Extraction site not closed after two months advice appreciated

[JamesH]

Due to a cracked root, I had my upper left first molar (UL6) extracted on 22 February by a dental surgeon on the NHS.

The procedure was quick, the tooth came out in one piece and the surgeon told me it didn’t look like my sinus had been torn.

When I got home and checked the wound, to my surprise, as well as the usual hole in the top of the extraction site, there was a big hole on the outside of the gum where the UL6 had been. Presumably the gum was torn there during the extraction.

It’s now more than two months since the extraction and the hole still looks a long way from being closed and the area is still tender.

I’m pretty concerned, as the info I’ve read online suggests the extraction site should have closed within one month. I’m starting to wonder if it’s going to heal properly and whether I should book an appointment with a specialist (a periodontist perhaps?) to get this looked at?

I’m happy to spend the money on a private appointment if it’s of benefit, but naturally I don’t want to spend money unnecessarily.

Any thoughts/suggestions from dentists would be massively appreciated. What do you think?

I’ve pasted links to photos below so you can see the progress/rate of healing.

There was a fair amount of healing in the first month, but there’s really only been marginal signs of healing in the second month as far as I can see.

Thank you!

26 Feb (4 days post extraction): https://photos.app.goo.gl/aLZwsjDcg2KXiv8CA

23 March (29 days post extraction): https://photos.app.goo.gl/q3DCYwA6ztrsrcxJ7

26 April image 1 (63 days post extraction): https://photos.app.goo.gl/6fBn1QRH3vb9UGxF9

26 April image 2 (63 days post extraction): https://photos.app.goo.gl/LKp6c825QRk83H8Q7

 

[MattKW]

It's certainly achieved basic healing and looks fully epithelialised (covered with skin). Yes, when the tooth was extracted a large chunk of buccal bone came out, and this sometimes happens. It takes at least 3 months for the bone to reshape, but I doubt you'll get much more difference over the next month. This sort of defect is a bit unattractive but does not need further treatment unless you wish to place an implant; in which case you'd need a bone graft.

 

[JamesH]

It's certainly achieved basic healing and looks fully epithelialised (covered with skin). Yes, when the tooth was extracted a large chunk of buccal bone came out, and this sometimes happens. It takes at least 3 months for the bone to reshape, but I doubt you'll get much more difference over the next month. This sort of defect is a bit unattractive but does not need further treatment unless you wish to place an implant; in which case you'd need a bone graft.

Thanks very much for looking at it.

So, it’s likely this is how the gum there is ultimately going to look?

Will the white, light-coloured area harden/toughen up and turn a normal pink gum colour?

As things stand, the white/light-coloured area is very tender and I think it would tear easily, so I’m mostly eating on the other side of the mouth.

Just this week (after feeling okay for some weeks), the area has started to feel sore and stiff/achey, off and on.

I've started rinsing with salt water again a couple of times a day and Corsodyl original (the chlorhexide digluconate version). Am I doing the right thing?

Some websites say Corsodyl should be avoided as it's too strong, and others that it helps with healing.

Is it worth me booking an appointment with a periodontist or some other type of specialist? I’m hoping perhaps there might be something they can do to treat/remedy this. Any suggestions on anything I can do to improve the ultimate outcome greatly appreciated. Thank you.

 

[MattKW]

There is no need for further mouthwash or other treatment. I don't understand what you are trying to remedy or what you expect the utlimate outcome to be. You have bone damage that has healed up OK. Because you no longer have a tooth there, any hard food you eat will bump the soft gum and be a bit annoying; that's what happens whatever tooth you have removed, and most people adapt to it.

 

[JamesH]

There is no need for further mouthwash or other treatment. I don't understand what you are trying to remedy or what you expect the utlimate outcome to be. You have bone damage that has healed up OK. Because you no longer have a tooth there, any hard food you eat will bump the soft gum and be a bit annoying; that's what happens whatever tooth you have removed, and most people adapt to it.

For people I know of who have had a molar extraction (and according to the photos I’ve seen online) within a few weeks the extraction site is a normal pink gum colour and the gum has a strength to match that of regular gum tissue.

In my case, the ‘newly formed’ gum (if that’s the correct term) where the big tear was is soft/weak/tender/pale white in colour. It lacks the strength of regular gum and would tear easier than regular gum would. So, from my perspective – although it has a skin layer of sorts – the gum in the area hasn’t fully healed.

The salt water/Corsodyl is to hopefully aid further healing and stave off infection (as I say, the area has started to feel a little sore/achy/stiff) and the salt water/Corsodyl seems to relieve that, which again suggests to me that it isn’t fully healed.

 

[MattKW]

For people I've extracted teeth from in my 40+ years and 15,000+ extractions, that is in the range of normal healing and requires no further treatment. Please try to stop worrying about it.