Tooth Extraction and Bone Graft Recovery: What To Expect?

Dental implants are a long-lasting solution for fallen teeth. Many dentists recommend procedures like tooth extraction and bone grafting before planning your implant surgery. Tooth extraction is especially required when you need full mouth restoration, but your jaws are left with a few teeth.^[1] Besides, one also needs tooth extraction to remove a severely decayed tooth that is hard to restore. On the other hand, a bone graft will be required when your jawbone is inadequate to hold the dental implants. Typically, dental implants are surgical screws fixed inside the jawbone. They support artificial teeth and require enough jawbone to hold them in place with stability. 

There's no doubt that these procedures can lengthen your stage-wise journey of dental implants. However, tooth extraction and bone graft recovery allow your jaws to heal properly. Now, let’s understand what tooth extraction and bone grafting deal with in detail. 

Tooth Extraction and Bone Graft: What It Deals With?

Dentists adopt various methods, such as dental crowns, fillings, inlays, or onlays, to restore the functions of a damaged tooth. However, periodontists or oral surgeons will perform the tooth extraction procedure when tooth decay is severe. Tooth extraction is commonly called tooth pulling and involves removing the tooth from the socket. Your dentist will numb the gums and loosen the tooth gently using specialized instruments. In some cases, decayed teeth break, leaving small pieces in the jaw. In those cases, dentists make incisions in your gums to gain access to these broken pieces. Your dentist places a piece of gauze on the extraction site and leaves it to heal after tooth extraction. The bleeding stops as you apply firm pressure, and a clot forms. Over time, the site heals, making it ready for upcoming procedures. 

On the other hand, bone grafting is slightly different. Your dentist will replace the missing jawbone using a procedure called a bone graft. Many patients ask us, “Are bone grafts necessary after tooth extraction?” The answer is “the necessity of bone graft after tooth extraction depends on the case. Now, let’s address the question oppositely.

What Happens if I Don't Get Bone Graft After Tooth Extraction? 

Typically, tooth extraction leaves an empty socket in the jaw. The adjacent teeth slowly drift towards the space if you leave the socket for a few days. Before getting into details, let us brief you on bone remodeling in the human body. Bones in the human skeleton remodel themselves continuously. Considering jawbone in this context, specialized osteoclasts break down the existing bone cells, and osteoblasts generate new bone cells. When you chew, the physical force exerted by the natural tooth roots stimulates osteoblasts. However, when a tooth falls off or is extracted, the jawbone does not receive stimuli for new bone formation. However, the osteoclasts continue their activity of jawbone resorption. Over time, the jawbone resorbs, and adjacent healthy teeth drift in, causing bite issues. 

Why Bone Graft After Tooth Extraction?     

Typically, bone graft adds up the bone material to the areas with a thinning jawbone, restoring the volume and density of your jawbone. So when the missing tooth space is bone grafted, it fills the tooth socket with enough bone material that is devoid of viable bone cells.^[2] The added bone material stimulates the osteoblasts to grow and spread on the framework of the added bone material. Over time, they grow through the biological processes of osteoconduction, osteoinduction, and osteopromotion.^[3] In simple words, your jawbone remains adequate without much resorption. It can efficiently hold dental implants that bear artificial teeth.  

During a bone graft, your dentist will lift open the gums, add bone materials, reposition the gum tissue, and close the incisions. 

Now you know the details of the procedure. Let’s begin to understand what happens after tooth extraction and bone graft.

What To Expect After Tooth Extraction and Bone Graft?

After tooth extraction and bone graft, your gums will swell and bleed. You will start experiencing pain as the local anesthesia wears off. Note that the incision site needs to heal to control the bleeding and associated pain. The symptoms of swelling, pain, and incision site bleeding are a part of the tooth extraction and bone graft healing process. Some patients experience a slight elevation in body temperature on the day of the procedure. It’s a part of the body’s inflammatory response. Now, let’s examine each aspect in detail.

Bleeding After Tooth Extraction and Bone Graft

The dentist will place gauze on the incision site, and you must apply firm pressure to the gauze to control bleeding. Over time, a temporary clot will form, which you should avoid disturbing. It's better to refrain from talking for a while. The incision forms a clot only when you apply firm pressure. Talking or removing the gauze can move the gauze out of position, causing bleeding. Rest for a while and sleep with your head in elevation. This controls bleeding. After the first few hours of tooth removal, replace the gauze with a fresh one every 20 minutes. Bleeding subsides slowly. You will notice pink saliva occasionally during the week of tooth extraction and bone graft recovery. Don’t worry, as it's completely normal.

Throbbing Pain After Tooth Extraction and Bone Graft

Tooth extraction and bone graft will be performed under local anesthesia. So you don’t feel much pain during the procedure. However, you’ll start noticing pain as the anesthesia wears off. Your dentist will prescribe pain relievers and antibiotics immediately after the procedure. This offers relief from any discomfort. Typically, the pain lasts for 2 weeks after tooth extraction and bone graft. Refrain from strenuous activities like weight-lifting or running for a couple of days and take time off. Avoid self-driving while you are on pain medication, as it makes you feel drowsy. 

Swelling During Tooth Extraction and Bone Graft Healing Time 

It's completely normal for the operated site to swell slightly after tooth extraction and bone graft. Proper aftercare measures reduce swelling, relieving any existing discomfort. Apply an ice pack every 20 minutes and continue for the initial 24 hours after the procedure. Most usually, you don’t need it on the day following. Further, the swelling reaches a maximum between 24-72 hours of tooth extraction and bone graft recovery time and gradually subsides. 

How Long Does It Take for a Tooth Extraction With Bone Graft To Heal?

Your jaws will heal within 1-2 days after a simple tooth extraction procedure. It will take slightly longer, around a week, for a surgical tooth extraction to heal. However, if your dentist performs tooth extraction with a bone graft, it will take longer to heal. Although the incisions heal within a week, you may consider this to be initial healing after tooth extraction and bone graft. You need to wait for around 3-12 months for your jaws to heal and receive a dental implant procedure. It's because dental bone graft healing is beyond suture healing. The newly added bone material should stimulate jawbone formation, making your procedure successful. 

Stages of Bone Graft Healing

Early after the dental bone graft, your gums will feel soreness around the incision site. A typical bone graft initially heals within a week. During this period of topical healing, the incision wounds heal, and your gums will start feeling normal. While this one-week period refers to the incision site healing, complete healing can take anywhere between 3 and 12 months. The long healing phase refers to the bone regeneration time. Typically, the added bone material follows a sequential process. We briefed it below: ^[4] 

• Inflammation revascularization: The incision site prepares itself for bone regeneration. The blood vessels carry oxygen, nutrients, and other active biomolecules to the site to actively supply the required components for bone regeneration. 
• Osteogenesis remodeling: New bone tissue starts to form, and the body starts to accept the newly formed osteoblasts.
• Incorporation into host skeleton: A dense solid bone replaces the previously interwoven bone material to form a mechanically stable structure. 

Are you worried about the long healing time after a bone graft? Allowing your bone graft to heal completely allows your jawbone to form enough bone material. The recovery period indeed depends on your overall health condition, too. Here, we listed some common aftercare measures that will help you recover well. 

How To Speed Up Bone Graft Healing?

Tooth extraction and dental bone grafts are outpatient procedures. So, you will return home on the same day after treatment. You will receive the post-treatment medicine along with some aftercare instructions as you leave home. After the initial healing, you need to visit your dentist for a follow-up checkup. This will be a routine examination to ensure that the incision site has healed completely and is free from infections. Note that following proper aftercare can speed up the healing process after getting a tooth extraction and bone graft. Here, we outlined a few aftercare measures you can adhere to. 

• Physical forces like chewing and suction can disturb the clot. Hence, rely on soft foods and liquid foods to avoid discomfort. Avoid using straw cups for drinks. Instead, opt for using open cups. Also, avoid hot and spicy foods for a few days during initial healing.
• Drink plenty of fluids, and slowly, you may transition to a normal diet based on tolerance. 
• Avoid crunchy and sticky foods like popcorn, seeds, nuts, gums, and candies. Trapped food particles in the oral cavity can be a source of infection.
• Maintain oral hygiene. You may start brushing your teeth a day after the procedure. In case of a bone graft, avoid direct brushing on the incision site for a couple of weeks. Remember that spitting can disturb the blood clot. Hence, avoid spitting. 
• You may rinse your mouth with salt water a day after the procedure. However, be gentle. Rigorous rinsing can disturb the clot and sometimes cause bone material to be lost from the graft site. 
• Apply ice packs to reduce swelling and use pain killers and antibiotics medication. 
• Do not smoke or consume alcohol for at least two weeks, as it inhibits the healing process. 
• Do not disturb the bone graft site with a finger or tongue.  
• Most importantly, attend the follow-up checkups. Never ignore the bone graft failure symptoms and contact your dentist in case of emergency.

Signs of Failed Bone Graft

Bone graft procedures usually succeed when done by a qualified and experienced dentist. However, like any other medical procedure, you can expect failure. Bone graft material consists of small particles that resemble sand. In some cases, the bone material leaches out when the graft site is disturbed physically. Don’t worry. Look for the following symptoms of bone graft failure. Losing bone graft material associated with any of the following symptoms can be considered a failed bone graft. 

• Uncontrollable pain, swelling, or bleeding that continues after the first week.
• Foul-smelling pus or discharge from the bone graft site.
• Receding gums on a long term showing teeth pulled away from the gum line.

Tooth extraction and bone graft recovery are crucial to deciding the success of your dental implant procedure. While tooth extraction alone heals quickly, getting a bone graft can lengthen your recovery time to one year. You will need to wait for the jaws to heal completely and your jawbone to recover before getting dental implant surgery. You can simplify the healing process by following proper aftercare instructions as prescribed by your dentist. At Envoy Health, we believe a well-informed decision ensures a stress-free experience. Gain essential insights by signing up with our platform and taking control of your dental health with confidence. Begin your dental journey with Envoy Health by your side.  

References

1. Oral Surgery, Extraction of Teeth
2. Bone Grafts and Substitutes in Dentistry: A Review of Current Trends and Developments
3. Bone Grafts in Dentistry
4. Biological Principles of Bone Graft Healing