Complications after tooth extraction: how and why?

Author of the article:

Soldatova Lyudmila Nikolaevna

Candidate of Medical Sciences, Professor of the Department of Clinical Dentistry of the St. Petersburg Medical and Social Institute, Chief Physician of the Alfa-Dent Dental Clinic, St. Petersburg

Let's figure out how to determine that gum inflammation has begun after tooth extraction, how to quickly get rid of it and prevent its occurrence.

Signs of normal wound healing

After a tooth is removed, a hole is formed in the empty area in which a natural blood clot accumulates. It is very important to monitor it closely. This substance must not be removed, scrubbed, washed or dissolved. A blood clot is the most reliable protection of a wound from infection and inflammation.

Gum restoration begins 3-4 days after tooth extraction. If the operation was traumatic, the healing process lasts 5-7 days. After removal of wisdom teeth (“eights”), the healing process can exceed 10 days. The back teeth are the most “complex”, as they have many canals, so after their removal the risk of gum inflammation is especially high.

Within 5-7 days after tooth extraction, a white film appears at the bottom of the empty socket. This film is an absolutely normal reaction of the body, as protective fibrin covers the wound from “attacks” of pathogenic organisms. Just like a blood clot, the film should never be processed.

The speed of healing of the hole depends on a number of factors:

• depth of the operation performed;
• localization of the focus of the operation;
• associated dental problems;
• the state of immunity and other characteristics of the patient’s body.

If the gums are swollen and begin to bleed within half an hour to an hour after tooth extraction, this is normal. However, if the inflammation does not subside within a few hours, be sure to contact your surgeon.

Types of inflammation

The most common types of inflammation that occur after tooth extraction are:

• Alveolitis is an inflammation of the walls of the empty socket of an extracted tooth. The patient suffers from swelling, redness, and “tugging” pain. Weakness, malaise appear, and body temperature rises.
• Gingivitis is inflammation caused by tooth extraction. The tissues turn red, begin to swell and bleed.
• Periostitis is an inflammation of the jaw bone (periosteum). The disease is characterized by severe toothache, swelling of the gums, gumboil, and distortion of the facial contour. Pathological mobility of the tooth appears, lymph nodes are palpated in the face and neck.
• Periodontitis is inflammation of the periodontium, the area around the root of the tooth. The disease is characterized by aching or sharp pain in the tooth, which intensifies when biting. Without treatment, the pain gradually turns into throbbing, tearing pain. The patient complains of severe weakness, fever, and sleep disturbances.
• Trauma to the gums from dental fragments. With mechanical damage to tissues, swelling, redness appear, and spontaneous pain begins, intensifying when touched. If the injury persists for a long time, a dark pressure ulcer with purulent and serous discharge may form at the site of injury.

Why remove wisdom teeth?

PHOTO: Extracted wisdom tooth. Please note: the roots spread in different directions, thanks to which the tooth is held very firmly in the jaw.

Removal of a wisdom tooth is resorted to in situations where, in the process of its development and eruption, it threatens the health of nearby healthy teeth, adversely affects the development of dental occlusion, or there is not enough space for eruption. When a wisdom tooth does not have enough space in the dentition, it begins to “push” adjacent teeth, which often causes malocclusion and the appearance of crowding of the front teeth in older age. A beautiful smile with evenly spaced teeth can be lost due to loose front teeth.

If infection and inflammation of the gums develop in the retromolar area, pain appears when opening the mouth and eating - it becomes difficult to open the mouth; The submandibular lymph nodes enlarge, body temperature rises. Inflammation of the gum mucosa may decrease and disappear, or an abscess (abscess) may develop, which will require emergency surgery and hospitalization. If a wisdom tooth constantly bothers you, the gum above it hurts (the hood of the mucous membrane), it must be removed.

Incorrect position of the third molar in the dentition is often the cause of the development of caries both on it and on the adjacent tooth. Treatment of wisdom teeth is difficult due to their remote location in the oral cavity and causes patients a lot of discomfort, as they have to sit for a long time with their mouth very wide open.

Symptoms of inflammation

Inflammation of the gums after tooth extraction is indicated by the following symptoms:

• Bleeding from the wound. Even cold compresses do not stop the bleeding.
• Redness, swelling, pain in the gums that does not subside within 5-7 days after extraction.
• Throbbing sharp pain in the empty socket.
• Unpleasant putrid odor from the mouth.
• Discharge of pus from the wound, the resulting fibrous film becomes green.
• Numbness of the jaw, cheeks.

Dry socket after tooth extraction

A blood clot should remain in the socket after surgery. This is a very important part of the healing process. This clot protects the bone and nerve endings and serves to form bone tissue after tooth extraction. Therefore, you should not rinse your mouth for a day after the procedure and eat hot food - this will help the clot dissolve. But sometimes it does not form, and a dry socket appears.

Dry socket is considered a complication. It most often occurs after complex removals accompanied by significant trauma. If there is no blood clot, then the hole after tooth extraction hurts, and sometimes it seems that the ear also hurts. Often there is an unpleasant taste in the mouth. The consequence of a dry socket after a traumatic tooth extraction can be inflammation of the gums or alveolitis. Therefore, if you experience acute pain in the socket, consult a doctor immediately. He will place a tampon with a special anti-inflammatory gel on the hole. Tampons are changed until healing begins.

Treatment of inflammation

Treatment of gum inflammation after tooth extraction depends on the disease that arose during the operation. If a problem is suspected, the patient is advised to consult a doctor. An experienced dentist will determine the nature of the inflammation and prescribe proper treatment.

• In case of alveolitis, tissue curettage is performed, all contents are scraped out of the hole, and the tissues are sanitized. The doctor places a swab with an antiseptic on the wound.
• Periostitis is usually treated surgically. The doctor opens the rotting lesions and carries out medical treatment using anti-inflammatory, painkillers and antibiotics.
• Gingivitis requires the removal of tartar, normalization of oral hygiene and gum care using special rinses.
• For periodontitis, complex treatment is carried out using antibiotics, antiseptics, as well as anti-inflammatory and painkillers.
• Broken tooth fragments are removed by a surgeon; rinses, applications, and baths with antiseptics can be used to relieve inflammation.

Sometimes, for inflammation of the gums after tooth extraction, the patient is prescribed physiotherapeutic procedures, for example, exposure to a helium-neon laser, a course of fluctuarization. Also, gums can become inflamed after brushing your teeth.

With proper treatment of gum inflammation after tooth extraction, the socket is restored in about 10 days, and the outbreak itself disappears within two weeks.

Tooth extraction: swelling

Tooth extraction is a difficult operation that traumatizes the tissue surrounding the tooth. Therefore, it is not surprising that unpleasant consequences occur after tooth extraction: the most common of them is swelling. Patients often complain that after tooth extraction, the gums become swollen, swelling of the cheek or a slight gumboil appears. This is caused by partial destruction of the soft tissue around the tooth. This is unpleasant, but if the tumor is small, it goes away on its own in 2-3 days. To relieve swelling after tooth extraction, ice can be applied to the cheek for about 10 minutes. If the swelling has not gone away after a day, apply heat. Keep the heating pad for 20 minutes, then take a break for 10 minutes and put the heating pad back on.

Sometimes swelling can be caused by an allergy to the anesthesia. In this case, histamine, an antiallergic drug, will help. But if the swelling increases, then it may be a sign of inflammation that has arisen after tooth extraction. In this case, you should immediately consult a doctor.

First aid

If after tooth extraction there is mild inflammation and there is no suppuration, it can be removed at home and prevent the spread of discomfort.

1. For 30 minutes after tooth extraction, do not remove the antiseptic tampon placed in the hole.
2. Do not eat for 2 hours after removal.
3. If there is bleeding after tooth extraction, apply a cold compress, such as an ice cube, to the gum.

If a doctor prescribes rinses for the treatment of inflamed gums, they should be done as carefully as possible. It is important not to wash the protective clot out of the hole. On the first day after surgery, you should avoid rinsing, and on the second day, use antiseptics and herbal decoctions.

During the healing period, it is also recommended to avoid food and drinks that are too cold or too hot, and never touch the socket with your fingers, toothpicks or other foreign objects.

A reliable rinse that will help eliminate gum inflammation is the ASEPTA ACTIVE mouth rinse. This unique two-component rinse with a combination of chlorhexidine + benzidamine has antimicrobial, anti-inflammatory and analgesic effects and provides an immediate anesthetic effect.

Pain after tooth extraction

Another common complaint is that after tooth extraction, the gums, adjacent tooth, jaw, and throat hurt. As a rule, these are common symptoms after a traumatic procedure. They are caused by damage to the periodontal tissues and nerves, which goes away on its own after a few days. For example, if a temporary aching pain appears after tooth extraction, this is normal. To relieve discomfort, you can take painkillers. But if the pain intensifies, it is still worth visiting a doctor.

Folk remedies

Let's look at useful rinse recipes that are used to treat gingivitis and alveolitis after tooth extraction.

One tablespoon of dry crushed chamomile (sage, calendula) should be steamed with 250 ml of boiling water. The mixture should be left for an hour, wrapped in a towel, then filtered and used for rinsing. It is recommended to rinse your mouth every 2-3 hours.

The following healing recipes will help relieve inflammation and relieve discomfort:

• Mix 20 drops each of tea tree oil, cloves and liquid vitamins A and E, add a pinch of cayenne pepper. Moisten a cotton swab with the resulting medicine and apply it to the painful area.
• Wet baking soda with water to form a paste and apply it to the inflamed area.

ASEPTA gel with propolis will help you quickly cope with gum inflammation. This unique product containing the waste product of bees relieves inflammation of the gums by 31%, has anti-inflammatory, antimicrobial effects against gram-positive bacteria, as well as antipruritic and analgesic effects (reduces the pain of affected tissues), accelerates the process of regeneration and epithelization of wound surfaces, stimulates metabolic processes.

We hope that our recommendations for the treatment of gum inflammation after tooth extraction will be for informational purposes only. Treat yourself carefully and remember: at the first symptoms - acute pain in the gums, sudden changes in temperature, severe swelling of the gums, discharge of purulent exudate - consult a doctor as soon as possible. A lesion can be disastrous, so take care of yourself after surgery.

Sources:

1. Clinical and laboratory assessment of the influence of domestic therapeutic and prophylactic toothpaste based on plant extracts on the condition of the oral cavity in patients with simple marginal gingivitis. Doctor of Medical Sciences, Professor Elovikova T.M.1, Candidate of Chemical Sciences, Associate Professor Ermishina E.Yu. 2, Doctor of Technical Sciences Associate Professor Belokonova N.A. 2 Department of Therapeutic Dentistry USMU1, Department of General Chemistry USMU2
2. Clinical studies of antisensitive toothpaste “Asepta Sensitive” (A.A. Leontyev, O.V. Kalinina, S.B. Ulitovsky) A.A. LEONTIEV, dentist O.V. KALININA, dentist S.B. ULITOVSKY, Doctor of Medical Sciences, Prof. Department of Therapeutic Dentistry, St. Petersburg State Medical University named after. acad. I.P. Pavlova
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5. Report on clinical trials of anti-inflammatory balm for gums "Asepta" adhesive, St. Petersburg State Medical University, 2007
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