Is It Normal? Extraction Bone Graft White Membrane Showing

Is It Normal? Extraction Bone Graft White Membrane Showing

Is It Normal? Extraction Bone Graft White Membrane Showing

A extraction socket bone graft for dental implants that has a non-dissolvable membrane should look like this while it is healing. This procedure is done in preparation for dental implants.

My patient called me to ask what is that white thing there? I told him that it is a non-dissolvable PTFE (polytetrafluoroethylene) membrane with PTFE stitches. It holds the bone in and prevents gum from growing into the socket.

This is intended to stay like this for about 3-6 weeks. The reason why I suggest you have your socket bone graft done this way is that the results are very predictable. This white membrane with good technique has a very predictable outcome.  It is all about the technique not so much the product.  Experience matters.  The most important thing is that your socket is completely cleaned out and that the membrane is stable.

He just really wondered what this white piece was. He came back a few weeks later and I snipped the sutures and removed the membrane in about 60 seconds. This is typically very painless.

After removal of the membrane you should see pink new gum healing with possibly some surface bone particles if a particulate graft was used.

Here is the complete photo series from failing root canal x-ray, extraction, bone graft, membrane healing at 10 days, implant placement with L PRF platelet gel, final x-ray of two dental implants:

Failing root canals with bone infections
PTFE white membrane normal healing over socket extraction bone graft for dental implants
Membrane removed showing very nice healing
Implants placed with PRF platelet gel in between and will be allowed to heal for 3 or 4 months

So it is important to clarify that on this patient that I extracted two bad root canal teeth that this membrane was purposely left exposed. Some membranes that I put in are under the gum and not intended to be exposed at all. The specific type of PTFE membrane does well exposed.

If you have had this done, do not chew on this area until everything is completely healed and the membrane is out. The bone typically takes 4-6 months to form.

Ramsey A. Amin, D.D.S.
Diplomate of the American Board of Oral Implantology /Implant Dentistry
Fellow-American Academy of Implant Dentistry

16 Comments

  1. Lynne

    Hi Dr Amin

    I just had a bone graft two days ago. The doctor said he put a membrane and stitches but when I look at the site I don’t see any membrane just stitches?! I’m so confused if the membrane fell out or not. Could it fall out without me noticing or pain?
    I still see the stitches and the stitches area looks dark red/black. Is that normal?

    November 12, 2020 at 12:55 am Reply
    1. The membrane for the bone graft was under the gums. That is most likely the situation.

      January 15, 2021 at 2:07 pm Reply
  2. Allyssa Labonete

    Hi! I recently had bone graft about a week ago and I also need some orthodontic treatment. What I want to know is can I not choose to have implants and can the teeth be just moved? I’ve had a talk with my dentist that I want to just move the teeth after extraction but she said I had to see a tmj specialist that would delay my ortho so the bone graft had to be done bc she said I don’t have enough bone on that upper right molar

    August 24, 2020 at 10:11 am Reply
    1. Ramsey Amin

      It depends…it is hard to bodily move a tooth a long distance. (What I want to know is can I not choose to have implants and can the teeth be just moved?)

      August 30, 2020 at 9:58 pm Reply
  3. Paula Collins

    Hi Dr. Amin,
    Firstly, thank you for providing this service! One week ago I had a lower left molar extraction with bone graft.
    My questions are:
    1. Is the mesh like substance with holes the actual membrane? What is the gel substance?
    2. Is it normal one week into this process that the gel like substance fell off? (stitches are still in place)
    3. I specifically asked my dentist if I need antibiotics and he said ‘no’. I am 56 years old and I do not want complications of infection.
    Note: Other than needing Motrin at night and in the AM I am relatively fine. BTW: I am a huge baby, so I know I am probably over reacting – but I wanted antibiotics as extra insurance more than needed them. Better safe blah blah blah….
    Thoughts?
    I appreciate all time! – Paula

    August 20, 2020 at 6:58 pm Reply
    1. Ramsey Amin

      It should look like this. And antibiotics and useful when bone that is not your was used! The gel may have been L-PRF made from blood from your arm?

      August 30, 2020 at 8:08 pm Reply
  4. Jen

    I had a socket graft done March 9, tooth #11, the gum tissue is still red/irritated. I saw my dentist last week because I was concerned. He said its red due to the extra bone particles. Does gum tissue usually stay red/ irritated after a socket graft?

    April 20, 2020 at 5:12 pm Reply
    1. Ramsey Amin

      sometimes…but only at the surface…not deep in the bone

      April 22, 2020 at 5:45 pm Reply
  5. Leon zuckswert

    Hi I had a implant done on my upper left front tooth about 2 years ago now and it has like a white kinda some black stuff around it behind my tooth toward the top idk if it’s something to be worried about or if it’s normal it doesn’t hurt or anything

    March 30, 2020 at 5:07 pm Reply
    1. Ramsey Amin

      You need to see someone asap. The implant maybe losing bone.

      April 2, 2020 at 12:52 am Reply
  6. Laura V

    Twenty-three days ago I had a lower right molar removed and a bone graft placed. The surgeon extracted blood for a “plasma rich fibrin membrane” and likely some other type of membrane covering. I recovered from the surgery pretty well, took all my amoxicillin at the precise times, followed all the advice re: oral hygiene, and eating. I was told not to chew on the right side of my mouth for a month and was scheduled for a follow up Jan 9 ( a little longer than a month post surgery and bone graft). The stitches dissolved at about day 7 or 8. THe area feels really good, but instead of gum tissue growing closer together, it seems to have widened a bit and I can see a bit of the membrane, but the gum edges are “rolled” over the site still. I just assumed that the gum edges would grow closer together and I am freaking myself out about the edges getting further apart. It was just a slight gap and now it’s a bit larger—seems like it is going in the wrong direction. THere’s no redness, no blood, no pain. I even forget sometimes that something was done.

    I rinsed with the peroxyl for more than 7 days and wonder if I slowed down the healing. Now I just rinse with the warm salt water after meals.j Then I wondered if the gum was even SUPPOSED to heal over the membrane (have no idea if it is re-absorb type or not). I haven’t accidentally brushed the surgery area and use a q-tip to clean the molar behind and the tooth in front. I avoid using the waterpik on that side of my mouth.

    Eventually the plan is to get an implant. It was super expensive and I’m a bit freaked out, but wondering if I am over thinking it.

    December 28, 2019 at 3:50 am Reply
    1. Ramsey Amin

      We all have the tendency to worry. It sounds like it is going well. The gum will close for sure. It may be purposeful in this scenario.

      December 31, 2019 at 4:57 pm Reply
      1. Renee

        Is it normal after a week of having a tooth extracted and the white membrane being placed, that your breath still stinks?

        March 19, 2020 at 2:25 pm Reply
        1. Ramsey Amin

          You need to clean around the area. Go ahead and brush gently or use a Q-tip with some Listerine or special mouth rinse that was provided by your dentist. Nothing should be stinky..

          March 24, 2020 at 9:03 pm Reply
  7. Ingrid Engle

    A week ago, I had a bone graft done in my upper right jaw because I have 2 missing teeth there. I am on Brillanta, an anti-platelet medicine. The surgergical site kept oozing. So, about 4 days ago, my cardiologist allowed me to stop this medicine and use low dose aspirin instead. This helped the bleeding, but I developed a hematoma on my cheek! My surgeon just said to put warm compresses. My daughter is s nurse and says they can use ultrasound to break up the clot. Have you ever had this happen? What is your advice?

    October 8, 2019 at 8:31 pm Reply
    1. Ramsey Amin

      Heat, pressure and time is best. If you have access to the ultrasound you can try that but it is not common in dentistry.

      October 10, 2019 at 2:18 am Reply

Write a Comment

Monica D.
Monica D.
December 29, 2020.
There aren't enough words (and I have a lot of words) to tell you how grateful I am to have found Dr. Ramsey Amin and his wonderful staff. I had an enormous amount of bone loss and I was hopeless after being treated by a different doctor for two years. I had multiple procedures such as gum graft, extractions, and a sinus lift. After all of that, the doctor released me and told me he could not help me any longer. He sent me to a large teaching hospital - who also had no idea how to help me. I was terrified and embarrassed. I had been missing teeth due to those procedures since 2017. That sent me out on a journey of meeting with no less than five different dentist/oral surgeons. Most of them shamed me for the bone loss and wondered what I had done to cause this. In reality, I had done nothing. The bone loss is my body's immune system fighting me, as well as hereditary traits. In fact not only was I having difficulty being able to have implants, I also had so much bone loss that I was also not a candidate for dentures. I researched "what to do when you have bone loss and can't get implants" and I found Dr. Amin's website. Then I researched him, read his reviews, watched every one of his You Tube videos. I called and got an appointment, and kept going to consultations with other providers. I had long since stopped smiling and being social. Missing teeth and the shaming was affecting my life so adversely. When I met with Dr. Amin for my consultation he was ready. He had all of my records and had already reviewed my scans. But more than that, he genuinely wanted to get to know about my life. He was/is authentic, kind and extremely professional with so much success and experience in difficult cases like mine. He worked up a treatment plan & I came back two weeks later to discuss my options...and the journey began. I have had three procedures under IV sedation, no pain, no narcotics needed for aftercare. Dr. Amin is a consumate, experienced oral surgeon who cares about your health & understands your fears. He communicates every step of the way and will provide you with all the information you need to make a decision to improve your health. I am still working toward my end goal, and we had to zig from traditional implants and zag to zygomatic implants instead...which is the reason I chose him in the first place. If there was nothing else that could be done to get me healthy & smiling again, I knew he would have that option to help me. And of course 2020, the year of CV-19. Don't worry, Dr. Amin & his staff follow all health & safety protocols. This review is long, because it is important you know my journey, so you might understand how fortunate I feel to be healing. I'm torn, because this place is like a great restaurant, I want to shout from the rooftops how great it is, how great he is. And at the same time, I want to keep this all to myself. I come 75 miles each way to see him. I know people travel from all over the world for his expertise. Do yourself a favor, have a consultation. You won't regret it. Dr. Amin is amazing and so is his staff.
Jennifer B.
Jennifer B.
December 18, 2020.
I cannot speak highly enough of Dr. Amin and his professional staff. I have to start off and say that I am absolutely TERRIFIED of the dentist due to several past experiences. I found myself putting this off for YEARS until I was referred over to Dr. Amin. I was petrified on my first visit... but he along with his WONDERFUL staff made me feel so calm and at ease. I had quite a bit of work that needed to be done, but we found the perfect plan that worked out for me, and I couldn't be happier. Words cannot express my gratitude to each and every staff member that made me feel safe and comfortable. Dr. Amin was always so attentive in asking if I was ever in pain... and I never was. These are truly remarkable individuals, and I'm so lucky to have a dentist that I can trust. I ABSOLUTELY LOVE each and every one of you! Thank you,
D M.
D M.
December 17, 2020.
I cannot say enough positive things about Dr. Amin and his staff. I originally found them on Yelp about two years ago. I needed an implant, front tooth of all places, and was extremely nervous not only about surgery but about how it would turn out. Let me just say I just adore the staff. Everyone is crazy friendly and the whole office has a very positive vibe. The staff is adorable and always has me smiling by the time I leave. They are all thorough and on-point about what they do, and I truly appreciate it. They are quick to respond to my emails no matter the question, and their appointment reminders are great too. Dr. Amin is very thorough and reassuring, and answered any questions my husband or I had. My regular dentist had questions about the procedure and Dr. Amin's office even reached out to them at my request (my dentist said they never received a call, but Dr. Amin's staff had date, time and notes - love the thoroughness!). After surgery the Dr. called to leave me a message about how it went. Very minimal pain during healing, never any pain during any visits. It took a few tries to get everything just right for the permanent crown (color, etc), but the end result is beyond fantastic! At one point during healing I thought I was experiencing some looseness or wiggling but unfortunately couldn't make it to the office. When I was finally able to make it in the Dr. was so relieved, bless his heart. Luckily it was just a false alarm and everything checked out ok. They're a bit further out from me, but I wanted the best. I sure found it! I wish they were my regular dentist, and I'm looking forward to seeing them again for my check-up which was delayed due to COVID.
Melissa E.
Melissa E.
December 9, 2020.
I found Dr. Amin a few years back after I hadn't been to a dentist in a decade. Many traumatic dental experiences in childhood have made me so phobic that even getting a cleaning was a knee-knocking, heart-pounding trial. But finally I couldn't put off some things any longer. During my first anesthesia session, Dr. Amin replaced five old metal fillings, and during the second he did three more plus a crown. I was completely comfortable, and never felt a thing. Because they were extra-long sessions, I did sleep for about 12 hours after, but the next day I felt just fine. This past week, my back top tooth cracked in half and fell out of my mouth, and a couple days later the crown on the remainder of the tooth fell out too! Despite being nervous about Covid 19, I had to get it taken care of, so I called and quizzed the staff about precautions, which turned out to be even above and beyond what I would have expected. So yesterday I went for the tooth extraction and plug. After they put on the blood pressure cuff and put in the IV, I gradually got a little tired and closed my eyes. I sat there for about 10 minutes and thought Gee, I wonder if they're going to get started any time soon, and a minute later Dr. Amin said "Wake up, you're all done!" That was a short session, and I didn't have the kind of fatigue I did my first time. I stayed up most of the evening. Today, everything is good! I'm taking my antibiotic and eating soft foods, and there is surprisingly little pain now that the numbness has worn off. The tooth site and my cheek are a little sore, and the corner of my mouth, and I have a very slight headache, but nothing to any great level--I'm not even taking the acetaminophen. I feel good, and wide awake. Thanks to everyone at the office for a comfortable and professional job! I really REALLY appreciate you for giving me painless dental experiences!
Tanya S.
Tanya S.
December 3, 2020.
What can I say about Dr. Amin he is the best! I'm so grateful for him. He has literally changed my life and given me the confidence to smile more. I had major restorative dental work done and everything went smoothly. Dr. Amin is very compassionate and he really cares about his patients he made me feel comfortable and cared for. He is very knowledgeable and has a great sense of humor. His office is very clean and they take the patients health and safety very serious. His staff is also amazing they made me feel very welcomed and important. I'm so happy I did my research and found Dr. Amin.  Thank you Dr. Amin and team.
Sheila S.
Sheila S.
November 6, 2020.
Two implants done! Finished all procedures and I couldn't be happier. It's the first time in years I looked forward to going to the dentist. Even during Covid life the staff and Dr. Amin took care of me. There is a possibility I may move to Long Beach but I would still travel to keep Dr. Amin as my dentist.
Allison S.
Allison S.
November 4, 2020.
I could not ask for a more caring, exceptionally knowledgeable dental care provider. He's not just a dentist, but someone who looks after your immediate dental needs and helps you plan and prepare for the future.
Julia R.
Julia R.
October 8, 2020.
I've been going to Dr. Amin since I turned 16 and have been going since. Before going to Dr. Amin's dental office, I had 4 crowns that I was not happy with and dealt with it until finally I asked Dr. Amin and because I  feel comfortable and because I trust him with his work I recently had my crowns fixed and worked on by  Dr. Amin and have never loved my smile the way I do now, I can actually enjoy my pictures, I can enjoy my smile from either angle and that really mattered to me. Thank you so much Dr. Amin still and will be in love with MY smile
Aaron D.
Aaron D.
October 6, 2020.
I've been coming to Dr. Ramsey for about five years and I have to say, he is by far the best dentist I've had - ever. The staff is professional and kind, the office is exceptionally well maintained, and Dr. Ramsey is careful and extremely knowledgeable about current developments and research in dentistry. I recently had a dental implant which was a long process but well worth it. I required a sinus lift as well as a bone graft. The surgery went off without a hitch, I was comfortable and the healing process was quick and without complication. Highly recommend!!
Flo O.
Flo O.
September 21, 2020.
This is my 1st review of Dr. Amin, and in my over 17 years of being with him, my experiences with Dr. Amin and his staff have always been positive.  I don't recall a bad experience with the several implant procedures i have had.  They run an efficient office.  I like that they are proactive and reach out to their patients to remind us of routine care needed.  Dr. Amin's bedside care is impeccable.  They are also technologically up to date in terms of sending out texts as reminders, ability to incorporate any appointment into your mobile phone.  That is certainly a plus.  Keep up the great care!!!