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The Healing Procedure after tooth extraction
Proper dental care will ensure that your natural teeth remain healthy and strong, but it is often that accidents, infection or decay, or simple growth of the wisdom tooth result in the need for a tooth removal. It is often the last resort for most cases but if your doctor does recommend removal, do not back out. Extraction of teeth is actually quite a simple, quick and straightforward process but special aftercare is absolutely necessary and neglect may make the problem much worse. Until the hole has fully closed, neglect is not an option. Let’s look at the time-based stages for the complete healing of the tooth socket after extraction.
The first 24 hours following the extraction:
The very first step on the road to recovery is the formation of the blood clot that will normally fill the entire socket after the bleeding has been stopped. This is also the most crucial step for it is the platelets and other cells in the blood clot that trigger the healing process by the production of chemicals that aid the process. The Bleeding needs to be stopped because persistent bleeding will hinder and may even stop the healing.
The pain will gradually subside but the region around the socket, in these 24 hours, will be soft and tender to touch. This area will also appear whitish and may swell in addition to slight swelling on your face.
If the blood clot that filled the socket is lost, it results in a condition called “dry socket”. Since there is nothing covering the socket, the nerves underneath are exposed which often results in intense pain. This condition is treated by professional dental care where the wound is cleaned and covered by a special dressing so that the nerves are no longer exposed.
Weeks 1 and 2:
By the end of the first week after extraction, the blood clot that had formed will be colonized, not yet completely, by granulation tissue which contains collagen that is significant in blood-vessel and tissue growth. By the end of the two weeks, the mesenchymal cells will start growing in this granulation tissue. It is these cells that will ultimately specialize in cells like those present in bone tissue.
Within the first two weeks of extraction, a significant amount of healing will have taken place around the socket. The skin around the hole would visibly have started closing up and the hole will be smaller. The degree of repair that has taken place in this time frame will be determined by the initial size of the hole. If it was a large molar (multi-rooted), premolar or canine that was removed, the healing will take longer than it would in the case of the removal of an incisor (single-rooted).
Weeks 3 and 4:
The mesenchymal cells will continue to grow and by the end of this time period, will have replaced more than half the granulation tissue. Some of these cells will have specialized into bone cells and the first bone tissue will start to develop adjacent to the sides and the bottom of the socket.
Most of the healing will have taken place by now. A slight indentation will remain at the site of extraction (the hole) but if the tooth removed left a large socket or if several teeth in a row were removed, the indentation would be significantly noticeable and will remain for quite some time, even months.
Filling in of the socket:
The filling in of hole in your gums is the process that is the most time-consuming. Bone formation begins by the end of the first week after the extraction and it takes about 5 to 7 months for the jaw-bone to have fully formed. By the end of 8 to 10 weeks the socket will have nearly filled in with new bone and it will usually be after 4 months of the tooth-removal that the socket will fully be filled in with bone. By another 2 to 4 months, the extraction site will completely be smoothed out with the contours of the jawbone and at the end of this time; the bone will mature to the density of the surrounding bone.
Thus, it takes approximately between 4 and 8 months for the hole to fully close after the tooth extraction, depending upon the size and number of teeth removed. Single-rooted teeth like incisors will take longer than canines, premolars, molars or several removed in a row. During the entire time, the hole will gradually get smaller until the indentation disappears. However, the bone’s height would be less than the original, resulting in a saddle-shape of the jawbone at the site of removal.