Types of removal Causes of complications How long does the pain last What is the pain associated with?
Aching jaw Painful to swallow Throbbing pain How to relieve pain? Recommendations after removal Dental treatment can be therapeutic or surgical, and pain can occur after any type of intervention. If your wisdom tooth hurts after treatment, in most cases, this is a normal physiological reaction of the tissues to the procedure performed. Usually, painful sensations are quickly relieved with painkillers and go away on their own within a couple of days. But there are situations when pain after removal of the figure eight occurs due to complications or a violation of the technology of the therapeutic manipulation.
The dentist will definitely consult the patient about how the recovery process after the intervention should normally proceed, and if any symptoms appear, you should immediately consult a doctor. If all the doctor’s recommendations regarding the rehabilitation period are followed, but the painful sensations only increase, this is a direct indication to come for another appointment.
Types of deletion
Wisdom teeth (eights, third molars) are larger than other dental units in the row. They differ not only in size, but also in the complex anatomy of the root system. Eight has from 2 to 6 roots
, which are often closely intertwined with each other. Given the complex arrangement of wisdom teeth, when they are removed, a significant wound is created.
The risk of complications will directly depend on how difficult the figure eight extraction was. With simple extraction, when the tooth is intact, the roots are not intertwined, and there are no other pathologies (pulpitis, periodontitis, etc.), the risk of complications is minimal. In such a situation, the doctor uses forceps or an elevator to remove the tooth from the socket.
If the wisdom tooth is incorrectly positioned (horizontal eruption, severe curvature), intertwined roots, significant destruction of the coronal part, or the presence of inflammation, a more global surgical intervention may be required. An incision in the gum, cutting a tooth into pieces with a drill, removing root fragments through the jaw bone and other manipulations significantly increase the traumatic nature of the procedure. Aching pain, swelling after removal of the figure eight, increased temperature (up to 37.5℃), hematoma on the cheek - this is a normal reaction to the intervention, which lasts no more than 5-7 days.
Types of pericoronitis
Depending on the complexity and localization of inflammation, pericoronitis is divided into:
- Spicy.
The initial stage of the disease, which is characterized by pain, hyperemia and swelling of the gums. In case of acute pericoronitis of a wisdom tooth, there is no purulent discharge and the general condition of the patient does not suffer. With proper timely treatment, this type of disease disappears in 3-5 days.
- Ulcerative.
The disease develops against the background of epithelium damaged by fusospirochetes. A characteristic symptom of ulcerative pericoronitis is the appearance of a necrotic rim along the edges of the gums. Small ulcers form on the mucous membrane. When plaque is removed from the gum surface, bleeding begins.
- Purulent
Pericoronitis, as a rule, occurs in a subacute form and is manifested by severe pain. Pus is released from the source of inflammation, and the temperature rises. In the absence of timely treatment, the disease can provoke the formation of abscesses, phlegmon and periostitis.
- Posteriormolar.
The disease develops when molars erupt incorrectly. A gingival hood forms, which then becomes infected due to the active proliferation of bacteria.
Why complications arise
After extraction, a wound is left in the gum and bone in which a blood clot (fibrin) forms. It “seals” the wound, preventing infection, and becomes the basis for the formation of new tissue that fills the space formed after the removal of the 8. After uncomplicated removal, healing lasts about a week. On days 3-4, the blood clot is gradually replaced by granulation tissue, which gradually fills the entire socket. Already after a month, the granulation tissue is completely replaced by connective tissue, and after 3 months - by bone.
Removal of third molars can have negative consequences that appear almost immediately after the intervention. Among the most common complications:
- “dry socket” - when a blood clot does not form or dissolves too quickly;
- paresthesia - damage to the nerve endings around the removed unit;
- alveolitis - inflammation of the socket;
- bleeding;
- cyst - fibrous formation at the site of an extracted tooth;
- endogenous periostitis (flux).
In rare cases, stomatitis, osteomyelitis, jaw trauma, and perforation of the bottom of the maxillary sinus are observed. The occurrence of complications is usually associated with ignoring the dentist’s recommendations regarding oral hygiene during the healing period, decreased immunity, and violation of surgical technique.
Pain after wisdom tooth removal
Patients are always interested in the question, how many days does the jaw hurt after wisdom tooth removal? Pain after surgery is a standard tissue response to injury. Normally, the pain subsides within a few hours or within 3 days after extraction (in case of complicated removal). The pain a patient experiences after wisdom tooth removal indicates the success of the procedure.
- The first discomfort and pain appear 2-3 hours
after the intervention (when the anesthetic wears off). - The first 3-4 days
there is aching pain, redness and swelling of the soft tissues. If the extraction is successful and the hole is properly cared for, the pain will gradually disappear. - Over the next 2 weeks
, if there are no complications, the wound will heal completely, and minor pain may occasionally occur in the late afternoon. - After 3 weeks,
all discomfort should disappear.
If a wisdom tooth has been pulled out and it hurts for more than 5 days, the intensity of the pain increases, it becomes throbbing, debilitating, accompanied by fever, swelling - this indicates a complication and requires immediate medical intervention.
Simple and complex removal
How complex the operation will be directly depends on the location of the eighth molar, the correctness of its growth, the complexity of the root system and the integrity of the tooth being removed. For example, if there is severe caries damage, the doctor will have to cut it into several pieces and only then remove it.
Easy removal
Simple extraction is the extraction of a tooth using forceps, without the help of any other dental instruments. During a simple extraction, the molar is easily removed from the gums, usually without complications. Most often, figure eights of the upper jaw are removed this way, because they are clearly visible and their roots are located exactly in the gum. In rare cases, there is a problem with the removal of upper molars. Accordingly, tissue regeneration also occurs quickly. On the 3-4th day, instead of a blood clot, young connective tissue forms, after 2-3 weeks filling the entire depth of the hole. On average, bone tissue is formed after 3 months.
Complex removal – what to expect?
Complex removal is one that requires drilling out the jawbone or cutting through soft tissue. This is mainly required when extracting figure eights from the lower jaw, since the root system here is more complex. Often there is abnormal growth (impacted or dystopic tooth), in which case only complex extraction is indicated. In the area of the lower jaw, the vessels pass close to the root system and there are more nerve endings, so it is always more difficult to remove lower molars. If the doctor considers it necessary, stitches are applied after the operation.
How long pain and healing last after wisdom tooth removal depends on the following factors: the presence of an inflammatory process during the procedure, the complexity of the operation, the degree of trauma after removal, the characteristics of the body, proper hygienic care, and taking medications after surgery. A timely operation is accompanied by rapid tissue regeneration, without the need for antibiotic therapy.
Attention! A wisdom tooth hood is a soft tissue that covers an impacted tooth. This is an “extra” formation in the oral cavity, and it is very important to remove it before inflammation begins. The hood is an additional source of inflammation. If it is not excised in time, an inflammatory process may begin and antibiotics may be required.
What could be causing the pain?
If the pain after removing the figure eight does not subside within 5-7 days, but rather intensifies, this may indicate the following complication:
- Alveolitis
is an inflammation of the socket associated with the absence of a blood clot, poor hygiene, infection of the wound, or the presence of a bone fragment in the socket (if the tooth was extracted in parts). - Severe damage to the blood vessels
of the surrounding tissues - in addition to pain, there is a hematoma, swelling of the gums and cheeks. - Allergy
to anesthetic, hemostatic sponge (if it was used during the procedure).
As inflammation develops, pain is accompanied by an unpleasant odor, purulent discharge from the socket, the formation of gray plaque, enlarged lymph nodes, increased temperature, and deterioration in general well-being. In this case, you need to see a doctor immediately.
Aching jaw
When the jaw hurts after wisdom tooth removal, it is usually due to the fact that the surgeon put pressure on it to gain access to the molar. Or during the procedure, blood vessels, nerve endings, and ligaments of adjacent dental units were injured. These symptoms are quite normal, if there is no difficulty opening the mouth, there is no pronounced swelling of the gums or soft tissues of the face.
It hurts to swallow
After extraction of the lower 8, you may experience a sore throat or pain when swallowing. This symptom appears against the background of severe damage to soft tissues, with severe swelling of the gums, cheeks, or due to trauma to the trigeminal nerve. If the trigeminal nerve was affected during the operation, there is not only pain, which can radiate to the temple, ear, neck, but numbness on the face, in the area of the removed unit, and increased salivation. Also, a sore throat may occur if there is inflammation or purulent process around the affected molar. This symptom can last up to 2 weeks. To avoid complications, you should visit a neurologist or dentist.
Throbbing pain
If your gums ache after wisdom tooth removal, but the discomfort is quickly relieved with an analgesic and disappears after 2-3 days, this is evidence of normal healing. On the contrary, throbbing pain in the jaw or gums indicates possible inflammation, damage to blood vessels and nerves. With neuritis (damage to the jaw nerves), it can radiate to the neck, throat, temple, ear, eye. The pain increases, prevents you from falling asleep, and interferes with normal life - in this case, you need to immediately consult a dentist, this is a sign of inflammation.
How to relieve pain and discomfort
- Do not touch the blood clot in the socket with your tongue, toothbrush, hands or foreign objects;
- make oral baths from herbal decoctions and antiseptic solutions;
- if the pain radiates to the ear or another part of the head, take a painkiller;
- exclude hot food and drinks.
If your gums hurt for several days after wisdom tooth removal or you have a headache, you don’t need to worry too much. Analgesics prescribed by your dentist will help you cope with these symptoms. If the discomfort does not go away after a week, painkillers do not help much - you need to go to the doctor. If the temperature is above 37.5℃, which does not decrease to normal, the development of an allergic reaction (to an analgesic, hemostatic sponge), or a sharp deterioration in health, you should consult a doctor immediately.
Causes of perforation.
The dentist is not always to blame for this complication. It can often appear due to the individual anatomical characteristics of the patient. It may also be due to the course of the inflammatory process in the tissue surrounding the root.
The causes of perforation may be the following:
- Perforation of the maxillary sinus during tooth extraction occurs most often. Its bottom is perforated when a tooth is suddenly removed with great force.
- In some patients, the roots of the upper teeth penetrate into the sinus cavity. When teeth are removed, the integrity of the bone plate is automatically violated. During treatment, filling material may enter the cavity.
- For technically complex endodontic treatment. With this type of treatment, the inflammatory focus is located deep in the gums or under the root of the tooth. Instead of removing the diseased tooth, the dentist tries to save it. During this type of treatment, the bone plate is easily damaged.
- In the process of installing an implant in the upper jaw bone with subsequent dental prosthetics, the maxillary cavity can be easily damaged. This is because the implant is similar to a screw and must be screwed into the bone. If there are defects in this manipulation or anatomical and topographical features, the patient’s bone plate of the upper jaw may be damaged (the size of the implant was incorrectly selected, there were defects in preparation for implantation). Before placing an implant, the doctor does not take into account the fact that when a tooth is removed, the thickness of the bone plate quickly decreases.
- Perforation can occur due to chronic inflammation of the tissues surrounding the tooth (periodontitis). With this pathology, the bone plate delaminates and becomes thin. If a tooth has to be removed in such a situation, perforation almost always occurs.
- Carrying out manipulation to remove an impacted tooth from the maxillary cavity.
- Perforation often occurs during tooth root resection procedures. The need for this manipulation arises when extracting a root with a festering cyst.
