Stages of socket healing after tooth extraction and possible complications. What to do after tooth extraction: recommendations Types of complications after tooth extraction

Every doctor tries to save a diseased tooth, since any removal of it can cause quite serious complications in the future. For example, when at least one tooth is missing, the quality of the so-called mechanical processing of food consumed by a person in the mouth deteriorates. This, in turn, can lead to the development of various diseases, such as gastritis, stomach ulcers and colitis. And after the removal of the front teeth, the overall appearance deteriorates significantly - a violation of correct articulation occurs. This inevitably leads to the fact that a person develops strong complexes. But, despite all these consequences, it often becomes impossible to save the tooth and it simply has to be pulled out.

Indications for tooth extraction

There is a list of indications for tooth extraction:

1. Single teeth that interfere with the fixation of the prosthesis.

People often have single teeth that do not allow the correct installation of a removable denture, which is an indication for removal.

2. Purulent periodontitis.

In the presence of this disease, the doctor decides to perform an extraction in the case when the proper outflow of pus from the periodontium cannot be carried out, since the tooth has or does not have passable channels, or very curved.

3. Granulomatous, granulating periodontitis in severe chronic form.

As a rule, the doctor decides to remove a diseased tooth if the patient has excessively curved and difficult-to-pass canals (we are talking about root canals).

4. Pathological processes in the wisdom tooth area.

If any pathological processes on the lower jaw in the area of ​​the wisdom tooth, it is removed.

5. Odontogenic osteomyelitis.

If a person is faced with such a serious illness, he should be prepared for the fact that his tooth will be removed immediately. The fact is that the elimination of pathogenic bacteria and all their tissue decay products is possible only by removing the affected tooth. This procedure allows the doctor to completely limit the course of inflammatory and infectious processes.

6. Inflammatory process in the maxillary sinuses and trigeminal neuralgia.

When the patient has teeth that provoke chronic inflammation maxillary sinuses, or due to their cause, trigeminal neuralgia is observed.

The inflammatory process may become an indication for tooth extraction

7. Atypical arrangement of teeth.

The presence of supernumerary and simply atypically located teeth also serves as an indication for removal. Such teeth significantly worsen the bite and can injure the oral mucosa.

8. Exposed roots.

If a person’s tooth is pushed out of its socket too much and the roots are exposed. Such teeth usually prevent a person from chewing food normally, cause injury to the soft tissues of the mouth, and make the process of prosthetics absolutely impossible without removing them.

9. Jaw fracture.

Removal is required when the patient has teeth located directly in the area of ​​the jaw fracture, and they are not subject to reposition of the fragments, but only act as potential conductors of infection.

10. Destroyed dental crowns (roots).

If a person has a thorough destruction of the dental crowns, or in other words, the roots, it is almost impossible to avoid tooth extraction.

11. Multi-rooted teeth.

As a rule, dentists try to treat multi-rooted teeth. But if such treatment is unsuccessful and a complication develops in the form of an acute inflammatory periodontal process, removal of the diseased tooth is required.

Tooth extraction: possible consequences

Typically, after completing a thorough examination of the patient’s mouth and teeth, the dentist offers several options for treatment procedures. It is believed that tooth extraction is the cheapest method of treatment. But one should take into account the fact that prosthetics, which will certainly be required in the future, will cost much more than tooth extraction.

Possible consequences of tooth extraction include:

Violation of the entire series.

After tooth extraction, neighboring ones begin to shift somewhat. Accordingly, a person begins to experience significant difficulties in the process of chewing food.

Deformation and destruction.

Displaced teeth begin to gradually deform and decay, which becomes another problem and a reason to visit the dentist for treatment.

Examination by a dentist

1. Deciding on the method of treatment.

The decision to remove a tooth can be made by the doctor only after a thorough examination of the entire oral cavity. In addition, part of a dental examination often includes an x-ray of the diseased tooth. From this image, the dentist assesses the general condition of the tooth, its roots and other internal parts that are located around the bone itself. Taking into account all these points, the dentist offers either to perform the operation directly in his office, or sends the patient to a surgeon (it all depends on the degree of complexity).

Before removing a tooth, the doctor must conduct a thorough examination.

2. Survey.

Before proceeding with tooth extraction, the dentist certainly conducts not only a thorough examination, but also asks a certain list of questions that help him obtain the necessary information for the successful completion of the planned operation.

A series of questions the doctor asks:

• about general health and the presence of any diseases;
• about previous visits to dental specialists, about treatment methods, about tooth extraction, how the gum healing process proceeded;
• about allergies and individual intolerance to any drugs/medicines;
• The doctor also asks about taking medications. This information is truly considered important for any dentist, since even traditional medications, such as aspirin, citramon, can reduce blood clotting, and other drugs can increase blood pressure. The danger is that all this can cause bleeding after the tooth extraction procedure. If you are taking any hormonal/birth control pills, be sure to tell your doctor about this, since dry sockets are quite common in women who take these types of medications.

Is it necessary to take antibiotics before tooth extraction?

Let's start with the fact that people today have different opinions regarding the need to take antibiotics before tooth extraction. Some are sure that taking antibiotics is really required - this helps to avoid the development of inflammation after the tooth extraction procedure. The remaining half of humanity claims that taking antibiotics has no beneficial effect at all and only puts a strain on the kidneys/liver.

In reality, the question of taking an antibiotic should be decided not by the patient, but by the doctor himself, and such a decision is made on an individual basis, that is, in each specific situation. Usually, the doctor recommends using an antibiotic before the tooth extraction procedure in the event that he detects an excessively large amount of infection present in the mouth. Accordingly, if the attending physician prescribes a certain antibiotic, the patient must strictly adhere to its dosage regimen. In any other case, antibiotics will not only be useless for humans, but will even be harmful to the body.

There are times when, after taking antibiotics, a person experiences somewhat strange reactions in his body, for example, the appearance of a rash on the body, shortness of breath. If you experience this, stop using the drug immediately and report any deterioration in your health to your doctor.

Tooth extraction under general anesthesia

IN last years modern dental clinics often perform tooth extractions exclusively for general anesthesia. Experts say that the pharmacological drug, which is used for general anesthesia, does not cause any harm to the human body.

It is easier to survive an unpleasant procedure under general anesthesia

Doctors suggest removing teeth using general anesthesia in the following cases:

Fear.

When a patient has an uncontrollable, panicky fear of dental procedures. Such people can simply clench their teeth uncontrollably, preventing the doctor from performing the necessary manipulations.

Presence of a gag reflex.

Of course, no one likes to have a doctor armed with a variety of instruments crawling into his mouth. But there are people whose gag reflex is highly developed, and this kind of manipulation causes sudden attacks of vomiting. Accordingly, it is most advisable, when possible, to carry out tooth extraction directly under general anesthesia.

If the patient is allergic.

When a person is susceptible to allergic reactions that are caused by traditional local anesthetics, they are simply forced to endure the pain that occurs during the tooth extraction process, since local anesthesia is strictly contraindicated for allergy sufferers. The fact is that such a situation can even lead to the onset of painful shock. As for general anesthesia, it never provokes allergic reactions, which is why doctors successfully use it to treat allergies.

Of course, tooth extraction under general anesthesia greatly facilitates the dentist’s work, and also helps the patient himself avoid stressful situations. However, it is important to know that if you are offered to have a tooth removed directly under general anesthesia, the medical institution must have the appropriate license, and an anesthesiologist must work in the clinic. Calculating the dose of anesthesia and monitoring the patient’s condition should not be done by a dentist, but exclusively by an anesthesiologist!

Tooth extraction: preparatory process

When a doctor informs his patient that a tooth needs to be removed, the person usually experiences a feeling of anxiety and fear before such a procedure, which is a natural reaction. Fear is usually caused by ignorance. Therefore, we have described below how tooth extraction occurs. Well, now, let's talk in more detail about preparing for the procedure:

1. Anesthetic injections.

Before the doctor begins the tooth extraction procedure, he will certainly give the patient local anesthesia– he will numb the gums and nerves of the diseased tooth with an injection of anesthetic. Before giving the injection, highly qualified doctors usually treat the injection site with so-called icecoin spray. This is necessary to reduce pain. Icecoin spray quite effectively reduces the sensitivity of the gums, thereby reducing painful sensations from the injection itself to a minimum.

Local anesthesia is used for pain relief

2. Waiting for the anesthetic to take effect

After the doctor gives the injection, he asks the patient to wait a little for the painkiller to take effect. As a rule, the waiting time takes no more than ten minutes. The patient begins to feel how sensitivity in the injection area gradually decreases.

Tooth extraction: features of the process

Be prepared to feel a lot of pressure during the procedure as the doctor uses his physical strength.

The fact is that the root of the tooth is located quite tightly in the bone socket. In order to extract a diseased tooth, the dentist needs to widen this hole as much as possible. Due to the fact that jawbone characterized by the ability to shrink well, the doctor expands the hole, loosening the tooth forward/backward. These actions make the patient feel significant pressure from the doctor. But there is no need to strain or be afraid; this will not result in a feeling of pain. The anesthesia used to relieve pain in all dental procedures completely blocks all nerve endings that are directly responsible for pain, but at the same time, such anesthesia has virtually no effect on those nerve endings that are responsible for the feeling of pressure. Accordingly, during the tooth extraction procedure, which is performed under anesthesia, a person does not feel pain, but only feels pressure.

If you suddenly (this is unlikely) suddenly feel even the slightest painful sensation, tell your doctor immediately. The doctor, in this case, introduces an additional volume of anesthetic substance into the area of ​​tooth extraction - it will completely block the nerve endings.

Be aware that taking any analgesic drugs, for example, such as Baralgin or Ketonov, which many people take to eliminate painful sensations in the tooth, can reduce the effectiveness of anesthesia. Therefore, try not to take any medications approximately 12 hours before the tooth extraction procedure. If you do take an analgesic drug, be sure to inform your doctor about this.

Wisdom tooth removal

The removal of such teeth is often accompanied by certain difficulties, primarily due to inconvenient access to them and the presence of anatomical important formations next to the wisdom teeth (any damage to them during tooth extraction is simply unacceptable). And the dense and strong bone tissue that surrounds wisdom teeth, and the often crooked roots, also significantly complicate the procedure. And we are not yet talking about various cases of tooth tilt, which are combined with incomplete eruption (or even retention).

There is another indication for the removal of wisdom teeth – their rapid and severe destruction. As a rule, the doctor warns that investing a lot of money in the treatment/preservation of such teeth is inappropriate. After all, in the future you will need to install a pin, a filling or make an inlay, or a special crown covering. Of course, the removal of a wisdom tooth is a recommendation, and if the patient is against it, then the removal is not carried out.

Indications for wisdom tooth preservation:

• correct location (when absolutely nothing interferes with the tooth and it erupts normally);
• in cases where the wisdom tooth has no carious lesions, and nothing will prevent its further qualitative treatment;
• if the patient needs a wisdom tooth as the only support for reliable prosthetics and the tilt/displacement of the tooth is not so significant as to require its removal.

The complex process of tooth extraction

As a rule, difficulties in the process of tooth extraction arise if the roots have an irregular shape - crooked/curved. In such cases, doctors have to remove the tooth piece by piece.

The essence of this technique is as follows:

1. Excision of the tooth into fragments.

The tooth is excised with special instruments into small fragments - the doctor extracts them one by one using medical forceps. Most people, upon learning that the doctor is going to perform such a tooth extraction on them, are immediately frightened. In fact, you shouldn’t be afraid of this at all - the procedure is absolutely painless and allows the doctor to remove the tooth much faster and easier, and also avoids many complications.

2. Thorough inspection.

As soon as the tooth extraction process is completed, the dentist must inspect the hole to make sure that there are no tooth fragments or deposits left in it.

3. Clamp the hole.

Then the doctor places a cotton swab into the hole, which must be pressed tightly and held for about an hour.

4. Patient consultation.

The doctor will certainly advise the patient about what he cannot do after the tooth extraction procedure and what should be done in order to minimize the risk of possible postoperative complications.

1. If bleeding from the hole begins.

Typically, bleeding should stop after tooth extraction in about half an hour. Earlier in this article, we mentioned that the doctor places a sterile cotton swab on the hole, and the patient needs to press it tightly for an hour. But in some cases, bleeding continues for several hours longer. In this case, you may need a sterile bandage - you need to cut off a small piece with thoroughly washed hands, form a tampon from it and repeat the procedure. But, if bleeding continues for more than two to three hours, you should urgently seek medical help from a doctor.

2. Formation of a blood clot in the socket.

Experts assure that such a clot after the tooth extraction procedure is actually necessary for further successful healing of the wound. Therefore, there is no need to worry. It is important to follow the following list of rules in order to prevent the destruction and removal of a blood clot:

• Smoking and drinking drinks through a straw often leads to some displacement of the blood clot. This is explained by the fact that during smoking and drinking a vacuum is formed in the mouth, which, in turn, causes the clot to dislodge;
• do not rinse your mouth and try not to spit saliva in the first day after tooth extraction;
• do not drink hot liquids (tea, coffee) and do not eat hot food (for example, soups/borscht) - this may lead to the dissolution of the formed blood clot;

3. If swelling appears.

If your cheek is swollen after tooth extraction, this is normal, as this happens sometimes. It is believed that the more difficult the extraction procedure, the higher the likelihood that swelling of the soft tissues adjacent to the extracted tooth will occur. In order to remove such a tumor, doctors usually advise patients to apply the lek to the cheek for about ten minutes (this should be done every hour). This procedure should be continued until the swelling disappears. Just do not under any circumstances apply ice to the gum itself - this can lead to infectious inflammation, since pathogenic microorganisms may enter the wound.

Swelling may occur after tooth extraction

4. Temperature.

As a rule, people who smoke are much more likely to experience various complications, and it is they who usually develop fever after tooth extraction. There may even be inflammation of the hole. Therefore, if you are able to abstain from smoking, do so for at least 1-2 days.

5. Cleaning your teeth.

During the healing process after tooth extraction, it is very important to maintain oral hygiene. As practice shows, many people, after a tooth extraction procedure, prefer not to clean their teeth for several days. But this action inevitably leads to reproduction in the mouth pathogenic microflora and threatens inflammation of the hole. Remember, you must brush your teeth, but first you should replace the traditional brush with a softer one. Do not use any mouthwash under any circumstances.

6. Painkiller.

The pain that appears after tooth extraction is quite tolerable and is quickly relieved by taking painkillers. But you should definitely check with your doctor which specific drug you can take as soon as the effect of the injection wears off. It is imperative that you read the instructions that are included with each medicine. And do not forget that it is advisable to combine any painkiller medication with food in order to reduce the negative impact of the medication on the stomach.

Pain can be relieved with medications

7. Limiting activity.

It is recommended to refrain from playing sports and avoid physical strenuous work. It is also advisable to place an extra pillow under your head while sleeping. This is necessary so that the head is positioned a little higher (the risk of damage to the blood clot, which we wrote about above, is reduced).

8. Antibiotics.

Sometimes a few days before the scheduled date of the tooth extraction procedure, the dentist prescribes the patient to take an antibiotic. In this case, you should not stop taking the antibiotic immediately after the procedure, as this may lead to some deterioration in your general condition.

9. Treatment of remaining teeth after removal of the diseased tooth.

When a person has diseased teeth that require treatment, he will naturally be concerned about how and when, after removal, he can cure them. Experts typically recommend that patients wait and delay treatment for about a week.

10. Nutrition.

If the tooth extraction procedure was not complicated in any way, then there are no special restrictions regarding nutrition. But it is important to ensure that food is chewed exclusively on the side opposite the wound.

But, if tooth extraction causes complications, the dentist usually advises the patient to follow a diet based on soft/liquid foods.

Tooth extraction: possible complications

As practice shows, the most highly professional dentist cannot give the patient any guarantee that he will not have any complications. We will describe the main complications that most often occur in people after tooth extraction:

Stitching.

If the removal procedure was very difficult and the gums were significantly damaged, the doctor may suture the gums. In most cases, sutures are placed on the gums using dissolving threads. However, insoluble threads can also be used by a doctor for suturing. Accordingly, the seams that are applied with such threads will need to be removed. Of course, there is no need to be afraid of this procedure - it is completely painless and proceeds quickly.

Dry socket.

A complication such as “dry socket” after tooth extraction can be encountered quite often. A dry socket forms if a blood clot has not formed at the site of the wound, which plays an important role in the healing process. The hole itself becomes defenseless and is negatively affected by any external influence. For this reason, an inflammatory process (for example, alveolitis) may develop in it.

Complications during tooth extraction cannot be ruled out.

With this complication, a person experiences pain, which can be felt immediately after the tooth extraction procedure, but most often the painful sensation appears after two to three days. The gum mucosa swells noticeably, and the edges of the socket become inflamed. At this moment, the person may have a fever and pain when swallowing. Along with the listed symptoms, a general malaise is usually felt, and the wound begins to smell unpleasant due to a dirty gray coating.

Troubleshooting:

To treat such a complication, local and general funds. Sometimes simply thoroughly washing the hole is sufficient. antiseptic solution– for this, the hole is treated with an aseptic special paste/ointment. Then, with the help of vitamins and antibiotics, general anti-inflammatory therapy is carried out.

In severe cases, the doctor may prescribe physical therapy or laser therapy.

Paresthesia.

This complication occurs infrequently. The cause of paresthesia is nerve damage during tooth extraction. The main symptom of paresthesia is numbness in the chin, cheeks, tongue and lips. In general, paresthesia is considered temporary and usually disappears after 1-2 days, but can last up to several weeks.

Troubleshooting:

The doctor treats paresthesia through therapy with vitamin C and B complex, as well as with injections of galantamine and dibazole.

Socket bleeding.

It can occur immediately after the operation, that is, within an hour, but sometimes the holes begin to bleed even after a day. Hole bleeding can be caused by the use of adrenaline, because as soon as it stops working, there is a risk of short-term vasodilation, which leads to bleeding.

In addition, socket bleeding may begin due to a violation of the dentist’s recommendations during the postoperative period - usually the sockets bleed due to external disturbance of the wound.

Also, the causes of bleeding from the socket include concomitant diseases (jaundice, sepsis, leukemia, scarlet fever, hypertension, etc.).

Troubleshooting:

As a rule, the effectiveness of stopping such bleeding directly depends on how well the doctor correctly identified the causes of alveolar bleeding:

If the blood comes directly from the gum tissue, he places sutures on the edges of the wound.

If the source of bleeding is a vessel in the wall of the socket, then the doctor first applies local cold, then tightly squeezes the bleeding vessel and places a tampon soaked in a special hemostatic agent into the socket. The tampon is removed no earlier than after five days.

If local methods do not help, the doctor turns to more serious hemostatic general remedies.

Defects.

After removing the diseased incisor, neighboring teeth begin to gradually tilt, namely towards the removed tooth. This leads to the fact that the chewing process is disrupted and the chewing load increases significantly. As a result, the general condition of the jaw is disrupted and a malocclusion occurs.

Every person should remember that only careful adherence to all the recommendations of the attending physician will avoid complications that are possible after tooth extraction. Therefore, follow all the doctor’s instructions, this will reduce the risk of unpleasant complications.

Tooth extraction in children: features of the procedure

Of course, the removal of primary incisors in children has a list of features. It is immediately worth noting that the dentist must make such a decision with full responsibility in order to prevent the occurrence of a mass of violations, for example, such as the formation of a malocclusion in a child and violation of the integrity of the so-called rudiments of permanent incisors.

Milk teeth are removed by a doctor for the following indications:

• When a baby has complicated forms of caries that cannot be treated.
• When a tooth begins to interfere with the normal eruption of the next/permanent tooth.

The woman is faced with the question of what to do: continue to suffer from pain, or still decide and remove the tooth? In fact, only a specialist, namely a surgeon or dentist, should decide for a woman. Yes, the statement that pregnancy is a contraindication to the procedure of tooth extraction, but this contraindication cannot be considered absolute.

Every pregnant woman should definitely visit the dentist at least once every 3 months for a preventive examination of the oral cavity. In addition, the doctor provides useful recommendations that help in caring for your teeth. But when an expectant mother experiences toothache, she needs to contact her dentist unscheduled. And, if her pregnancy is short, she needs to personally inform the dentist about her pregnancy.

Of course, any surgical intervention in the body is a great stress for every expectant mother. It is for this reason that all planned tooth extractions, as a rule, are carried out either after or before pregnancy, but during it - exclusively for emergency reasons. Fortunately, pharmacologists have already developed special safe anesthetics for pregnant women that are not able to penetrate the placental barrier, and, accordingly, they do not cause the slightest harm to the fetus.

Never forget that regular and proper care for the entire oral cavity - this is the key to the health of your teeth.

Despite many modern effective techniques therapy of dental diseases, it is not possible to save a decaying tooth in every case.

Often the reason lies in the abuse of self-medication and untimely application to a specialist.

As a result, the tooth has to be removed. This procedure, although perfected by dentists to the smallest detail, is not as harmless as it might seem.

Among the consequences of this operation, there may be both minor local complications and quite complex pathologies.

Inflammation of the socket as a result of its infection, called alveolitis, occurs in 30-40% of cases of tooth extraction. It occurs due to a disruption of a blood clot at the site of a missing molar. This may happen for one of the following reasons:

• non-compliance with the dentist’s recommendations during the postoperative period;
• complex surgical intervention as a result of the structural features of the dentition;
• decreased immunity;
• dentist's mistakes during the procedure.

The main signs of alveolitis are the absence of a blood clot in the socket, swelling and inflammation of the mucous membrane, increased body temperature and lymph nodes.

If symptoms of the disease persist for more than three days after surgery, it is necessary to examine a specialist and prescribe general and local impact to relieve the inflammatory process.

Perforation of the bottom of the maxillary sinus

The main causes of rupture of the floor of the maxillary sinus are as follows:

• location of dental roots inside the maxillary sinus or close to its bottom;
• thinning bone tissue due to certain dental diseases.

Perforation of the maxillary sinus manifests itself in bleeding with the formation of air bubbles from the formed hole, discharge of blood from the nose, and acute pain.

Diagnosis and treatment of pathology must be carried out immediately. For minor changes, it is enough to apply a tampon to the damaged area to promote the formation of a blood clot.

If the damage is pronounced or was noticed untimely, plastic closure of the damaged area may be required, which is preceded by measures to eliminate inflammation.

Injuries

Often complications after tooth extraction are associated with mechanical trauma to the gum or periodontal tissue or damage to adjacent teeth.

The reason for the occurrence of such situations may be both the anatomical features of the structure of the dentition and the unqualified actions of the dentist.

Fracture

Breakage of a tooth in the crown or root part can occur due to the peculiarities of its location or structural pathologies as a result of certain dental diseases.

Symptoms of this complication include pain at the site of the extracted tooth, swelling and inflammation of the gum tissue.

To remove the broken section of the root, another surgical intervention may be required, which is carried out after preliminary examinations with x-rays.

Dislocation or fracture of adjacent units

Damage to the teeth adjacent to the molar that is to be removed can occur if the elements of the jaw row are too closely spaced.

In this case, poor access to the required molar often leads to chipping of tissue on adjacent teeth.

In addition, if an insufficiently stable tooth is used as a support during surgery, it may become dislocated or fractured.

To avoid these complications, the dentist must carefully consider the course of the operation and also carefully select instruments.

Fracture of the alveolar process

The main causes of damage to the alveolar ridge area:

• pathology of the structure of the dentition;
• deformation of bone tissue as a result of dental diseases;
• insufficiently careful movements of the dentist.

Most often, this complication occurs during complex removal of elements of the upper jaw. To eliminate it, alveoplasty is used using protective membranes and bone tissue.

Damage to the gums

By extracting a molar from a difficult-to-reach area of ​​the mouth, the dentist may cause unintentional damage to soft tissue.

This is often accompanied by insufficient visibility of the operated area, as a result of which the circular ligament is not completely separated from the neck of the tooth, which provokes gingival rupture.

To avoid gum damage, dentists often use the method of peeling gums in the area of ​​​​adjacent teeth.

If a rupture occurs, excessively damaged areas of tissue are cut off and the edges are sewn together.

Damage to the oral mucosa

Trauma to the oral mucosa often accompanies complex tooth extraction, which is carried out in several stages using a large number of instruments.

Also, the cause may be insufficient quality of pain relief, as a result of which the patient makes minor movements caused by painful sensations.

As a result, dental instruments can slip, causing mucosal injuries of varying severity.

Pushing the root into soft tissue

This complication most often observed during the extraction of lower molars. The reason, as a rule, is pathological change structure of the alveolar wall as a result of previous inflammation.

In addition, a complication can occur due to the dentist applying excessive force or unreliably securing the alveolar process.

If it is possible to palpate the displaced root, it is removed by dissecting the soft tissue.

If you cannot feel the root, you need additional methods diagnostics: x-ray, computed tomography.

Pushing the root into the maxillary sinus

This situation occurs when the dentist makes inaccurate movements during the removal of the upper teeth, especially in the case when the root and sinus are separated only by the mucous membrane. Diagnosis of complications is carried out by interviewing the patient and X-ray results.

In order to avoid pushing the root into the maxillary sinus, dentists are required to conduct the most detailed preliminary examination of the structure of the patient’s oral cavity and the condition of all its elements and tissues.

Dislocation of the temporomandibular joint

This complication most often occurs in elderly patients. The cause of this phenomenon may be opening the mouth too wide, as well as strong pressure instrumentation on the jaw during the removal of lower row molars.

The key symptom of a dislocation is the inability to fully connect the jaws. To diagnose complications, palpation is used to determine the displacement of the heads of the condylar process.

Treatment involves realignment of the dislocated joint by an appropriate specialist..

Dislocation of the lower jaw

The occurrence of dislocation of the lower jaw in most cases is diagnosed in elderly patients. Clinical symptoms– inability to close your mouth and severe pain. The jaw can be shifted to one side or the other (unilateral dislocation) or pushed forward (bilateral).

To avoid complications, dentists fix the patient’s lower jaw with their hands during tooth extraction.

Fracture of the lower jaw

The complication is quite rare, mainly when excessive pressure is created during the removal of the last and penultimate molars.

As a rule, this is accompanied by the patient’s advanced age or the presence of osteoporosis and undiagnosed bone tissue pathologies.

To avoid fracture during tooth extraction, dentists rely on the results of radiographic examination and assessment of the “indirect load” symptom.

To treat a fracture of the lower jaw, reposition and fixation of bone fragments using dental splints or osteosynthesis techniques can be used.

Loss of consciousness

Brief loss of consciousness or fainting can occur both during tooth extraction surgery and after its completion.

The reason for this phenomenon is a decrease in the amount of oxygen entering the brain as a result of excessive psycho-emotional stress.

Often, loss of consciousness is not a serious pathology, since the patient comes to his senses after loosening tight clothing, getting fresh air and bringing ammonia to his nose.

Dry socket

The absence of a blood clot in the socket, accompanied by severe pain and inflammation, is also a complication that occurs after tooth extraction.

Most often, the formation of a dry socket is caused by incorrect actions of the patient - frequent rinsing of the operated area of ​​the jaw, eating solid food and other violations of the rules of oral care.

If this pathology is detected, you must contact a specialist to select anti-inflammatory drugs or clean the hole if necessary.

Bleeding

Bleeding from a hole formed at the site of an extracted tooth can occur both during and after surgery.

There can be many reasons for this phenomenon:

• damage to blood vessels or alveolar ridge during surgery;
• concomitant diseases and infections;
• non-compliance with the dentist’s recommendations in the postoperative period.

In addition to obvious bleeding, in some cases hidden bleeding into soft tissues may occur, which manifests itself in the formation of hematomas on the gums and cheeks.

In this case, you must immediately contact your dentist for professional help.

Neuritis of the inferior alveolar nerve

The occurrence of neuritis of the inferior alveolar nerve is often associated with the presence of chronic periodontitis.

The complication is accompanied by severe pain and unpleasant odor from the mouth, swelling of the treated gum area, numbness of the lips and chin.

It may take 1.5-2 months until the functionality of the inferior alveolar nerve is fully restored. Treatment in each situation is individual.

Paresthesia

During tooth extraction procedures, a complication called paresthesia may occur - damage to the nerves located in the treated area.

Most often, this situation occurs when the third molar is removed. The reason may be either the fault of the dentist or the complexity of the structure and location of the element of the row being removed.

Paresthesia is expressed in numbness of the tongue, lips and some areas of the cheeks and chin. In case of minor damage, restoration of sensitivity takes no more than two weeks.

In more difficult situations Consultation with a neurologist and a specialist in maxillofacial surgery is required.

Temperature

A slight increase in body temperature after surgery, which is tooth extraction, is often observed for 2-3 days.

As a rule, the thermometer reaches 37-37.5 degrees during the day, and in the evening it can rise to 38 degrees.

A dangerous factor is an increase in temperature to 39 degrees or its persistence for more than three days. In this case, you need to contact a specialist to find out the cause.

Osteomyelitis

Inflammation of bone tissue occurs after tooth extraction quite rarely, however, it can lead to serious consequences.

Main symptoms of the pathology:

• severe pain at the site of the extracted tooth;
• gray plaque in the area of ​​the hole, when pressed, pus is released;
• temperature increase;
• increased weakness;
• headache;
• swollen lymph nodes;
• sudden changes in blood pressure.

Osteomyelitis can develop against the background of reduced immunity or advanced alveolitis.

To treat the disease, both surgical and medicinal method, which are complemented by symptomatic therapy. Osteomyelitis should be treated exclusively by a dentist.

Changing the position of neighboring units

As a result of the appearance of free space in the jaw row after tooth extraction, there may be a gradual displacement of adjacent elements into the newly created space.

The result of this movement is often an increase in crowding of teeth and the development of bite defects.

To prevent this phenomenon, dentists recommend not delaying implantation or installation of a prosthesis.

Allergy

The use of anesthetic drugs during tooth extraction may cause an allergic reaction. For minor allergies skin and the mucous membrane may become covered with small rashes.

However, the body's reaction can be more serious, including swelling respiratory tract and anaphylactic shock, which require immediate qualified medical care.

To avoid serious consequences, during a consultation with a dentist, it is necessary to indicate the drugs to which you are allergic.

Problem eights

Complications after removal of the last molars occur quite often, which is associated with difficult access to this area of ​​the dentition.

In addition to the above consequences, problems such as hematomas, the formation of a cyst or flux, and the development of stomatitis as a result of infection may arise.

At the same time, it is worth understanding that for 2-3 days in the area of ​​the extracted tooth it may remain It's a dull pain, and body temperature be slightly elevated.

If these sensations do not disappear a few days after the operation, you should seek help from a specialist.

Baby teeth

Tooth extraction may be required not only in adults, but also in childhood, if an element of the row has been severely affected by caries.

In this case, a specific complication may arise. Root baby tooth has the ability to self-resolve and in some cases the dentist may mistake the rudiment of a permanent one for it.

When the germ of a permanent tooth is removed, there is no longer any possibility of its growth.

Prevention

The course of the postoperative period as a result of tooth extraction depends not only on the qualifications and experience of the dentist, but also on the actions of the patient himself. When preparing for surgery you should:

• stop drinking alcohol on the eve of surgery;
• warn the attending physician about the presence of allergic reactions to certain drugs and medications taken;
• report existing chronic diseases.

After the operation, it is also necessary to observe some important points:

• the tampon must be removed from the hole 15-20 minutes after the end of extraction;
• refuse to eat for 3-4 hours after the procedure;
• Avoid eating hard, hot and spicy foods for three days after surgery;
• refuse physical activity, visiting baths and saunas, solarium;
• refrain from rinsing the mouth to avoid washing out the blood clot;
• carry out procedures prescribed by the dentist.

If pain, swelling or inflammation occurs in the area of ​​the extracted tooth, you should immediately seek professional help.

You can learn about the causes of complications after tooth extraction and their symptoms from the video.

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 turns out to be without a 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).

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.

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 cutting the gums and sawing out the bone), then after removal it will be enough. 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 –
  such 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 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).

• Antibiotics –
  after a complex extraction, or if the extraction 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. On this 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. soluble tablets(taken 100 mg 2 times a day, 5 or 6 days).

  Very often, doctors also prescribe a drug from the Soviet past - (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.

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,
• bad smell from the socket of an extracted tooth,
• painful swallowing
• difficulty opening the mouth,
• temperature,
• bleeding,
• the appearance of a hematoma on the face.

1. 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 (). 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 hole is empty, or it is filled with food debris and necrotic decay of the 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).

2. 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 to sound the alarm –
if the 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 after wisdom tooth removal does not appear or is minimal, it is advisable to take antihistamines (Suprastin is best) for the first 2-3 days before bedtime - once a day before bedtime. Antihistamines have not only an antiallergic effect, but also a decongestant.

3. Temperature after wisdom tooth removal –

• If the tooth was removed NOT due to inflammation –
  if you have a wisdom tooth removed, the temperature may well rise to 37.5 degrees, but only on the first evening. The body sometimes reacts to injury just like this small low-grade fever, even if the tooth was removed not due to inflammation. This is especially true if the removal was difficult. Normally, the next morning after removal, the temperature should disappear.

  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.

5. 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.

1. How to rinse your mouth after wisdom tooth removal -

It is best to rinse your mouth after wisdom tooth removal. 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 gently, 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.

2. 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!

Since childhood, most of the population has been unimaginably afraid of visiting the dentist. As many people get older, they naturally stop being nervous, realizing the need preventive examinations and boldly go to the next appointment. One of the most common actions performed by doctors every day is tooth extraction. Like most others surgical interventions, this surgery can have its own challenges that can affect the recovery process, reducing the ability of the injured area to heal.

Complications after this usually come down to several problems. First of all, this is secondary bleeding. In most cases, such consequences appear after the removal of wisdom teeth, since such an operation is the most difficult among other similar actions. The risk category includes patients who have hypertension or diseases associated with a decrease in the ability of blood to clot. Among other things, complications after may be closely related to any individual characteristics patient. Bleeding does not necessarily occur immediately after surgery. It is quite possible that blood appears after a short period of time. In this case, it is recommended not to delay and contact the dentist who performed the operation, or call an ambulance.

Complications after tooth extraction are sometimes expressed in the form of swelling. You should know that not only the gums at the extraction sites are affected, but also the cheeks. Typically, this reaction is a consequence of the destruction of the soft tissue around the unwanted tooth. However, an allergy to the drug that was used as anesthesia is also possible. If such complications after tooth extraction do not go away on their own, then you should contact your dentist again, who will prescribe an antibiotic to relieve swelling and prevent the inflammatory process from developing.

One of the most unpleasant complications can be fever after tooth extraction. In principle, if it has risen slightly in the first couple of days after the removal procedure, then there is no cause for special concern, just as in the case of swelling. In a normal person, a slight change in temperature, especially in the late afternoon, is considered normal, and even more so after undergoing stress (meaning tooth extraction surgery). In cases where it lasts more than four days, it is better to consult a doctor. The same applies to a strong increase in temperature.

Another rather unpleasant complication is dry socket. It is called this because for some reason there is no small amount of dried blood at the site of the extracted tooth. As a result, various microorganisms, including harmful ones, can easily enter the wound. Most often, such difficulties arise in patients who smoke or those who do not follow the specialist’s recommendations for treating the wound on their own. It often happens that the doctor himself can remove the clot if he does not perform any actions carefully. This usually becomes obvious after a few days, when painful sensations begin to appear, ranging from aching to sharp. This indicates the beginning of the inflammatory process, which, moreover, is accompanied by the appearance of an unpleasant odor. As a rule, when dealing with such complaints, the doctor prescribes compresses with certain medications applied to the wound.

Quite rarely, but it still happens that when pulling out an unnecessary tooth, a dental surgeon damages the jaw nerve. With this outcome, the lower part of the face and tongue may become numb. The sensations are similar to the effects of anesthesia. The duration of such a complication can be calculated in several weeks, but it does not pose a particular threat and goes away on its own.

The most important thing is that if you have any doubts or complaints, do not wait for the problem to “resolve itself,” but seek advice from a specialist dentist (preferably the one who performed the tooth extraction operation) and strictly adhere to the recommendations he prescribed.

Tooth extraction is a real surgical operation that can have systemic action for the whole body.

As with other interventions, after removal the patient may experience discomfort, pain and other unpleasant sensations. In order not to miss or start a complication, you need to understand when you just need to be patient, and when you need to urgently consult a doctor for help.

Complications after tooth extraction

If the technique is violated, or due to improper care of the tooth socket, a number of complications may arise that need to be diagnosed and taken as quickly as possible:

• alveolitis - inflammation of the socket, occurs if a blood clot has not formed to protect the socket from oral bacteria;
• alveolar bleeding;
• paresthesia – nerve damage.

The photo shows inflammation of the tooth socket

These complications can be recognized by various symptoms - fever, pain, numbness, bleeding, etc. But most of these symptoms are considered normal after tooth extraction. When should you see a doctor?

Temperature

Any operation can be considered as a trauma to the body. It goes without saying that the body cannot help but react to this, so after tooth extraction the patient may feel unwell and even have a fever.

Temperature increase

There are often cases when in the evening on the day of removal the temperature rises to 38-39 degrees and is accompanied by weakness and feeling unwell. You shouldn’t panic right away, in order to understand whether this condition is normal - it needs to be assessed over time. In the absence of postoperative complications, the patient will feel much better the next morning. In the evening of the second day, the temperature may rise again, but not more than 38 degrees.

If the dynamics are negative and the patient feels worse the next morning, this may indicate the presence of an inflammatory process. In such cases, you should contact your doctor to agree on further actions.

Pain and swelling

These symptoms are a completely normal reaction of the body. Typically, the patient begins to feel pain several hours after surgery due to the cessation of the pain medication.

Photo: pain and swelling

If the healing process proceeds normally, then every day the pain will become less and less. After complex removal, the pain may be more intense and last longer. If swelling occurs, this may also be a normal reaction. The main criterion for the absence of complications is positive dynamics and gradual fading of unpleasant sensations.

When to see a doctor:

If the pain is acute, throbbing and does not go away within 2-3 days (1.5-2 weeks after complex removals), you should see a doctor as soon as possible. If a painful hematoma occurs in the area, accompanied by fever and poor health, then a doctor is also needed.

Other warning symptoms

You should not postpone a second visit to the doctor if, some time after the operation, blood comes from the socket, as this may indicate a violation of the integrity of the blood clot, which plays a huge role in the healing of the socket. One more alarming symptom is the presence of pus on the surface of the socket, which most often appears there due to the development of alveolitis.

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Feelings after tooth extraction

After this type of surgery, symptoms such as:

• Swelling of the gums;
• Pain after the effect of the anesthetic wears off;
• Discomfort when opening the mouth;
• Hematoma in the cheek area;
• Temperature increase.

If the healing process proceeds normally, then postoperative symptoms disappear in less than a week. If more than a week has passed and the discomfort remains, then this is a signal to consult a specialist.

Swelling

Swelling is common after dental surgery. Sometimes it can appear in the form of a small flux, which is a consequence of the destruction of nearby tissues. If the tumor is small, it will disappear in a few days. To avoid these consequences, it is necessary to apply ice after extraction. If the swelling does not decrease after a day, then it must be heated for twenty minutes, taking a break for ten minutes. You can also relieve swelling with an antiallergic drug, but if this does not help, then you should make an appointment with a specialist.

Temperature increase

An increase in temperature in the postoperative period is quite common occurrence. This is a consequence of the body’s protective reaction to injury, which is surgery. Fever is an indicator that the body is fighting infection. Temperature jumps – normal phenomenon, if it lasts no more than 2-3 days, increasing in the evening. When the temperature reaches 38 degrees or higher, it is necessary to take antipyretic medications.

Pulsating pain at the site of tooth extraction

The cause of throbbing pain is that a blood clot has not formed. If the pain does not decrease with its presence, this may indicate the presence of an inflammatory process in the pulp. The pulp is a soft dental tissue containing nerve endings and blood vessels. At complete removal pulp may begin to become inflamed with the nerve it contains. The indication for pulp removal is pulpitis. If some of the pulp remains, the disease may spread.

In this case, inflammation worsens and nerve irritation occurs. Increased pain, which is localized at the site of itch removal, may be a signal of the beginning of purulent processes in the hole or in the gum. The cause of inflammation of the gums may be the presence of root particles in it. The hole becomes inflamed if there is no blood clot in it.

Pain in adjacent teeth after extraction

Sometimes pain can spread to neighboring teeth. This is due to the fact that if the operation was complex, then the gum or nerve could be affected adjacent tooth. To prevent unpleasant sensations, it is necessary to carefully monitor oral hygiene, rinse your mouth with chamomile and soda after each meal.

Signs of complications after tooth extraction

If you notice any of the symptoms described below, you should make an appointment with your dentist as soon as possible, as these may be complications due to improper tooth extraction.

Dryness in the socket

Normally, a blood clot remains in the hole that remains in place of the extracted tooth. He performs protective function, protecting the bone and nerve endings from various influences, thereby accelerating the healing process. On the first day after surgery, it is better not to rinse your mouth and avoid hot foods. By following these recommendations, you can protect your blood clot. Often this blood clot does not form at the site of the extracted tooth, which is called a dry socket.

If a blood clot has not formed, then you need to consult a dentist. He will place a tampon soaked in a special solution into the hole to promote healing. This kind of complication can result from a number of objective reasons, such as smoking, taking birth control pills, age. The absence of a clot can cause severe pain not only at the surgical site, but also in nearby areas. This pain is often so severe that it can radiate into the ear with pulsating shocks. In this case, you need to monitor the dynamics of pain intensification and its duration, because after a few days it may appear new problem– alveolitis.

Alveolitis

The cause of alveolitis after tooth extraction is usually infection in the postoperative wound.

Dry sockets are the most vulnerable to pathogens. Sometimes - periodontitis, which is a consequence of the fact that dental fragments remain in the tissues. All of the above factors are a “green light” for infection and inflammation of the socket, which is accompanied by severe pain. Conductors of pain are nerve trunks. In the area of ​​edema, pus may accumulate and, as a result, an unpleasant odor. When the inflammatory process worsens, the hole becomes covered gray coating, and the pain worsens so much that chewing food becomes impossible.

A doctor will help solve this problem; you should contact him immediately, because alveolitis can turn into periostitis (inflammation of the periosteum), and also cause phlegmon or an abscess. Rarely, it can cause osteomyelitis. In this case, acute pain and swelling of the gums can be supplemented high temperature and general malaise associated with a weakened immune system. Osteomyelitis can move to nearby teeth. This disease is treated only through surgery, after which a long course of inpatient therapy begins.

Pus

If an infection gets into the hole, then those tissues that are located nearby begin to fester. Pus can be a consequence of poor hygiene, as well as when dental fragments penetrate into the tissue. Pus can often appear after wisdom teeth are removed. If purulent inflammation is not treated in a timely manner, a more serious problem may arise, such as a fistula or even a cyst. Here, the number of days that have passed since the operation is absolutely not important. Pus is a signal to make an appointment with a doctor. Only he will be able to establish the cause of inflammation, prescribe antibiotics and prescribe irrigation with an antiseptic.

Pain after wisdom tooth removal

Surgical removal of a wisdom tooth is a rather difficult process, and therefore postoperative pain can be severe. Painful sensations are phenomena that accompany the eruption of wisdom teeth. The eighth tooth is usually removed for the simple reason that it begins to shift the row to make room for itself. There are often cases when a tooth grows crookedly and damages tissue. this is why dentists insist on extraction on early stage. Only experienced dentist can determine whether this is necessary or not.

During the procedure, a nerve may be affected because these teeth are located near the facial nerves. Therefore, a feeling of paresthesia may accompany treatment, which will manifest itself in the form of numbness of the tongue, lips and even chin. This kind of complications occurs quite rarely and disappears a few weeks after surgery. Does not lead to complications.

During the extraction of a wisdom tooth, the gums are injured. The patient suffers from aching pain, but after a couple of days it goes away. Inflammation of the socket and gums very often occurs in combination with an increase in temperature. When it increases, hypothermia occurs. In such a situation, the dentist will prescribe antibacterial therapy, stitches using threads that dissolve on their own.

Postoperative therapy if severe pain does not go away after tooth extraction

Pain during the postoperative period is absolutely normal. But, nevertheless, one must take into account its duration and nature. To reduce pain at first, doctors recommend:

• Apply cold compresses;
• During the day, avoid any impact on the operated area (applies to brushing teeth and rinsing);
• Take antipyretic and painkillers.

After the tooth is removed, a roller is placed in its place, which is not removed for 20-30 minutes. Eating should be delayed for several hours to avoid infection in the wound. Avoid eating hot and spicy foods. You cannot chew on the operated side. Smoking and alcohol are taboos after tooth extraction.

In the first stages after extraction, you should carefully cool the gums. Be careful: don't chill your gums! You should not take hot baths at this time: increased bleeding may occur due to increased blood pressure. If it starts, place a cotton swab between your jaws or apply a cold compress. Rinsing the mouth is strictly prohibited, as it can damage the blood clot, which should normally be in the socket. On days 2-3, you can start rinsing your mouth using soothing solutions. Take a glass of water at room temperature, dissolve a teaspoon of soda or ½ teaspoon of salt in it. Rinse your mouth with this solution daily, 2-3 times.

If the pain intensifies, analgesics can be used. The most effective: ketanov and analgin. For inflammation, the doctor will recommend antibiotics, such as sumamed, biseptol, amoxiclav. The duration of the course of taking them depends on the degree of complexity of the condition, however, it cannot be interrupted even after getting rid of the pain. If complications arise, the dentist can irrigate with antiseptics.

How to avoid complications?

Preventive methods consist of strictly following all the doctor’s advice regarding oral care. Simple recommendations will help prevent increased pain and complications. The rules are:

• Do not touch the wound for the first 2-3 days
• A couple of days after surgery, cleanse with antiseptics.
• The daily number of painkiller doses should not exceed 2 times
• Cold compresses can only be used on the first day to avoid gum inflammation

The doctor selects antiseptics after the operation. You should avoid taking medications that contain aspirin, including citramon. Such drugs thin the blood, preventing it from clotting in the hole. An additional visit to the doctor is required if you notice the slightest deviation from the norm, such as swelling, pus, etc.

How to deal with pain?

To relieve pain after tooth extraction, as a rule, non-narcotic analgesics are prescribed, the action of which is aimed at cyclooxygenase (an enzyme that responds to the synthesis of biologically active compounds that produce pain). Many analgesics are recommended for use in the postoperative period, as they are able to fight inflammation. Often analgesics exhibit their side effect in the form of irritation of the gastric mucosa, increased bleeding (analgesics thin the blood). Most often, dentists choose a drug based on the principle of the greatest degree of activity and the smallest list side effects.

• Ibuprofen combats pain well, acting for 12 hours, eliminating any manifestation of inflammation and swelling. In order to reduce the burden on the stomach, it is better to take it after meals.
• Nimesulide (Nimegenzic, Nimesil, Nise) are drugs that act locally on the tooth socket, reducing inflammation. However, it is better for patients with liver pathologies to avoid this drug due to its increased hepatotoxicity.
• Lornoxicam, Meloxicam (Mirlox, Movalis, Xefocam) are drugs that are much stronger in terms of action than nimesulide and ibuprofen. Moreover, they have less impact on the stomach. These remedies eliminate pain for a fairly long period without causing bleeding. Therefore, their use is largely safe.
• Rofecoxib (Vioxx, Rofica) are drugs with strong anti-inflammatory and analgesic effects. It is indicated after complex operations, such as the removal of restored teeth. These medications act simultaneously on two fronts: they remove swelling and relieve pain.

What medications should you not take?

Some drugs, despite their popularity, have an extremely subtle effect, which, moreover, is accompanied by a number of side effects. These include:

• Aspirin or acetylsalicylic acid. It has a minimal analgesic effect, but has an antipyretic effect. They thin the blood, which can cause bleeding from the tooth socket. Has a negative effect on the mucous membranes of the stomach. However, in combination with other drugs, it is quite effective.
• Paracetamol. Paracetamol is an antipyretic in its action. It does not have the desired effect in the fight against inflammation and negatively affects the functioning of the liver. Used in combination with complex drugs.
• No-shpa. This drug, despite everything, is not classified as an analgesic at all. This remedy is an antispasmodic. Thus, no-spa exhibits an analgesic effect if the pain sensation is antispasmodic in nature. In other cases, this medicine is weak.

Nutrition after tooth extraction

Spicy and salty foods are the main irritants for the mucous membranes. They increase pain. Hot food and drinks are factors that affect the condition of blood vessels, dilating them, which provokes bleeding and swelling. Hard foods can cause mechanical damage to the mucous membranes and injure the blood clot. The result is pain and bleeding.

The first meal after surgery should not injure the operated area. This could well be meat broth, yogurt or ice cream (it’s better not to bite into it). Ice cream is recommended by both dentists and otolaryngologists after tonsil removal. Cold causes blood vessels to constrict, reducing the risk of bleeding and reducing swelling.

An urgent problem that worries many patients in the postoperative period is a cold nerve after eating ice cream. You don't have to worry about this. Neuritis can be caused by exposure to a draft or hypothermia. Ice cream should be eaten slowly, without biting into large pieces. Then you can avoid inflammation and cool the area that is bothering you.

net-doctor.org

Root remains inside the gum

Incomplete tooth extraction is the most common problem with such dental surgery.

Symptoms of this type of complication:

• pain in the area of ​​the operation;
• edema;
• development of inflammation.

In some cases, when the patient does not consult the doctor again even in the presence of these manifestations, alveolitis may develop. There are two main reasons for incomplete removal:

The first is rarer: when the doctor was not sufficiently prepared for the operation and simply did not notice the fragment that was formed in the process.

The second reason is the surgeon's conscious decision to leave the fragment. It is dictated by the location foreign body, when removed, an infection may occur or a nerve may be damaged.

To remove the fragment it is necessary to perform a second operation. The patient must pass before her x-ray examination, and the doctor carefully studies the images and plans his actions.

There is another option, which takes longer, and is used when repeat surgery is problematic.

With complete healing using sea buckthorn oil lotions, the fragment will be “pushed out” by the soft tissues on its own.

Bleeding

It also occurs quite often. And this can occur either immediately after surgery or an hour, several hours or even a day after it.

The reasons for this may include some concomitant diseases (hypertension, leukemia, jaundice), as well as the actions of the dentist or the patient himself.

During the operation, the doctor may make some mistakes, for example, damage blood vessels, part of the alveoli or interradicular septum.

Also, bleeding from the socket occurs when it is mechanically damaged, which is the fault of the patient who did not follow the surgeon’s recommendations for rehabilitation.

To avoid a general deterioration in health, you need to see a doctor as soon as possible.

Dry socket

Clear signs of a dry socket are:

• the absence of a visible blood clot in it, instead of which bone visible;
• strong pain;
• inflammation.

The cause of this phenomenon may be the actions of the patient himself:

• Unnecessarily frequent rinsing after surgery;
• drinking “with effort”, for example, through a straw;
• periodic spitting.

For treatment, you must consult a dentist, who will recommend anti-inflammatory drugs, and in difficult cases, he will additionally clean the hole, cover it with a special gel, or prescribe antibiotics.

Temperature

Increase in body temperature during the first two or three days after removal is normal and expected.

The fact is that this is how the body reacts to traumatic intervention. However, higher values ​​(up to 38–38.5 degrees C) can be observed in the late afternoon.

Alveolitis

The main indicator of alveolitis is pain that occurs after a few days which can be very distressing to the patient.

In addition, the following symptoms are present:

• swelling of the mucous membrane at the site of removal and local inflammation;
• there is no normal blood clot in the socket itself;
• difficulty swallowing.

This problem occurs if healing processes are disrupted, which can be caused by non-compliance with the dentist’s recommendations after tooth extraction.

The reason may also be an operation process that turned out to be too complicated due to specific tooth position or other factors.

As a result of this, pathogenic microorganisms from the oral cavity penetrate into an open wound, starting the process of development of alveolitis.

Another option - patient's body weakened by infection, which cannot resist microbes.

If the pain and symptoms only get worse after 3 days, you should definitely visit the dentist. Most often, they are prescribed physical therapy along with general anti-inflammatory drugs and topical ointments.

Osteomyelitis

A more complex disease that sometimes develops after tooth extraction is inflammation of the tissues of the jaw bones. In addition to pain at the site of inflammation, the following symptoms are observed:

• headache;
• general weakness;
• increase in temperature;
• worsening sleep;
• blood pressure surges;
• enlarged lymph nodes.

Treatment can be either surgical, when incisions are made in the periosteum, or classical medication. This should only be done by a professional.

During the rehabilitation period, the patient may be prescribed not only symptomatic treatment, but also local physiotherapy and antibacterial, antiviral, detoxification therapy.

Paresthesia

During the operation nerve endings may be affected, and not always through the fault of the doctor - an option with a complex location, structure and the removal of the diseased tooth is possible.

This can cause neurological complications, one of which is paresthesia - numbness of the tongue. In addition, a feeling of numbness, “pins and needles” sometimes appears in the area of ​​the lips, cheeks and chin.

Your doctor may prescribe injections of medications such as Galantamine and Dibazol, as well as taking vitamins C and B.

Trauma to the alveolar ridge

There are times when it happens removal of part of the alveolar ridge, serving directly to hold the tooth.

If the tooth position is complex and there is insufficient visibility, The surgeon can apply forceps, in addition to the tooth itself, to part of the bone. This causes a strong cosmetic and aesthetic defect, perceived as deformation.

This is especially noticeable when working with the front teeth. Also, the patient himself cannot close his jaws normally and experiences pain.

Treatment involves only bone grafting (alveoplasty) using, most often, artificial bone tissue. To prevent it from moving, special protective membranes are used, which are applied at the last stage of the operation before suturing.

The cost of such an operation can be from 30 thousand rubles, and the use of a membrane, depending on the type and manufacturer, is about 3–9 thousand.

Chipping of adjacent hard tissues

During surgery the surgeon may touch the teeth that are located next to the one to be removed.
The reason for this is that the teeth are too closely spaced or the surgical site is inaccessible, when the doctor has practically no normal access to it.

To prevent this from happening, the doctor must carefully study the preliminary images and think through the operation plan.

In addition, it is very important right choice instruments that the surgeon will use during the removal process.

Damage to the oral mucosa

Most often similar complications occur when the tooth is in an awkward position and requires removal or during a long and complex operation. In this case, a large number of different tools are used.

During the operation when the patient makes awkward movements caused by fear or rejection of what is happening, tools can slip, causing injury varying degrees heaviness to the surrounding soft tissues.

This can also happen if the doctor has not carried out sufficient preparatory actions - separation of the gums, etc.

Dislocation of the temporomandibular joint

This type of injury occurs in most cases when removing molars when the patient needs to open his mouth very strongly and make efforts to do so.

Otherwise, the surgeon simply will not have access to the desired area of ​​the jaw.

If the lower jaw is dislocated, the patient will experience quite severe pain., which makes it possible to almost immediately determine the presence of a problem.

It must be said that For some people who have weakened ligaments due to various diseases, the risk of dislocation is increased.

Treatment consists of having a specialist realign the joint using one of the appropriate methods.

In this case, conduction or infiltration anesthesia is usually used, since the process is quite painful.

Perforation of the floor of the maxillary sinus

Happens only when upper teeth are removed, and this problem in most cases is associated with the anatomical characteristics of the patients.

Gaimorova or maxillary sinus located directly above the alveolar process in the upper jaw.

In some cases, the dividing edge in the form of an alveolar process practically disappears.

To avoid perforation, the doctor will need to perform thorough and detailed preliminary examinations, including x-rays or pantomograms.

If purulent inflammation occurs in the sinus, this is a contraindication for tooth extraction, as it can lead to long-term and very serious problems.

Treatment must be carried out immediately during the same visit to the doctor. If the case is pronounced, then the doctor will close and suture the communication in a certain way using a mucoperiosteal flap.

Sometimes it is enough to apply a thick tampon, which in a few days helps the blood clot to appear in the hole, to close the hole on its own.

Features of manipulations in the presence of a cyst

A cyst forms at the top of the tooth root. It is a formation containing pus inside.

The complexity and peculiarity of operations to remove such teeth is that the doctor will need to completely clean the hole and the additional void formed in it. The pus and infection must be eliminated very carefully.

Otherwise there may be recurrence of cyst, as well as some complications that were discussed earlier - alveolitis and osteomyelitis.

Difficulties in extracting baby teeth

With such an operation, the root of the baby tooth may already be so reabsorbed that The doctor takes the rudiment of a permanent one for him.
This happens very rarely, however, If the germ of a molar tooth is removed from the socket, it will no longer be able to grow.

How to avoid problems after surgery

Very often, the patient’s actions become the cause of complications. The main recommendation before tooth extraction surgery is its timely implementation.

If delayed, this can provoke very serious consequences, which, in addition to the operation itself, will require long-term and complex treatment.

What criteria do you use to choose a reliable doctor?

• his qualification, confirmed by certificates, diplomas and other documents;
• experience work;
• demand– how busy the schedule is;
• honest and complete answers to questions when communicating with the patient, including warning about risks;
• also don't forget about personal recommendations friends, colleagues, relatives and other patients.

Before surgery

• before surgery you can't drink alcohol;
• the doctor should know about all medications taken the day before;
• in a few hours before the appointed time satisfy your hunger;
• Removal should not be performed in a state of severe stress, exacerbation of chronic diseases, or the presence of viral infections(for example, herpes) and acute infectious ENT diseases;
• extremely it is undesirable to carry out such manipulations during the first 3 months after a heart attack;
• high blood pressure on the day of surgery also serves as a reason to postpone it.

After surgery

• Necessarily remove the tampon from the hole after 15–25 minutes after the end of the procedure;
• avoid hard foods and hot foods on the same day and several subsequent ones;
• do not eat for 3–5 hours after leaving the surgeon;
• do not rinse frequently, especially hot or very cold liquid;
• do not touch the formed hole finger, toothpick, brush;
• visit the bathhouse or accept similar "warming" procedures, including visiting the beach on a hot day;
• do not engage in sports in the next few days and avoid any physical activity.

We invite you to watch a video in which a specialist talks about what complications there are and what needs to be done.

zubovv.ru

• What is alveolitis?
• Why does alveolitis occur?
• How does the disease manifest?
• How to treat the complication?
• Main symptoms of perforation
• Diagnosis and treatment
• Bleeding
• Paresthesia

What is alveolitis?

Alveolitis(also called post-extraction alveolitis) is an inflammatory process that sometimes develops after tooth extraction. Inflammation affects not only the hole, it also spreads to the tissues surrounding it.

Alveolitis in most cases is a complication after unsuccessful extraction, accounting for 25-40% of all types of complications. Most often, inflammation develops after the removal of the lower teeth, and in the case of eights, it occurs in 20% of cases.

Important: Normally, healing of the socket is painless and only bothers the patient for the first few days after surgery. Immediately after the tooth is extracted, the hole fills with blood, and after a couple of minutes a blood clot forms in it. It reliably protects the wound from infection and various mechanical damage, acting as a barrier.

After a week or a week and a half, when the wound is covered with new epithelium, the clot disappears. If a blood clot does not form or is insolvent, as well as due to the influence of many other unfavorable factors, an infection enters the wound, resulting in alveolitis.

Why does alveolitis occur?

The disease will make itself felt within a couple of days after tooth extraction. The main reasons for the development of alveolitis:

1. Active mouth rinse on the day of surgery.
2. If the patient does not follow the doctor’s recommendations after tooth extraction.
3. Smoking.
4. Insufficient treatment of the socket after surgery, as a result of which fragments of tooth and pathological tissue may remain in it.
5. Poor oral hygiene.
6. Neglect of diet after surgery (eating hot, cold, spicy foods, drinks).
7. The operation was accompanied by complications.
8. Weakened immunity.
9. Errors and unprofessionalism of the doctor during the process of tooth extraction (violation of antiseptic rules, for example).
10. Systemic chronic diseases of the body.

Read also:

• When and what antibiotics to take after tooth extraction
• General doctor's recommendations after tooth extraction

How does the disease manifest?

How to understand that you have alveolitis? The following symptoms may occur within two or three days after surgery:

• there is no blood clot in the wound,
• the gums are red and inflamed,
• pus began to come out of the wound,
• a gray coating appeared on the surface of the hole,
• increase in body temperature,
• there was a bad smell from the mouth,
• severe pain in and around the socket,
• the cervical lymph nodes became enlarged and began to hurt,
• general condition worsened (weakness, malaise).

Advanced stage The disease is characterized by the following symptoms:

• the pain increases and can radiate to the temple, ear, headaches often occur,
• the temperature remains subferile (37 – 37.5, such temperature indicators are a sign of an inflammatory process),
• the jaw hurts so much that it becomes difficult to chew and talk,
• the mucous membrane around the hole is inflamed and very painful,
• The cheek on the side of the extracted tooth may swell.

Alveolitis – serious illness which requires professional treatment. Without treatment, the disease can develop into more serious problem(osteomyelitis, for example).

How to treat the complication?

Alveolitis is quite easy to diagnose by external signs, as well as by the results of a patient interview. If you have signs of alveolitis, immediately go to the dentist; self-medication is inappropriate here. How is the treatment carried out? Therapy for alveolitis of the socket is as follows:

• local anesthesia is performed,
• the hole is cleared of blood clot remnants,
• the doctor scrapes out granulations, purulent discharge, and tooth remains from the socket ( this procedure called curettage)
• then the wound is treated with an antiseptic,
• A tampon soaked in a special drug is placed on the hole.

After such procedures, the patient is prescribed painkillers, a diet, and oral baths using an antiseptic solution. If the curettage was carried out efficiently, and the patient responsibly followed all the dentist’s recommendations, alveolitis is successfully cured in a few days.

If the patient has contacted the dentist already advanced stage of alveolitis, treatment proceeds as follows:

• after antiseptic treatment and curettage, a tampon impregnated with an antibiotic and drugs that normalize the microflora of the oral cavity and also stop the inflammatory process is placed in the hole,
• such blockades are carried out several times,
• if tissue necrosis has begun, proteolytic enzymes are used, which make it possible to clean the hole from dead tissue, as well as relieve inflammation,
• if the inflammatory process has penetrated inside, the doctor blocks the nerve along its entire length with lidocaine or novocaine. If pain and signs of inflammation do not disappear, the blockade is repeated after 48 hours,
• physiotherapy is used: microwaves, laser, ultraviolet radiation,
• the patient is discharged vitamin complexes, analgesics, sulfonamides,
• if there is a risk of the inflammatory process spreading to nearby tissues, the patient is prescribed a course of antibacterial drugs orally.

Perforation of the bottom of the maxillary sinus

Most often, perforation of the maxillary sinus occurs at its bottom; a number of factors contribute to this:

• the roots of the teeth are located very close to the bottom of the sinus: in some people the thickness of the bone layer between the roots and the bottom of the sinus is less than 1 cm, and sometimes only 1 mm,
• it happens that the root is located in the maxillary sinus itself, they are separated only by a thin mucous membrane,
• The bone layer quickly thins out due to various dental diseases (cyst, periodontitis).

Main symptoms of perforation

Perforation of the bottom of the maxillary sinus, which occurred during tooth extraction, is manifested by the following symptoms:

• in the blood that is released from the hole, air bubbles appear, the number of which increases if you exhale sharply through the nose,
• appear from the nose bleeding from the perforation side,
• The timbre of the voice changes, a “nasality” appears.

Diagnosis and treatment

Diagnosis is usually not difficult and is carried out by interviewing the patient. If there is any doubt and you need to make sure the diagnosis is correct, the following studies can be carried out:

1. Probing the hole makes it possible to make sure that there is no bone bottom in the wound. The instrument passes freely and unhindered through soft tissue.
2. X-ray areas of the maxillary sinuses: the image will show darkening that resulted from the accumulation of blood in the sinuses.
3. CT scan.
4. General blood analysis.

Perforation treatment tactics depends on what changes have occurred in the maxillary sinus after injury to its bottom. If the complication was detected immediately and inflammation did not develop in the sinus, the dentist’s main task is to keep the blood clot in the socket and prevent infection from entering the wound.

A tampon is placed at the bottom of the hole, which is soaked in iodine solution. It is left there for a week until full granulations are formed. In addition, the defect can be closed with a special plastic plate, which separates the oral cavity and sinuses and promotes speedy healing.

The patient is also prescribed a course of antibacterial drugs, vasoconstrictor drops and anti-inflammatory drugs to prevent the development of the inflammatory process.

If perforation was not detected immediately, then after a few weeks acute symptoms will subside, and at the site of the lesion it will form fistula. This process is accompanied by symptoms of chronic sinusitis:

• dull pain in the sinus area that radiates to the temple, eye,
• the nose is constantly stuffy on the side of the perforation,
• pus is discharged from the nose,
• the cheek may swell on the side of the perforation.

Perforation at such an advanced stage is difficult to treat. The only way out is surgery, during which the sinus is opened, all pathological contents are removed from its cavity, treated with an antiseptic, the fistula is excised, and the procedure ends with plastic closure of the defect.

After the operation, the patient is prescribed a course of antibiotics, as well as anti-inflammatory and antihistamines.

Bleeding

After tooth extraction, bleeding may occur, which can be external or hidden. And if external bleeding can be noticed and stopped immediately after surgery in the dentist’s office, hidden bleeding provokes quite large blood losses.

Hidden bleeding makes itself felt by the appearance of hematomas on the cheek, gums, and mucous membrane of the respiratory tract. In particularly advanced cases, the hematoma spreads to the neck and chest.

Bleeding is stopped as follows:

• the wound is opened wide to determine the cause of the hemorrhage,
• the damaged vessel is ligated or cauterized,
• depending on the amount of blood released, the hole is either sutured or drained,
• hematomas resolve on their own over time.

Various injuries after extraction

Since tooth extraction is a full-fledged operation that requires certain knowledge and skills, various injuries occur during the process:

Tooth fracture

The most common fracture encountered in dental practice (read more about what to do if a tooth breaks off here) is the root or crown. This complication can occur under the influence of the following factors:

• anatomical features of the tooth,
• pathological changes in its structure as a result of various diseases,
• restless behavior of the patient during the operation,
• insufficient qualification of the doctor.

Luxation or fracture of adjacent teeth

This happens if the doctor uses an insufficiently stable tooth as a support.

Fracture of the alveolar process

Most often it happens when the upper teeth are removed. Complications may arise due to anatomical features jaw structure, various diseases, and also be the result of excessive force applied by the dentist at the time of tooth extraction.

Damage to the gums

Various soft tissue injuries occur if the dentist removes a tooth in a hurry, in poor lighting, or with improper pain relief.

Pushing the root into soft tissue

Most often occurs when removing upper and lower molars. The reasons for root pushing can be:

• the doctor applied excessive force,
• the alveolar wall was broken off,
• the edge of the alveoli has resolved as a result of the inflammatory process,
• The dentist did not properly fix the alveolar process at the time of tooth extraction.

Pushing the root into the maxillary sinus

This happens if the root is separated from the sinus by a thin mucous membrane and the doctor makes an inaccurate movement with the instrument at the time of tooth extraction. The complication can be determined by interviewing the patient, as well as the results of radiography.

Dislocation of the lower jaw

Dislocation can occur if the patient opens his mouth too wide during surgery, the doctor uses a hammer and chisel, and additional stress occurs on the lower jaw.

Fracture of the lower jaw

This complication is very rare and is the cause rough work dentist

Paresthesia

Paresthesia(neuropathy of the inferior alveolar nerve) is a complication after tooth extraction if the nerve of the mandibular canal is damaged during the operation. The patient may notice symptoms of paresthesia only a few hours after the extraction, since only after this period of time the anesthesia wears off.

A person feels that his tongue, lip, sometimes cheek or even half of his face are numb. There are times when nerve damage makes it difficult to open your mouth (a condition called trismus).

The numbness usually goes away on its own and does not require treatment. But if part of the face remains numb, special therapy is performed. Paresthesia is treated exclusively in a dental clinic or hospital setting, using the following methods:

• physiotherapeutic procedures ,
• injections of vitamin B, B2, C, aloe extract, galantamine, or dibazol.

Changing the position of adjacent teeth

After a tooth is removed, its neighbors begin to gradually move into the vacant space. As a result, the dentition shifts, crowding of teeth may develop, and the chewing load increases. Various malocclusions develop, which negatively affects general condition teeth and oral cavity.

To prevent such consequences, it is necessary to carry out implantation, install a bridge, or use removable dentures.

detstoma.ru

Local

After removal surgery, it is normal to experience slight bleeding, which should stop on its own within a few minutes. How to stop bleeding after tooth extraction is described in a separate publication.

The next day you may experience discomfort, slight swelling and a slight increase in temperature. If the symptoms do not go away within 2-3 days, then you should look for the causes of such symptoms. TO local complications include the following phenomena:

Neuritis of the inferior alveolar nerve

This disease is accompanied by unpleasant and severe pain. They appear the next day after surgery. Signs of its development also include:

• the patient has bad breath;
• swelling is observed;
• the patient feels numbness in the chin and lip;
• the patient experiences discomfort in the area of ​​tooth extraction.

Neuritis occurs due to chronic periodontitis, which affects large premolars located near the canal.

Bleeding

This phenomenon always occurs after surgery and is not a cause for concern. But it happens that after a while the hole begins to bleed again. However, several hours or days may pass after tooth extraction. This condition is called secondary bleeding.

If it occurs a couple of hours after painful procedure, then this is the patient's reaction to adrenaline. The patient receives it along with the anesthetic. This process is called early second bleeding.

It occurs due to the contraction of the walls in the wound, and after a couple of hours the second phase of the drug’s action takes effect. It leads to vasodilation, as a result of which the wound may begin to bleed.

There is even later bleeding, which appears 2-3 days after surgery. This happens as a result of damage to intraosseous arteries, physical activity, and the development of inflammation in the wound.

Socket postoperative pain

It appears 1-3 days after getting rid of the diseased tooth. It is very strong, torments patients at night, and only goes away slightly after taking analgesics. The cause of such pain is the development of:

Pain can also occur as a result of sharp or protruding edges of the bone socket, when complete absence clot. This complication is eliminated by grinding the edges. If there is no clot, the walls of the wound are simply brought closer to each other.

Are common

Let's look at the most common consequences that occur after getting rid of a tooth.

Fainting and collapse

It appears in people who have signs of acute vascular insufficiency. Such phenomena are caused by an unstable state of a person’s psyche, which arose while waiting or feeling pain before or during the procedure.

Signs of fainting or collapse include pale skin of the patient, weak pulse, or the formation of cold sweat.

Allergic reaction

It manifests itself in the form of Quincke's edema, urticaria or anaphylactic shock.

• The safest reaction in this case is hives. Manifests severe itching, rash, barely noticeable swelling of the face.
• Anaphylactic shock is expressed by disturbances in the respiratory, cardiac and arterial systems.
• At angioedema the patient experiences nervousness and fear. Symptoms include swelling of the upper or lower airways.

Perforation of the maxillary sinus

The main signs of such a complication are bleeding from a wound that causes blisters to form. Also, while eating, the patient begins to feel it in the nose. Another sign of perforation is severe and persistent pain.

This is caused by the inept actions of the dentist, as a result of which tooth extraction is difficult and traumatic. Physiological characteristics can also cause the formation of perforation. For example, with increased bone fragility.

Hemorrhage into soft tissues

If external hemorrhages are detected immediately, then hidden ones proceed unnoticed. In this case, the patient loses a large amount of blood. Hidden hemorrhages lead to the formation of hematomas on the gum or cheek. They can even reach the chest or neck area.

If a tooth with a cyst was extracted

As a rule, the cyst is diagnosed in the later stages. Quite often, the doctor decides to remove not only it, but also the tooth on which it formed.

Such an operation can have serious consequences.. They occur due to fragments that remain in the jaw, which can serve as an impetus for the development of a new cyst.

Complications also include consequences such as a fracture or dislocation of the jaw. It occurs as a result of the removal of teeth with large roots or with a voluminous cyst.

It is not immediately possible to diagnose such a complication, since the patient is under anesthesia. The symptoms that appear at first are similar to inflammation of the wound or the development of infection.

To eliminate this consequence, the doctor applies a bandage and prescribes medications. Depending on the situation, these may be antibiotics or anti-inflammatory drugs. To maintain the patient’s immunity, the doctor prescribes vitamin complexes.

Treatment

In case of severe pain it is possible taking painkillers. Treatment measures are primarily aimed at eliminating unpleasant symptoms. Depending on the diseases that led to complications, the doctor prescribes certain procedures and medications.

Elimination of local complications

1. If neuritis is suspected, the patient should visit a neurologist. The doctor will prescribe complex therapy, which includes a visit to electrophoresis with novocaine, injections with vitamin B1 and a course of analgesics.
2. To cope with bleeding, you must first remove blood clots from the socket and dry it. Next, use an antiseptic spray. The next steps must be carried out by the dentist. He will be able to assess where the bleeding is coming from and the extent of its development.

   As a therapeutic method, doctors use turunda, which is impregnated with iodoform. To keep it in the hole, the doctor fixes it with sutures. To stop bleeding, special agents, such as Vikasol, are administered. After a week, the patient must visit the dentist again.

3. Treatment of alveolitis is carried out only by a doctor. First of all, he removes the remaining clot and applies a disinfectant to the wound. Fills the removal site with a tetracycline-type medication. For better effect You can undergo a course of laser therapy or other physical procedures. The maximum treatment period is 5 days. Limited osteomyelitis is treated in the same way, but the patient is not allowed to go home, but is placed in a hospital.

Elimination of common complications

Collapse a more serious condition that requires the administration of steroid medications. If the patient is not brought out of this state within 3 minutes, then he is subject to hospitalization.

Allergic reactions require taking antihistamines. At anaphylactic shock the patient is given a large dose of hormones and other drugs, after which he is urgently hospitalized.

At angioedema They soak the places where the allergen was introduced with adrenaline. They also resort to taking antiallergic drugs and prednisolone.

At perforation of the intramaxillary sinus It is important to create conditions for the formation of a blood clot. It is necessary for normal wound healing. In more advanced cases, they resort to treating the removal site with an antiseptic drug. After that, stitches are placed on the wound, while its edges are not stretched.

At massive hemorrhages the doctor opens the wound and determines the cause of hemorrhage. Then the damaged vessel is pierced and cauterized with an electrocoagulator.

Hematomas formed as a result of hemorrhage, resolve on their own. This takes no more than 2 weeks. To speed up the process, you can periodically apply dry heat to them.

Routine tooth extraction can lead to serious consequences. To make this procedure as soft as possible, it should be carried out in a trusted clinic, and after the operation, carefully follow the doctor’s recommendations. Many complications arise due to improper patient care for the formed hole..

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