcomes of 522 patients that had 3rd molars removed (from the simplest to very involved surgeries). 81% of the patients took time off from work, for an average of 3 days (with a range of 0 to 10 days). 19% of the patients took no time off.

Hu (2001)

This study also evaluated patient healing outcomes associated with 3rd molar extractions (about 2000 of them). It found that on average patients missed 1.2 days of work, or were unable to perform normal daily activities.

40% of the teeth removed were erupted (had come through the gums into relatively normal position). Removing erupted teeth typically creates less surgical insult than impacted ones, thus possibly explaining the lower amount of recuperation time reported by this study.

Extraction site healing.

Pictures of tooth extraction site healing.

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.

Socket (hole) healing.

At their surface, the sockets of smaller diameter, single-rooted teeth (such as lower incisors) may appear mostly healed. The same goes for baby teeth.

Wider and deeper wounds (holes) left by larger or multi-rooted teeth (molars) or surgical extractions (impacted wisdom 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 or divot in the area of the tooth's socket.

Restrictions on activities.

The tissues that initially form during the healing process are quite vascular (contain a large number of blood vessels). So, if you inadvertently traumatize your extraction site (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.

Other that that, the extraction area should be mostly a non-event and not a significant concern in regard to routine activities.

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 (hole).

Where large teeth have been removed (or a lot of bone was removed during the extraction process like with impacted wisdom teeth), 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 type of trauma shouldn't result in significant bleeding.

D) Bone healing.

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

What will you notice?

During the initial weeks of the healing process, it will be easy for you to see and feel the pronounced 'hole' left in your jawbone. In some cases in may be deep enough that it traps food and debris. (Especially large or deep sockets may require "irrigation" to keep them clean during the early weeks of healing.)

The shape of the bone will change.

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 (i.e. molars, impacted wisdom teeth) will take longer to heal and will result in a greater degree of bone contour changes.

Tooth socket bundle bone.

Immediately after an extraction, the outline of the socket is easily seen.

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.

Because it takes place so gradually, especially during the last several months you really shouldn't notice anything going on at all.

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 and the outline of the socket will have been mostly lost.

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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's healing process to take place doesn't mean that you have to wait that long until your empty space can be filled in with a replacement tooth.

A healing period may be needed.

With some 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. (Usually on the order of 1 to just a few months.)

But even if this wait period is required, there should be some type of temporary tooth or appliance 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.

Our next page discusses post-extraction recovery and care. ▶


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