Tooth extractions are a common dental procedure, but proper healing is essential for your comfort and long-term oral health.

“The healing process varies from person to person. Factors such as general health, complexity of the procedure, and adherence to postoperative instructions can affect healing time,” says the American Association of Oral and Maxillofacial Surgeons (AAOMS) .

If you’re wondering whether your extraction site is healing as it should, understanding the process, the role of oral surgeons, and the warning signs of complications is key.

What Are Extractions and Extraction Sites?

A tooth extraction is the removal of a tooth from its socket in the jawbone. Extractions may be necessary for a variety of reasons, including severe decay, advanced periodontal disease, trauma, or to address overcrowding before orthodontic treatment.

“Even with proper dental care, teeth age and can decay or break,” says AAOMS. “Many damaged teeth can be repaired with fillings or crowns, but when the damage or decay is excessive, the tooth should be removed.”

The area where the tooth was removed is called the extraction site or socket.

Why Would You Need an Oral Surgeon?

While some extractions are straightforward and can be performed by a general dentist, others require the expertise of an oral and maxillofacial surgeon (OMS).

Oral surgeons are dental specialists with advanced training in surgical procedures involving the mouth, jaws, and face. You may be referred to an oral surgeon if:

• The tooth is impacted (stuck below the gum line).
• The tooth is broken or fractured below the surface.
• There are complex root structures or proximity to nerves and sinuses.
• You have underlying health conditions that increase surgical risk.
• Multiple teeth need to be removed at once.
• There is a need for sedation or general anesthesia.

Oral surgeons are equipped to handle complications, ensure safe removal, and provide detailed aftercare instructions for optimal healing.

“When a dental professional refers a patient to an OMS for tooth extraction, it is to ensure the tooth is removed or managed with the highest level of expertise,” says AAOMS.

The Stages of Recovery from Oral Surgery

AAOMS says these are the oral surgery recovery stages:

• Immediate Post Surgery Stage: Bleeding may occur at the surgical site immediately after oral surgery. Your OMS will place gauze at the surgical sites to control the bleeding. Follow instructions and keep the gauze in place for the recommended amount of time. Utilizing gauze properly is essential for the formation of a blood clot, which is the first step of the healing process.
• Inflammatory Stage: Swelling, pain, and redness may occur around the surgical site during this phase. The body’s immune system sends white blood cells into the area to remove debris and defend against bacteria and infection.
• Proliferation Stage: New tissue begins to form to replace damaged or removed tissue, and blood vessels grow into the area to provide the oxygen and nutrients needed for healing. The wound gradually begins to close as cells multiply and fill in the gaps. The formation of a protective tissue that can be white, pink, or red and looks granular (granulation tissue) is a sign that healing is progressing.
• Maturation Stage: During the final stages of wound healing, newly formed tissue is strengthened and reorganized. Collagen fibers – a type of protein – begin to align, giving strength to the healing area. Scar tissue gradually rebuilds and becomes less noticeable.
  
  

Why Might an Extraction Site Not Heal Properly?

Most extraction sites heal without issue, but sometimes healing is delayed or impaired. Healing can be disrupted by:

• Infection at the site.
• Dislodgement or failure of the blood clot (dry socket).
• Poor oral hygiene.
• Smoking or tobacco use.
• Underlying medical conditions (e.g., diabetes, immune disorders).
• Trauma to the site.
• Presence of foreign material or bone fragments.
• Rarely, underlying pathology such as cysts or tumors.
  
  

Delayed healing increases the risk of pain, infection, and further complications, making it important to recognize when something is wrong and seek prompt care.

10 Signs Your Extraction Site Is Not Healing Properly

While some discomfort, mild swelling, and gradual improvement are normal after an extraction, the following 10 signs may indicate abnormal healing or complications:

1. Persistent or Worsening Pain: Pain that intensifies or does not improve several days after extraction may signal dry socket or infection. Dry socket pain typically starts 1–3 days post-extraction and can radiate to the ear, eye, or neck.
2. Dry Socket: The blood clot is missing, exposing bone at the extraction site. Severe, throbbing pain and a bad taste or odor from the mouth. Dry socket is one of the most common complications, especially after wisdom tooth removal.
3. Excessive or Prolonged Bleeding: Some bleeding is normal, but if it continues beyond 24 hours or is heavy, it may indicate a problem.
4. Swelling That Worsens or Does Not Subside: Swelling is expected in the first 48 hours but should gradually decrease. Persistent or increasing swelling, especially with redness or warmth, may be a sign of infection.
5. Foul Smell or Taste: A persistent bad odor or taste in your mouth can signal infection or dry socket.
6. Unusual Discharge or Pus: Any yellow or white discharge from the extraction site is a clear sign of infection and requires immediate attention.
7. Fever or Malaise: A low-grade fever can occur shortly after surgery, but persistent or high fever, chills, or feeling generally unwell may indicate systemic infection.
8. Non-Healing or Open Socket: The extraction site remains open, raw, or does not show signs of tissue growth after 2–4 weeks. Granulation tissue (pink, healthy tissue) should gradually fill the socket. Lack of progress is a warning sign.
9. Numbness or Tingling: Persistent numbness or tingling in the lips, tongue, or chin may be due to nerve injury during extraction and should be evaluated.
10. Difficulty Opening the Mouth:Trismus (difficulty opening the mouth) can be a sign of infection or trauma to the jaw muscles.
    
    

How to Support Proper Healing

To minimize the risk of complications and support healthy healing:

• Follow all post-operative instructions carefully.
• Avoid smoking and using straws for at least a week.
• Maintain good oral hygiene but avoid disturbing the extraction site.
• Attend all scheduled follow-up appointments.
  
  

When to Seek Help

If you experience any of the above symptoms, contact your oral surgeon or dentist promptly. Early intervention can prevent more serious complications and speed up recovery.

Seek urgent dental or medical care if you experience:

• Uncontrolled bleeding.
• Severe pain not relieved by prescribed medication.
• Signs of spreading infection (fever, chills, facial swelling).
• Difficulty breathing or swallowing.
  
  

Tooth extractions are routine but require careful management to ensure proper healing.

If your extraction site shows any signs of not healing properly do not delay in seeking professional care. Early attention can make all the difference in your recovery and long-term oral health.

The experienced doctors at Northwest Oral & Maxillofacial Surgery are specially trained to handle complex cases and reduce the risk of complications.

Contact Northwest Oral & Maxillofacial Surgery today for the safe removal of wisdom and diseased teeth and other oral surgery needs.