From this article you will learn:
- Wisdom tooth removed - how long will it hurt?
- what are the complications?
- How long does it take for gums to heal after wisdom tooth removal?
The article was written by a dental surgeon with more than 19 years of experience.
According to statistics, after the removal of a wisdom tooth, inflammation of the socket of the extracted tooth occurs in 25-30% of cases. For example, after the removal of any other groups of teeth, inflammation occurs only in 3-5% of cases. This is due: firstly, to the higher complexity of removing wisdom teeth, and secondly, to the fact that they are surrounded by a large amount of soft tissue.
The last circumstance is very important, because the presence of moving soft tissues in the area of the extracted tooth socket often leads to the loss of the clot - its loss or even destruction. If the socket of the extracted tooth is not closed by a blood clot, inflammation will inevitably develop in it.
Gums after wisdom tooth removal (normal) –
When wisdom teeth are removed, stitches are almost always required. This is necessary because these teeth are located deep in the soft tissues and in this place the mucous membrane is very mobile. The absence of sutures in this situation can lead to prolapse of the clot and inflammation. But if the patient has a long jaw and there is enough space for the wisdom tooth, the socket will look traditional (Fig. 3).
To learn how the sockets of extracted teeth should normally heal, and how to speed up this process, read the article: “How long should gums take to heal?”
Why complications often occur after wisdom tooth removal -
It must be said that the severity of negative symptoms after wisdom tooth removal directly depends on the degree of traumatic removal. In turn, the incidence of trauma depends not only on the simple or complex position of the tooth in the jaw, but, first of all, on the qualifications of the dental surgeon.
For example, surgeons often spend 1-2 hours trying to remove a patient’s wisdom tooth with just forceps and an elevator - instead of immediately making an incision in the gum, drilling out some bone around the tooth and/or sawing the tooth crown into several parts (after that, removing each root by separately), and spending only 15-20 minutes on it.
Another main cause of complications after complex wisdom tooth removal is the use of a drill by the surgeon, the surgical tip of which is not water-cooled. As a result, a thermal burn of the bone occurs, followed by severe pain and the development of suppuration in the socket of the extracted tooth.
Important: thus, the main causes of inflammation and other complications are the mistakes and negligence of the dental surgeon during the removal process. However, a lot also depends on the doctor’s prescriptions. Correct prescriptions dramatically reduce the risk of developing inflammation of the socket.
When to see a dentist
A visit to the doctor should not be delayed in the following cases:
- Initially or after a couple of days, a blood clot falls out;
- A purulent lump appears in the area of the hole;
- The pain does not go away for a long time and inflammation appears;
- The entire jaw begins to ache, radiating to the temple and eye areas;
- There is a constant iron taste of blood in the mouth;
- Pain appears in the area of the adjacent tooth;
- Within 5 days the gums are not covered with white plaque.
If you are worried about your teeth, you will be helped at the Doctor-RAF Dental Clinic (Almaty, Muratbayev St., 101). Our highly qualified specialists will help you solve all your dental problems.
During the operation, a neighboring organ may be damaged. This will manifest itself as symptoms of pain, and perhaps the tooth will begin to loosen.
Complex removal will require additional care and the use of bactericidal drugs, but only those prescribed by the dentist. Self-prescribing antibiotics is prohibited. An exception would be local gels and ointments, which are available without a prescription and have an anti-inflammatory effect.
8 reasons why the hole does not heal after tooth extraction, ways to speed it up.
After tooth extraction, it seems that the worst is over. However, this is a surgical operation that does not exclude the possibility of complications, especially if you do not follow the doctor’s recommendations. What to do when the hole does not heal?
What to do after wisdom tooth removal to avoid complications -
What to do after wisdom tooth removal will depend on the complexity of the removal. If the removal was simple (that is, it was not accompanied by an incision in the gum and cutting out the bone), then standard recommendations after removal will be sufficient. If the removal was difficult or was carried out against the background of purulent inflammation, then the following must be added to these recommendations...
- Antihistamines - these drugs are also called antiallergic. Taking them will reduce the swelling of the soft tissues of the cheek after removal, which will certainly appear the next morning, and in addition, they enhance the effect of analgesics. It is best to take Suprastin. This is a very strong drug, but with a hypnotic effect. Therefore, we recommend taking it in the first 2-3 days after removal shortly before bedtime (once a day).
– it is best to use analgesics from the NSAID group (non-steroidal anti-inflammatory drugs), which have both analgesic and anti-inflammatory effects. These include products based on ibuprofen, ketoprofen, etc.
NSAID-based analgesics
It is best to start taking these medications before your anesthesia wears off. Read about the right choice of medications at the link above. It is best to use them for the first 3 days, then as needed.
- Antibiotics – after a complex extraction, or if the removal was carried out against the background of inflammation in the tooth, taking antibiotics is mandatory. Because After tooth extraction, a bone wound is formed, then antibiotics should be specific to bone tissue. At the moment, the most popular antibiotics among dental surgeons are several drugs.
Firstly, Amoxiclav. The dosage for adults should contain 500 mg of amoxicillin and 125 mg of clavulanic acid. At this dosage, the drug is taken only 2 times a day. However, if you previously experienced diarrhea after taking antibiotics, then it is better to purchase another drug - Unidox-solutab in soluble tablets (taken 100 mg 2 times a day, 5 or 6 days).Very often, doctors also prescribe a drug from the Soviet past - Lincomycin capsules 0.25 (adult dosage - 2 capsules 3 times a day, for a total of 5-6 days). It is inexpensive, effective, but kills the entire intestinal microflora, causing you to suffer from dysbacteriosis later.
Do not rinse your mouth for the first 24 hours.
It is necessary to avoid warm foods and drinks, and not to take alcohol or blood thinners. It is possible to numb the wound with drugs such as Nimesil, Ibuprofen, Paracetamol. While brushing your teeth, you must avoid moving the bristles near the removed organ. If bleeding starts unexpectedly after a couple of days, you should immediately go to the doctor. This also applies to those cases when the pain is not relieved by simple analgesic and anti-inflammatory drugs.
On the third day, it is already possible to start rinsing the oral cavity with warm antiseptic solutions and herbal decoctions. This will speed up the healing of the hole and prevent inflammation and infection of the wound. For a couple more days you need to refrain from heat, sports, saunas, baths.
Some medications can have the opposite effect, leading to bleeding, so the medication must be coordinated with the dentist. Before removing the doctor, it is imperative to give a warning about concomitant and previous diseases. Tooth extraction has contraindications, and if they are missed, complications cannot be avoided.
What are the complications after wisdom tooth removal?
When a wisdom tooth has been removed, what to do after removal will directly depend on the symptoms that you experience. It must be said that according to statistics, complications after wisdom tooth removal occur in almost every 4th patient. Most often, patients encounter the following symptoms indicating the development of complications:
- severe spontaneous pain,
- pain when cold or hot water gets on the wound,
- swelling of the soft tissues of the cheek,
- unpleasant odor from the socket of an extracted tooth,
- painful swallowing
- difficulty opening the mouth,
- temperature,
- bleeding,
- the appearance of a hematoma on the face.
What does gum healing depend on?
Removing the eighth teeth is particularly difficult due to the incorrect location, which occurs in 80% of people. Accordingly, the postoperative period lasts a longer period of time. The process of tissue repair depends on the following factors:
- Traumaticity of surgical intervention;
- Size and location of the eighth tooth;
- State of the immune system;
- Patient's age;
- Presence of chronic diseases;
- Individual characteristics;
- Taking medications;
- Presence of seams.
Pain after wisdom tooth removal –
Having a wisdom tooth pulled out, how long will it hurt is the most common question patients ask. How much your gums hurt after wisdom tooth removal directly depends on the degree of traumatic removal. Normally, pain after wisdom tooth removal should not be very strong and, once it occurs, it should gradually only decrease. After a simple removal, the pain usually goes away completely in 1-2 days, and after a complex one, normally in no more than 3-5 days.
If you have a wisdom tooth pulled out and the pain immediately after removal is very strong and practically does not decrease in the first days, this indicates that the removal is excessively traumatic and the possible development of inflammation of the socket of the extracted tooth (alveolitis). Here you need to urgently go to the dentist for a second examination. In the worst case scenario, pain can last up to 3-4 weeks.
Symptoms of inflammation of the wisdom tooth socket - upon examination, you can see that the socket is empty, or it is filled with food debris and necrotic decay of a blood clot. Sometimes patients feel sharp/moving bone fragments with their tongue. There is always pain, there is always an unpleasant smell from the hole. The mucous membrane is swollen and red. Such symptoms are characteristic of a mild form.
However, in some cases, inflammation of the socket occurs with abundant formation of pus, swelling of the cheek, difficulty opening the mouth and painful swallowing. And it must also be said that if you experience pain when responding to cold or hot water, this clearly indicates the presence of an exposed area of bone. In any case, only a dentist can help you.
Inflammation of the socket of an extracted wisdom tooth: video
Below you can see what inflammation of the sockets of removed wisdom teeth looks like in the video. Please note that in video 2, when you press on the gums in the area of both removed wisdom teeth, thick pus comes out of the patient’s sockets.
Reasons for the development of alveolitis - if the patient rinses his mouth vigorously in the first days after extraction, this can lead to a blood clot falling out of the socket of the extracted tooth. This leads to inflammation in 100% of cases, because... the hole is immediately filled with food debris and microbes from the oral cavity. But in most cases, alveolitis still develops due to the fault of the doctor -
- traumatic removal,
- fragments or slightly movable bone fragments are left in the socket,
- when cutting out the bone, the doctor used a drill tip without water cooling, which led to overheating and necrosis of the bone,
- the doctor was too lazy to suture the mucous membrane above the hole (in some cases this can lead to exposure of a section of bone in the next few days),
- The doctor did not prescribe antibiotics after a complex extraction, or in the case when the tooth was removed due to inflammation.
Important: alveolitis is the most common complication after wisdom tooth removal. If the described symptoms occur, you should immediately run to the doctor and treat alveolitis. From experience I can say that when a doctor sutures a hole even after a simple removal, the number of cases of alveolitis development is almost zero. In addition, studies have shown that suturing the socket reduces the severity of pain after removal by 30-50%. Therefore, before removal, you should definitely ask the doctor to suture your hole, even if you have to pay extra for it (about 500 rubles for 2 stitches).
How long does it take for the mucous membrane to heal after removal?
The duration of the healing process depends on a large number of factors. First of all, the difficulty of removal matters. The removal technique also has an effect, that is, extirpation of the roots in parts, cutting of the tooth. It is important to take into account the initial condition when visiting the dentist. The hole will take longer to heal if the tooth is located outside the dental arch, grew in the jaw at an angle, or was located horizontally in the dentition. The presence of an inflammatory process near the tooth, especially signs of purulent inflammation and pericoronitis, also increases the healing period.
When sutures are applied after a simple removal, within a week the patient will forget about the procedure, but it is too early to think about prosthetics or implantation. With complex removal, the healing process will take slightly longer. If complications arise after surgical treatment, wound sanitation, treatment, and suturing are required, then the time for complete healing may increase to 20 days. Complete restoration of the mucosa takes at least three weeks. Only after this can implantation and prosthetics be performed in the area of the removed wisdom tooth.
Normally, gums must go through several stages:
When going to the dentist, it is recommended to immediately plan your day. This is especially true if there are already signs of inflammation or the teeth are severely damaged, that is, a difficult extraction is expected. Recommendations after wisdom tooth removal include, first of all, complete rest on the day after surgery. You should not make sudden movements, bend over, visit baths and saunas, or take a hot bath. It is prohibited to play sports or do any work while bending over. The best option would be complete rest. There is no need to do any special procedures on the day of the operation.
Smokers are advised to abstain from cigarettes if possible for three days or more if there are signs of complications. Nicotine causes vasoconstriction and disrupts tissue nutrition, which slows down regeneration processes. In addition, the risk of wound infection increases.
After a couple of days, you should visit the dentist who performed the procedure to assess the condition of the tissue and the healing process. This must be done even if the patient is not bothered. If signs of complications appear, pain and swelling increase, and bleeding does not stop, consult a doctor without waiting for the appointed date.
If sutures were placed on the wound, they are removed after 8-10 days, or a follow-up examination is scheduled if self-absorbable material was used for the sutures.
Do not touch the wound or try to remove part of the clot or remnants of the medicine in the form of sponges. This will only worsen the situation and cause complications.
What do we have to do?
On the first day, do not rinse your mouth. From the second day, procedures can be carried out. In this case, you do not need to intensively rinse the contents of the hole; just hold the solution on the sore side for a few seconds and spit. You need to repeat the procedure several times a day, especially after meals.
Chlorhexidine, furatsilin, miramistin, and potassium permanganate can be used as a rinsing solution. It is also possible to use herbal decoctions, for example, sage, chamomile, calendula or dental collection.
Pain may occur after the anesthetic wears off. To eliminate them, the dentist must prescribe analgesics. If there is no prescription, you can take any painkiller that the patient is used to using for pain. If the pain increases and the tablets do not help, you cannot increase the dosage. An increase in symptoms indicates a complication that requires medical intervention.
If you don't want to take medication, you can use a cold compress. These can be ice cubes wrapped in a towel. They need to be applied for several minutes, avoiding hypothermia of nearby organs, in particular the ear and tonsils.
If there is a high risk of inflammation, as well as if there is purulent discharge at the time of surgery, the dentist will definitely prescribe antibiotics. The doctor calculates the name of the drug and duration of use individually.
Features of nutrition after surgery
After wisdom tooth removal, it is forbidden to eat for two hours. If after the specified time the effect of the anesthetic still persists, it is better to wait until sensitivity appears. Eating food with a numb tongue and cheeks can cause injury to the mucous membrane.
On the first day after surgery, you can only eat warm food and drinks. Products should be soft, for example, cereals, chopped soups, yoghurts. Next, you should follow simple recommendations for several days:
- Avoid hot or too cold food.
- Avoid eating hard foods such as crackers and nuts.
- Chew food only on the healthy side so as not to put stress on the wound.
- After eating, be sure to rinse your mouth.
- You can include more fruits and vegetables in your diet to boost immune strength, or supplement with complex vitamins from the pharmacy.
You cannot drink alcoholic beverages. It is also recommended to reduce sweet foods in the first days, as they create a favorable environment for the development of bacteria.
Features of oral hygiene after removal
On the first day after extirpation, you should abandon the usual brushing of your teeth, limiting yourself to a light rinse before going to bed to remove any remaining food. The next day, you are allowed to use a toothbrush and toothpaste, but the surgical site is treated with special care. When brushing your teeth, do not forget that you cannot actively rinse your mouth. After three days, the wound will have healed and you can return to your usual hygiene regimen and brush your teeth twice a day.
Swelling after wisdom tooth removal –
If you have a wisdom tooth removed and your cheek is swollen the next day, then in some cases this is normal.
Normally, after simple removal, swelling rarely develops, and most often it occurs in people with an abundance of subcutaneous fat on the face. Such swelling most often becomes noticeable only in the morning of the next day. Normally, after a complex removal, swelling gradually develops immediately and gradually increases, becoming maximum the next morning. Usually the swelling is stable over the next 1-2 days, after which it begins to slowly decrease. If, against the background of swelling, there is no increasing temperature or pain, but on the contrary, all symptoms slowly decrease, then everything is OK.
- When removing an upper wisdom tooth, swelling of the upper cheek may occur (even if the removal was simple). The appearance of edema in this case is due to the fact that the area where the upper wisdom teeth are located is very richly supplied with blood, and therefore swelling of the surrounding soft tissues occurs. If the removal of the upper wisdom tooth was difficult or was carried out against the background of inflammation, then the occurrence of edema is all the more not surprising.
- When removing lower wisdom teeth -
swelling is natural if the removal was complicated (an incision was made, a bone was drilled, a tooth was sawed), or the tooth was removed due to inflammation. Swelling of the surrounding soft tissue near the removed lower wisdom tooth can lead to painful swallowing or difficulty opening the mouth.
When to sound the alarm - if swelling continues to increase over the next 1-2 days after removal, pain and temperature may also increase, pain when swallowing increases, and the mouth opens less and less - all these are unfavorable symptoms indicating suppuration. If you have at least one of the symptoms listed, you need to urgently run to the dentist.
Important: to ensure that swelling does not appear after wisdom tooth removal or is minimal, it is advisable to take antihistamines (Suprastin is best) for the first 2-3 days before going to bed - once a day before bed. Antihistamines have not only an antiallergic effect, but also a decongestant.
What is a wisdom tooth
In everyday life, wisdom teeth are the third molars, or the last, eighth teeth in a row, that is, “eights.”
The upper third molars can vary in shape and size, and are usually smaller than other molars and lower 8s. They have two or three roots, which sometimes grow together into one. But they always have three channels.
The lower wisdom teeth can also vary in shape and size, but, as a rule, they are larger than the upper “eights”. The roots of these teeth are short, sometimes fused, and often have a curved shape.
Temperature after wisdom tooth removal –
- If the tooth was removed NOT due to inflammation - if your wisdom tooth was removed, the temperature may well rise to 37.5 degrees, but only on the first evening.
The body sometimes reacts to injury with just such a low-grade fever, even if the tooth was not removed due to inflammation. This is especially true if the removal was difficult. Normally, the next morning after removal, the temperature should disappear (24stoma.ru). When to sound the alarm: if the temperature does not subside the entire next day after extraction, and even more so continues to increase, then this indicates suppuration of the hole of the extracted tooth. All you need to do is run to the dentist.
- If the tooth was removed due to purulent inflammation, in this case the temperature may be higher than 37.5. But normally, from the next day the temperature should decrease progressively. If it persists and, even more so, increases (this indicates an increase in inflammation), you need to urgently go to the dentist.
Bleeding after wisdom tooth removal –
Usually, in the socket of an extracted tooth, blood clots instantly, but with increased pressure or injury to a large vessel, prolonged bleeding may occur. Bleeding after wisdom tooth removal is not a big deal if it occurs while still in the dentist’s chair. The doctor will then immediately suture the wound with suture material and/or place a hemostatic hemostatic sponge into the socket of the extracted tooth (Fig. 8).
However, very often bleeding after tooth extraction occurs after leaving the clinic. Experienced doctors, to be on the safe side (especially if a large tooth is removed and the patient has a history of hypertension), usually always put 1-2 sutures on the wound, just to prevent bleeding. In addition, suturing allows the wound to heal faster.
Bleeding after removal of the upper 8th tooth: video
More detailed information on the possibilities of stopping bleeding at home is in the article: → “How to quickly stop bleeding after tooth extraction”
Hematoma after wisdom tooth removal –
A hematoma appears due to the fact that a vessel in the soft tissues has been injured. There is no point in blaming the doctor for this, because... When administering anesthesia, the doctor does not see where the vessels pass in your soft tissues. The needle can injure such a vessel and after a few days the skin may appear blue. Gradually it will pass.
However, the formation of a hematoma may require additional measures. A hematoma often festeres after the removal of a wisdom tooth. In this case, already on this day or the next day after removal, the patient experiences swelling of the cheek, a feeling of fullness, pain, and a slight fever. Here you need to urgently consult a doctor, because... when the hematoma suppurates, an incision is required to release the pus.
We answer frequently asked questions from patients -
If you have a wisdom tooth removed: what to do after removal, what to rinse with, how quickly the hole will heal and when it will be possible to treat your teeth... We answer all questions separately.
How to rinse your mouth after wisdom tooth removal -
It is best to rinse your mouth after wisdom tooth removal with the antiseptic Chlorhexidine. This drug is sold in every pharmacy and costs only about 30 rubles per 100 ml bottle. Please note that you can only rinse your mouth slowly, because... Strong rinsing can cause a blood clot to fall out of the socket of the extracted tooth. The latter will lead to the development of inflammation.
How long does it take for gums to heal after wisdom tooth removal?
How long it takes for the gums to heal after wisdom tooth removal depends on the complexity of the removal. Typically, you must wait 1 week to begin treatment after wisdom tooth removal. But after a complex removal, the gums may take longer to heal (up to 10-14 days), which will depend on the degree of traumatic removal. If inflammation occurs in the hole, healing may take 20-30 days. We hope that our article on the topic: Wisdom tooth removal, how much it hurts, turned out to be useful to you!
Sources:
1. Dental education of the author of the article, 2. Based on personal experience as a dental surgeon, 3. National Library of Medicine (USA), 4. “Pathology of wisdom teeth eruption” (Rudenko A.), 5. “Qualified removal of third molars” (Asanami S.).
Stages of healing
The process of tissue restoration consists of the following stages:
- During the first 24 hours after surgery, a blood clot forms in the socket. The formation closes the wound and protects against infection and food debris. Subsequently, the clot takes part in healing, so specialists urge not to touch or rinse the wound for the first day;
- After 3-4 days, the wound becomes covered with a white film, which indicates the formation of epithelial cells. The wound may have a yellow or grayish tint due to food pigments. If the wound is green, dark, or there is a putrid taste in the mouth, then you should visit a doctor;
- After 7-10 days, the gums become covered with a white coating, under which young granulation tissue is formed;
- On days 18-25, the wound heals and heals;
- Next, bone formation occurs, which can last 4-6 months.
