This white material is usually
For soft tissue “gum” grafts, the site(s) may appear white during the healing process (up to 2 weeks), this is normal and not a sign of infection. The tissue will change to a pink color as it heals.
The white stuff that you might see forming around your tooth socket after a tooth extraction is called granulation tissue. This tissue is comprised of blood vessels, collagens and white blood cells, hence its white colour.
In the next 24-48 hours following surgery the gum tissue will begin to heal, which involves the formation of granulation tissue. This tissue is typically white or cloudy over the incision, which sometimes causes concern for patients, but it is normal for healing gum tissue.
You will know that the graft is healing when the swelling subsides and the soft tissues are shrinking. Your gum tissue will begin binding to the root surface and bone. Then, new blood vessels will begin to form to enable blood flow to the graft. This stage takes four to six weeks from surgery.
If your gum graft failed, you'll probably notice a large patch of white tissue that has come off of your tooth. Its lack of color means that the gum graft lost blood supply and is dying.
Gum graft infection
One way to truly tell if you have an infection is that you will see pus coming from the graft site. This will look like a thick yellow fluid that is leaking from the surgical site. It is important to make sure to take antibiotics during the healing process to help prevent infection.
Purulent Wound Drainage
Purulent drainage is a sign of infection. It's a white, yellow, or brown fluid and might be slightly thick in texture. It's made up of white blood cells trying to fight the infection, plus the residue from any bacteria pushed out of the wound.
Chronic wounds may be covered by white or yellow shiny fibrinous tissue (see next article in this series). This tissue is avascular, and healing will proceed only when it is removed.
White gums often suggest that something is amiss with a person's oral health. Several conditions can cause white gums, from simple canker sores to long-term inflammatory illnesses. In rare cases, white gums can indicate oral cancer, so it is essential to see a doctor for a proper diagnosis.
Gum grafts can change color during healing. Both the graft and the donor site sometimes turn white, three to five days after the procedure. This is normal healing. Much like a sunburn, the surface tissue sloughs off and then regenerates.
A membrane may have been placed over the grafting site to aid in healing. It may appear as a white object in the socket site. Generally, after the first couple days a part of it will loosen and come out. This is normal.
Cleaning the Area Around the Gum Graft
Your dentist will recommend salt water rinses with warm salt water, 4 to 5 times a day for 7 to 14 days. Gently rinse your mouth with a mixture of a half teaspoon of salt in an eight ounce glass of warm, not hot, water. No swishing - this can disrupt healing.
The number of white blood cells rises and cell death increases, resulting in the accumulation of slough, which provides an environment for bacterial proliferation, increasing inflammation, and wound chronicity. A failure to remove the slough continues to prolong the inflammatory phase and impair healing.
Maceration occurs when skin has been exposed to moisture for too long. A telltale sign of maceration is skin that looks soggy, feels soft, or appears whiter than usual. There may be a white ring around the wound in wounds that are too moist or have exposure to too much drainage.
This black discoloration of the gums is due to dead tissue, or necrosis. This is a serious health issue, with symptoms that can also include bleeding gums, strong pain, and a foul smelling mouth.
After the initial discharge of a bit of pus and blood, your wound should be clear. If the discharge continues through the wound healing process and begins to smell bad or have discoloration, it's probably a sign of infection.
Discharge - If the wound is discharging small amounts of pus, it is a positive sign of healing. However, if there is continuous drainage and you start noticing bad odor or have discoloration, the wound is likely infected.
The skin graft will initially appear white and pale when it is ischemic, and then darken later as it revascularizes. In some patients, especially those with a thick graft, the graft may shed its epidermis, giving the physician and patient the impression of graft failure.
Signs of infection, including increasing swelling or redness of the graft, white or bad-smelling discharge from the graft, red streaks from the graft site, or pus at the wound site. Edges of the graft site that start to open up.
You will know that healing has begun when the soft tissues are shrinking and there is less swelling. The gum tissues gradually starts to bind to the root surface and nearby bone surface as well. New vessels will also start to form and the tissues will receive enough blood supply.
You will notice a material on the inside of the “putty” that closely resembles a tissue graft. This is not the patient's graft, it is a material we place over the graft. If the “putty” comes off, the patient can lightly rinse with warm salt water. No flossing or brushing near the gum.