After having wisdom teeth extracted, many patients will find white substances at the extraction site, which often causes concern and makes people worry whether there is an infection or other problems. In fact, the whitening of a wound is the result of the combined effect of multiple factors. Let’s explore this in detail below.
Manifestations during the normal healing process
(1) Organization of blood clots and formation of white pseudomembrane
After the wisdom tooth is extracted, a blood clot will immediately form at the wound site. This is a self-protection mechanism of the human body. Blood clots can seal wounds, prevent bleeding, and at the same time provide a basis for subsequent healing. Over time, subsequent healing provides a foundation. As time goes by, approximately 1 to 2 days after tooth extraction, the blood clot begins to undergo the process of organization.
Organization refers to the gradual growth of fibroblasts, capillaries, etc. into blood clots and their transformation into granulation tissue. During this process, a white or grayish-white pseudomembrane will gradually form on the surface of the blood clot. This pseudomembrane is mainly composed of fibrin, inflammatory cells and necrotic tissue, etc. It is like a “temporary protective shield” for the wound, capable of isolating external bacteria and irritants, and playing an important protective role in wound healing.
The false membrane is usually soft in texture, adheres closely to the wound, and generally does not fall off easily. Visually, it covers the surface of the wound, presenting a uniform white color with relatively clear boundaries. There are no obvious abnormal manifestations such as redness, swelling, or increased pain. Three to five days after tooth extraction, as the wound further heals, the prosthesis will gradually be replaced by new epithelial tissue.
(2) Epithelial tissue growth
The healing of the wound after tooth extraction is a complex process, in which the growth of epithelial tissue is of crucial importance. When the blood clot is organized to form granulation tissue, the surrounding epithelial cells will begin to migrate and proliferate towards the center of the wound. These newly formed epithelial cells will initially appear white or pale white during their growth process.
The growth rate of epithelial tissue varies from person to person. Generally speaking, within 5 to 7 days after tooth extraction, epithelial tissue will gradually cover the surface of the wound. The newly formed epithelial tissue is relatively thin and has low transparency, so it appears white. As time goes by, the epithelial tissue will continuously thicken and gradually return to its normal color.
At this stage, the wound may have a slight itchy sensation, which is a normal healing response, indicating that the epithelial tissue is growing actively. However, it should be noted that patients must not touch or scratch the wound with their hands to avoid damaging the newly formed tissue and affecting the healing process.
Possible Abnormal Situations
(1) White substances caused by infection
Although the whitening of a wound is mostly a manifestation of the normal healing process, it could also be caused by an infection. When a wound is infected by bacteria, an inflammatory response occurs, leading to local tissue necrosis and exudation. When these necrotic tissues and exudates mix together, they may form white or yellowish-white substances covering the surface of the wound.
Unlike the white pseudomembrane in the normal healing process, the white substances caused by infection are often accompanied by obvious abnormal symptoms. Patients may experience an increase in wound pain, which is far more severe than the normal pain after tooth extraction, and the pain lasts for a longer time and does not ease over time. In addition, there may be redness and swelling around the wound, obvious pain when pressed, and even systemic symptoms such as fever and bad breath.
If an infection occurs and is not dealt with promptly, it may lead to more serious complications, such as dry trough syndrome. Dry socket syndrome usually occurs 2 to 3 days after tooth extraction. The blood clot in the wound falls off, the bone wall is exposed, and there is a grayish-white, putrid and degenerated blood clot at the wound site, with a strong putrid smell. The pain is severe and can radiate to the temporal region of the ear, the submandibular area or the top of the head. Once an infection is suspected, medical attention should be sought promptly. The doctor will carry out debridement and anti-infection treatment based on the specific situation.
(2) Food residue retention
During the recovery period after tooth extraction, due to the presence of the wound, it is relatively difficult to keep the oral cavity clean, and it is very easy for food residues to remain in the wound. If patients do not maintain good oral hygiene, the food debris they eat may get stuck in the depression of the wound.
In the warm and humid environment of the mouth, these food residues will gradually be decomposed and fermented by bacteria, and some white plaque or soft deposits may adhere to the surface. From the appearance, it looks as if the wound has turned white. The white substances caused by the retention of food residues are usually uneven in texture, may have a granular feeling, and their positions are not fixed. They will change along with the patient’s actions such as rinsing the mouth and swallowing.
At the same time, the patient may feel a foreign body sensation at the wound site and have an unpleasant smell in the mouth. If not cleaned up in time, food residues will not only affect wound healing but also may breed bacteria and cause infection. Therefore, maintaining oral hygiene after tooth extraction is of vital importance. Patients can use the mouthwash recommended by their doctors and rinse their mouths in the correct way to reduce the residue of food.
How to Distinguish between Normal and Abnormal
To help patients better determine whether the whitening of the wound is normal or abnormal, it can be distinguished from the following aspects:
Time: During the normal healing process, the white pseudomembrane begins to appear 1-2 days after tooth extraction and is gradually replaced by new tissue over time. The white substance caused by infection may appear at any time after tooth extraction, especially if oral care is not done well.
Symptoms: Normal white pseudomembrane is not accompanied by symptoms such as increased pain, redness, swelling, and fever; If it is an infection, in addition to the white substance, there will also be obvious pain, redness and swelling, and even general discomfort.
Texture and appearance: The normal pseudomembrane is soft, uniform in texture and adheres well to the wound. The white substance formed by the retention of food residues has an uneven texture and is not fixed in position. The white substance formed by infection may have a putrid smell and an uneven surface.
Wound Care and Precautions
Whether the whitening of the wound is a normal or abnormal condition, proper wound care can help promote healing and reduce the occurrence of complications.
Oral hygiene: Do not brush your teeth or rinse your mouth within 24 hours after tooth extraction to avoid disrupting the blood clot. After 24 hours, you can use a mild mouthwash. When gargling, do not forcefully rinse your mouth to avoid causing the blood clot to fall off. When brushing your teeth in the morning and evening, be sure to avoid the wound and gently clean other parts of your mouth.
Dietary adjustment: After tooth extraction, the diet should mainly consist of light and easily digestible foods. Avoid spicy, stimulating foods, as well as hard or hot foods to prevent irritation to the wound. You can eat more foods rich in protein and vitamins, such as eggs, milk, vegetables and fruits, which can help promote wound healing.
Avoid external force stimulation: Do not lick the wound with your tongue, and never scratch it with your hands to prevent bleeding or infection. If there are sutures at the wound site, do not pull them at will.
Attend follow-up appointments on time: Follow the doctor’s instructions and attend follow-up appointments on time. The doctor will check the healing of the wound and promptly identify and address any potential issues.
Conclusion
The appearance of white substances in the wound after wisdom tooth extraction is mostly a normal manifestation of the healing process, but it could also be an abnormal condition. Patients should learn to make correct distinctions and take good care of their wounds. If you have any questions about the condition of the wound or experience any abnormal symptoms, you should seek medical attention promptly to receive professional diagnosis and treatment, ensuring the smooth healing of the wound.
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