What does this mean?
In a healthy mouth every surface of the jawbone is covered by mucosa. If a whitish or yellowish surface can be seen inside the mouth, hard and of a different texture from a tooth, that covering has opened. Mucosa normally closes over itself within days, so bone staying bare suggests that the tissue beneath has lost some of its capacity to close.
The telling points are how long it has lasted and whether there is pain. A bone surface seen at the base of the socket in the first days after an extraction can be a passing stage of healing, and it usually causes noticeable pain. Bare bone that does not close for weeks, even bare bone that stays painless, is a different picture; here quiet is not taken as a good sign, because pain often only begins once infection is added.
Your history is the strongest part of telling these apart. Medicines used against bone loss, some cancer treatments, and radiotherapy given to the head and neck area can lower the capacity of bone to heal. These medicines should not be changed on the patient's own decision; the decision about medicine belongs to the doctor who prescribed it, and planning on the dental side is done together with that doctor.
The cause of bare bone ranges from the normal healing stage of an extraction site to treatments that affect the blood supply and the renewal of bone. How long the bone has been exposed, together with any history of medicines and radiotherapy, are the two deciding headings.
Likely causes
What helps at home?
- Do not poke the area; trying to clean the bare bone with a brush, a toothpick or a fingernail makes the open area larger
- Do not try to move or take out a piece of bone that looks loose yourself
- Do not stop your bone medicines or your cancer treatment on your own decision; any change is made only by the decision of the doctor who prescribed it
- If you wear a denture and it presses on this area, do not carry on wearing it; take a list of the medicines you use with you when you go to be assessed
- If the bare bone has not closed for eight weeks
- If there is fever, swelling, pus or a bad smell in the area
- If you have new numbness in your lower lip or your jaw
- If neighbouring teeth have started to become loose, or pieces are separating from the bone
- If you have a history of bone medicines or of radiotherapy to the head and neck area, even if you have no pain
Frequently asked questions
- I have no pain at all, is it still important?
- Being painless does not mean it has healed. Part of this picture runs without pain for a long time, and pain only appears once infection is added. The assessment is based not on pain but on how long the bone has been exposed and on your history of medicines and radiotherapy.
- Can I clean it and cover it over myself?
- Anything done to this area tends to make the open surface larger. Cleaning with a brush, a toothpick or by hand pushes the mucosa back further. How the area should be cleaned, whether it will be covered over, and whether surgery is needed are decided after examination and imaging.
- If I stop my medicine, will the bone close over?
- Do not stop the medicine on your own decision. Stopping these medicines can have other consequences, such as a risk of fracture, and stopping does not close bare bone by itself. The decision is made by the doctor who prescribed the medicine and your dentist assessing it together; in the meantime the area needs to be kept under review.
This content is for general information and does not replace an in-person examination. Symptoms overlap between conditions, and a diagnosis can only be made clinically.