Features of the innervation of the upper and lower jaw
The upper and lower jaws are innervated, respectively, by the superior and inferior alveolar nerves, which are branches of the trigeminal nerve (the main sensory nerve of the head and face) and form the superior and inferior alveolar nerve plexuses.The superior and inferior alveolar nerves innervate the following anatomical structures:
- gums;
- periodontium – a complex of tissues surrounding the tooth root;
- teeth: dental nerves along with blood vessels enter the pulp through an opening at the root apex.
How long does pain last after tooth extraction?
Typically, pain persists for 4 to 7 days.Factors on which it depends:
- complexity of intervention: location of the tooth (incisors, canines, small or large molars), condition of the tooth and its surroundings bone tissue, dimensions of the tooth root;
- following the dentist's recommendations after removal: if they are performed, then pain can be completely avoided;
- doctor's experience, how carefully the doctor removes teeth;
- equipment dental clinic : the more modern instruments used for tooth extraction, the less pain will bother you;
- patient characteristics: Some people feel pain more acutely, others not so much.
What to do if the pain persists for a long time?
The best solution is to contact your dentist again for an examination and consultation. Painkillers can be used as a temporary measure.
What does the hole look like after tooth extraction?
After tooth extraction, a small wound remains. Stages of socket healing after tooth extraction:
| 1 day | A blood clot forms in the lenka. It is very important for the normal healing process. Under no circumstances should it be torn off or picked out. |
| 3rd day | First signs of healing. A thin layer of epithelium begins to form on the wound. |
| 3 – 4 days | Granulations form at the site of the wound - connective tissue, which is involved in the healing process. |
| 7 – 8 days | The clot has already been almost completely replaced by granulations. Only a small part of it inside the hole is preserved. On the outside, the wound is actively covered with epithelium. New bone tissue begins to form inside. |
| 14 – 18 days | The wound at the site of the extracted tooth is completely overgrown with epithelium. The clot inside is completely replaced by granulations, and bone tissue begins to grow into them. |
| 30 days | New bone tissue fills almost the entire hole. |
| 2 – 3 months | The entire hole is filled with bone tissue. |
| 4 months | The bone tissue inside the socket acquires the same structure as the upper or lower jaw. The height of the edges of the socket and alveoli decreases by approximately 1/3 of the height of the tooth root. The alveolar ridge becomes thinner. |
The wound at the site of the extracted tooth goes through all the described stages only if prosthetics are not performed.
What should you do after tooth extraction?
Usually, after tooth extraction, the dentist gives recommendations to the patient. If they are strictly followed, you can either avoid toothache completely or significantly reduce its intensity and duration.- Avoid physical activity. Rest should be passive whenever possible. At least during the first two days after tooth extraction.
- Do not eat during the first 2–3 hours after the procedure. Food injures the fresh wound and leads to pain, which can subsequently persist for a long time.
- For several days, you should not chew food on the side where the tooth was removed.
- Avoid smoking and drinking alcoholic beverages for several days. Cigarette smoke and ethyl alcohol irritate the mucous membrane of the gums, causing the development and intensification of pain.
- Do not touch the hole with your tongue, touch it with toothpicks or any other objects. There is a blood clot in the socket, which is very important for healing. If food particles get into the hole while chewing, then you should not try to remove them: you can remove the clot along with them. It is better to rinse your mouth after eating.
- Mouth rinses after tooth extraction are useful. But you shouldn't start them from day one.
- If the pain intensifies, you can take painkillers. But before doing this, it is highly advisable to consult a doctor.
How to rinse your mouth after tooth extraction?
Mouth rinses can be started from the second day after tooth extraction. In this case, solutions prescribed by the dentist are used. | A drug | Description | Application |
| Chlorhexidine | Antiseptic. Used to prevent infection of the socket after tooth extraction. Sold in pharmacies in the form of a ready-made 0.05% aqueous solution for mouth rinsing, which has a bitter aftertaste. | Rinse your mouth several times a day. While rinsing, keep the solution in the mouth for at least 1 minute. |
| Miramistin | Antiseptic solution. Its ability to destroy pathogens is inferior to chlorhexidine solution, but is active against herpes viruses. Available in bottles that come with a spray nozzle. | Rinse your mouth with Miramistin solution 2 - 3 times a day. While rinsing, keep the solution in the mouth for 1 - 3 minutes. |
| Soda-salt baths | Rinse your mouth with a strong solution of salt and table soda. As a rule, it is recommended by dentists in cases where there is an inflammatory process in the gum, when an incision was made in order to release pus. | |
| Herbal infusions | Sold ready-made in pharmacies. It is preferable to use infusions of chamomile, calendula, and eucalyptus. They have a weak antiseptic effect (much weaker than Chlorhexidine or Miramistin) | Rinse your mouth 2 – 3 times a day. While rinsing, keep the solution in the mouth for 1 - 3 minutes. |
| Furacilin solution | Furacilin is an antimicrobial agent that is effective against many types of pathogens. Available in two forms:
| Rinse your mouth 2 – 3 times a day. While rinsing, keep the solution in the mouth for 1 - 3 minutes. |
How to rinse your mouth properly after tooth extraction?
On the first day after tooth extraction, mouth rinses are not performed. The blood clot that is in the hole is still very weak and can be easily removed. But it is extremely important for normal healing. Start rinsing your mouth from day 2, as prescribed by the dentist. In this case, intensive rinsing is unacceptable, as it can lead to the removal of a blood clot. Baths are performed: the patient takes a small amount of liquid into the mouth and holds it near the hole for 1 to 3 minutes. The liquid is then spat out.
How to eat properly after tooth extraction?
In the first 2 hours after tooth extraction, you must refrain from eating. During the first day, you should not eat hot food, as it will irritate the wound and lead to increased pain. - eat only soft foods
- avoid sweets and very hot foods
- do not drink drinks through a straw
- give up alcohol
- do not use toothpicks: replace them with mouth rinses (baths) after each meal
How long can a socket bleed after tooth extraction?
Bleeding after tooth extraction may continue for several hours. If during this time an admixture of ichor appears in the saliva, this is normal. Measures that can be taken if severe bleeding occurs several hours after tooth extraction:
- Bite the gauze swab on the hole and hold it for a while. The bleeding must stop.
- Apply cold to the place where the extracted tooth is located.
Swelling of the cheek after tooth extraction
Causes.
Tooth extraction is considered a microsurgical intervention in dentistry. This is a trauma for the tissues of the oral cavity. After complex extractions (irregularly shaped tooth roots, lack of a crown, removal of a wisdom tooth), swelling almost always develops. Usually it is not very pronounced and does not last long (depending on the complexity of the intervention). If the swelling is quite severe and persists for a long time, then most likely it is caused by an inflammatory process.
Possible causes of the inflammatory process that causes swelling of the cheek after tooth extraction:
- errors in the doctor’s compliance with the rules of asepsis and antisepsis during tooth extraction
- violation of the dentist's recommendations by the patient
- insufficient sanitation (cleansing of pathogenic microorganisms) by the dentist of the wound after tooth extraction
- allergic reactions to medications, which were used during the manipulation;
- decrease in the patient's immune defenses
What to do?
If after tooth extraction there is slight swelling on the face, its resorption can be accelerated by the following measures:- in the first few hours - applying cold to the cheek
- subsequently, apply dry heat.
- the swelling is very pronounced
- swelling does not go away for a long time
- severe pain occurs that lasts for a long time
- body temperature rises to 39 – 40⁰C
- the general well-being of the patient is disrupted: headache, increased fatigue, drowsiness, lethargy
- over time, these symptoms not only do not decrease, but also increase even more
Increase in body temperature after tooth extraction
Causes.
Normally, body temperature can rise within 38⁰C for no longer than 1 day. Otherwise, we can talk about the development of an inflammatory process. Its causes and main symptoms are similar to those described above when considering cheek swelling.What to do?
If the body temperature rises within 38⁰C on the first day, it is enough to simply follow the recommendations given by the dentist. If the temperature rises and persists for a long time, you must visit the dentist or call a doctor at home.Complications after tooth extraction.
Dry hole.
Dry socket– the most common complication after tooth extraction. It is this that is the main cause of the development of a more serious complication - alveolitis. Causes of dry socket:
- no blood clot formed in the socket after tooth extraction
- a clot formed, but was then removed due to eating hard foods on the first day after removal, rinsing too vigorously, and trying to remove food trapped in the socket using toothpicks and other hard objects.
If you suspect that you have this complication, you should visit your dentist as soon as possible. As a rule, the doctor applies compresses to the tooth with medicinal substances and gives the patient further recommendations. The main goals of dry socket treatment are to speed up the healing process and prevent the development of alveolitis.
Alveolitis.
Alveolitis– inflammation of the dental alveolus, the cavity in which the tooth root was located.Causes of alveolitis:
- The patient’s violation of the dentist’s recommendations after tooth extraction and the rules of oral hygiene.
- Damage and removal of a blood clot located in the socket. Most often this happens when trying to get stuck food particles out, during intensive rinsing.
- Insufficient treatment of the hole, violation by the dentist of the rules of asepsis and antisepsis during tooth extraction.
- Reduced immunity in the patient.
- A few days after tooth extraction, the pain increases with renewed vigor and does not go away.
- Increased body temperature over 38⁰C.
- The appearance of a characteristic bad breath.
- Touching the gums is accompanied by severe pain.
- Deterioration of the patient's well-being: headache, increased fatigue, drowsiness.
Treatment of alveolitis
If the symptoms described above occur, you should immediately visit your dentist.
Activities that take place in the dentist's office:
- Anesthesia (injection into the gums of a solution of lidocaine or novocaine).
- Removing the infected blood clot, thoroughly cleaning the socket.
- If necessary - curettage holes - scraping it, removing all foreign bodies and granulations.
- Treating the inner surface of the hole with antiseptic solutions.
- A tampon soaked in medicine is placed on the hole.
Antibiotics used
| Drug name | Description | Mode of application |
| Josamycin (Valprofen) | Strong enough antibacterial drug, which rarely, unlike others, develops resistance on the part of microorganisms. Effectively destroys most pathogens of inflammatory diseases of the oral cavity. Available in the form of 500 mg tablets. | Adults and adolescents over 14 years of age take the drug in a dosage of 1–2 g per day (usually initially prescribed 1 tablet of 500 mg once a day). The tablet is swallowed whole, washed down with a small amount of water. |
| Hexalize | Combination drug, which includes the following components:
| Adults are prescribed 1 tablet every 2 hours. Maximum daily dose– 8 tablets. |
| Hexasprey | Almost an analogue of Hexaliz. The active substance is Biclotymol. The drug is available in cans as a spray for spraying in the mouth. | Inhalation is carried out 3 times a day, 2 injections. |
| Gramicidin (Grammidin) | Grammidin is a powerful antibiotic that destroys most pathogens present in the oral cavity. Available in the form of lozenges, each of which contains 1.5 mg of active substance (corresponding to 500 action units). | Prescription for adults and children over 12 years of age: 2 tablets 4 times a day (take one tablet, 20 minutes later - the second). Prescription for children under 12 years of age: 1 – 2 tablets 4 times a day. Total duration Taking Gramicidin for alveolitis usually lasts from 5 to 6 days. |
| Neomycin (synonyms: Colimycin, Mycerin, Soframycin, Furamycetin) | Broad spectrum antibiotic – effective against a large number of types of microorganisms. | After cleaning the hole, the dentist puts powder into it Neomycin and covers it with a tampon. Soon after this, pain and other symptoms of alveolitis disappear. It is often necessary to repeat the procedure after 1 – 2 days. |
| Olethetrin | Combined antibacterial drug. Is a mixture Oleandromycin And Tetracycline in a ratio of 1:2. | Olethetrin used similarly Neomycin: Antibiotic powder is placed in the hole. Sometimes, to reduce pain, a local anesthetic, anesthesin, is added to the antibiotic. |
Complications of alveolitis:
- periostitis– inflammation of the periosteum of the jaw
- abscesses and phlegmons– ulcers under the mucous membrane, skin
- osteomyelitis– inflammation of the jaw
Rare complications after tooth extraction
Osteomyelitis
Osteomyelitis is a purulent inflammation of the upper or lower jaw. Usually a complication of alveolitis. Symptoms of osteomyelitis of the jaw:
- strong pain, which increases over time
- pronounced swelling on the face at the site of the extracted tooth
- increase in body temperature
- health problems: headaches, increased fatigue, drowsiness
- inflammation may subsequently spread to adjacent teeth, capture increasingly larger areas of bone, while the patient’s well-being worsens
Directions of treatment:
- surgical intervention
- use of antibiotics
Nerve damage
Sometimes, during tooth extraction, a nearby nerve may be damaged. This happens when the tooth root has an irregular, complex shape, or when the dentist is insufficiently experienced.If the nerve is damaged during tooth extraction, numbness of the oral mucosa in the cheeks, lips, tongue, and palate is observed (depending on the location of the tooth). Nerve injuries are usually minor and resolve within a few days. If recovery does not occur, you should consult a doctor. Physiotherapy will be prescribed.
From this article you will learn:
- How much can you not eat after tooth extraction?
- what antibiotics and rinses to use,
- How long after you can smoke after tooth extraction?
The article was written by a dental surgeon with more than 19 years of experience.
If you have just had a tooth removed, it is very important to know what to do after tooth extraction. This will prevent inflammation of the socket, the development of bleeding or swelling, which often arise due to errors in patient behavior.
For example, very often patients strongly rinse their mouth, which leads to the loss of a clot and the development of suppuration, or take aspirin (promotes bleeding and the formation of hematomas)... Also at the end of the article you can see how the holes of extracted teeth should normally look at different times after extraction .
A tooth was removed: what to do after removal
All recommendations below are based on their personal 15 years of experience as an oral surgeon, as well as academic knowledge. But if something is unclear to you, you can ask your question in the comments at the bottom of the article.
1. What to do with a gauze swab -
A tooth was removed today: what to do after removal with a gauze swab on the socket... A swab soaked in blood is an excellent breeding ground for infection. And the longer you keep it in the mouth, the greater the risk of developing inflammation in the socket of the extracted tooth. If you still have a gauze swab on your socket, you need to remove it urgently. It is advisable to do this without jerking and not strictly vertically, but sideways (so as not to pull out the blood clot from the hole along with the tampon).
An exception may be a situation where the hole is still being touched up - in this case, the gauze swab can be held for a little longer. But it’s best to spit out this old gauze swab soaked in saliva and blood, make a new one from a sterile bandage, and place it on top of the hole (biting firmly).
10. If blood comes from the hole -
11. If you have high blood pressure -
If you regularly measure your blood pressure, if it is higher than normal, take the appropriate medication. Otherwise, there is a very high risk of bleeding or hematoma formation. The first can lead to weakness and dizziness, and the formation of a hematoma is fraught with its suppuration and the need to open it.
12. If you have diabetes –
If you have a device for determining blood sugar at home, it is advisable to immediately measure your sugar. The stress of removal contributes to the release of adrenaline, the concentration of which largely determines blood sugar levels. This will help you prevent feeling unwell.
13. Removal of sutures after removal –
After tooth extraction, the sutures are usually removed no later than 7-8 days. However, suture removal may not be necessary if the suture material For example, catgut is used. This material dissolves on its own within 10 days. When you see that the seams are very loose, you can simply remove them with clean fingers.
14. Treatment of teeth after extraction –
It is advisable to continue treatment after tooth extraction no earlier than 7 days later. If the removal was difficult, then sometimes it may take up to 14 days. This is due to the fact that carious teeth contain a lot of pathogenic infection, which, when drilling a tooth, can easily get into a blood clot and lead to suppuration.
What should a socket of an extracted tooth normally look like?
As you will see below, the blood clot after tooth extraction first has an intense burgundy color. Gradually, the surface of the clot becomes whitish/yellowish (this is normal, because fibrin effusion occurs). Normally, the blood clot should be dense the next day. If the clot becomes loose, this means it is disintegrating, and you should familiarize yourself with 
Oral care after tooth extraction –
The oral cavity requires careful care after tooth extraction. Teeth should be brushed as usual, including the group of teeth in the area of the extracted tooth. The latter are simply cleaned more carefully so as not to injure the blood clot. You also need to carefully rinse your mouth from foam so as not to rinse the clot out of the hole.
You also need to care for your gums after tooth extraction (antiseptic baths, which we described above, are sufficient for this). But the lack of proper hygiene will cause the accumulation of soft microbial plaque, which is fraught with suppuration of the hole and the development of alveolitis. We hope that the article on the topic: Tooth pulled out, what to do - was useful to you!
Complications after tooth extraction can occur in any person, since this procedure involves surgical intervention. Often they are caused by erroneous actions of a specialist. Sometimes the patient himself is to blame for the negative outcome of the operation. But before you start worrying, you need to understand the seriousness possible consequences. In addition, it is worth distinguishing between two concepts - “consequences”, which are the norm after any operation, as well as “complications”, which require prompt contact with a specialist. About the latest and we'll talk Further.
Important! Complications can arise both during the operation - they are called early, and in the first days of tissue healing. They are usually called delayed or late complications.
Consequences: how to separate them from complications
Below we will discuss what is considered normal after tooth extraction.
1. Increased body temperature
The first couple of days after surgery, your temperature may rise. If the thermometer shows a little over 37, and in the evening the readings rise to 38 degrees, this means that tissue restoration is actively undergoing a process. If a very high temperature lasts for more than three days, you should visit a dentist. Most likely, an infection has entered the wound, which requires a prompt resolution of the issue.
2. Pain in the area of the extracted tooth
The patient may feel pain at the site of tooth extraction. The tissues hurt because when the root is extracted, they are injured. Minor pain is again a normal reaction of the body. The discomfort will soon go away on its own. But if the pain only intensifies, does not go away within 2-3 days, and is not relieved by painkillers, you should immediately consult a doctor.
3. Tissue swelling
Swelling often develops after the procedure. A slightly swollen gum or cheek is not a reason to panic. Just apply cold on the side of your cheek (but do not overcool - it is better to wrap ice or meat from the freezer in a towel). Increasing swelling that does not decrease after 3 days is a sign of inflammation, so it is better to see a doctor.
4. Bleeding from the socket
A fairly common occurrence is bleeding. The socket may begin to bleed immediately after removal or several hours later. This usually occurs as a result of damage to small vessels of the soft tissues of the tooth. The patient himself can damage the wound if he violates the doctor’s recommendations for rehabilitation. Normally, the bleeding should stop within half an hour. Light bleeding over a couple of hours is not a problem. To speed up the healing process, simply apply something cold to the sore cheek. It is imperative to hold the tampon that the doctor placed on the gum. If the bleeding is severe and for a long time does not stop, again you should consult a doctor.
Important! Some vascular diseases and hematopoietic system(hemophilia, acute leukemia, scarlet fever, infectious hepatitis, etc.), medications and high blood pressure prevent blood clotting. In patients with such pathologies, bleeding may continue longer. It is also recommended to take appropriate medications in order to normalize this process.
5. Hematoma
It is also an absolutely normal process, especially when removing complex teeth. For example, impacted, i.e. those located inside bone tissue. Or have many branched roots. A hematoma often appears on the cheek on the side of the operation.
Complications: when is it time to see a doctor?
This section lists problems that require prompt medical attention.
1. Dry socket and tissue inflammation
But this is no longer a normal consequence, but a complication. If a blood clot has not formed in the socket, if it has been damaged or dissolved, the patient will face the problem of a dry socket. It is accompanied by slight pain and extremely unpleasant odor from the mouth. The clot is necessary for tissue rehabilitation to take place quickly and efficiently. Its damage leads to inflammation of the socket, which requires consulting a doctor and drug therapy.
2. Paresthesia or nerve damage
A numb tongue or paresthesia develops if nerve endings are damaged during complex extraction (tooth extraction). In addition, “goosebumps” are sometimes felt on the lips, cheeks, and chin. In cases where the unpleasant feeling does not go away for a long time, the doctor prescribes medicinal injections and vitamins B and C. Physiotherapeutic procedures are prescribed.
3. Alveolitis of the socket
This is the most common and serious complication that can develop during the extraction of any teeth.
With alveolitis, as a result of disruption of the healing processes, inflammation of the tissues of the tooth socket occurs. Possible reason– ignoring the dentist’s postoperative recommendations. Or bacteria that have penetrated an open wound and triggered the development of the inflammatory process. The patient experiences severe pain in the area of the missing tooth, difficulty swallowing, and swelling of the gums is possible. If these symptoms intensify after three days, you should immediately consult a dentist. He will prescribe physical therapy and select certain medications, and clean the hole from inflamed tissue.
Important! Rinsing during the healing period of the hole is contraindicated - they can damage the blood clot and thereby provoke the development of alveolitis. The broth should be cooled to room temperature, then taken into the mouth and held for about three minutes.
4. Osteomyelitis of the jaw
Osteomyelitis is purulent-inflammatory processes in bone tissue that develop due to infection. The course of the disease is characterized by bursting pain at the site of infection, general weakness, sweating, and fever. A slight swelling is noticeable in the affected area, the skin is hot and changes color. Over time, the swelling grows and a purulent fistula forms in its place. The patient is treated strictly in a hospital. After tooth extraction, osteomyelitis does not occur often - as a rule, inflammation spreads to the entire upper or lower jaw if the patient does not treat the alveolitis.
Symptoms and causes of the development of pathologies
Remember these manifestations: they all indicate that you need to immediately consult a doctor - often this is an indicator that the healing process of the hole is not going well.
The danger of tooth extraction in pregnant women and children
There is no categorical prohibition on removal for pregnant women. However, during this period, women are prohibited from taking most medications, including antibiotics. A high load during surgery can affect your well-being. expectant mother and a child. Therefore, if possible, it is better to refuse this procedure. But it is also worth remembering that a diseased tooth, affected, for example, is a breeding ground for infection, which can cause much more damage than such a surgical intervention.
Which local complications can occur in pregnant women? As a rule, simple extraction of incisors and molars ends successfully. But with difficult removal there is a high risk of bleeding, sharp increase temperature, occurrence acute pain, general deterioration of the pregnant woman’s condition and the development of inflammatory processes. In some cases, you will need to take antibiotics. It is also worth remembering that a woman in the “position” is quite sensitive emotionally, so even a simple procedure for removing teeth can provoke a miscarriage. early stages or premature birth in the 3rd trimester.
U small child or young children, complications usually do not occur. But if the dentist was not careful, the roots of a baby tooth could break. Removing debris remaining in the hole can cause severe inflammation. You also need to make sure that the child does not touch the wound.
Treatment and prevention of severe consequences
If after 2-3 days the pain has not subsided, it radiates to the ear, neck, the temperature has not returned to normal, the swelling has not gone away, bad smell from the mouth you need to rush to the dentist. The doctor will determine the cause of the problem and, if necessary, treat complications:
- cleans the hole from suppuration, removes root fragments,
- treat the wound with an antiseptic,
- apply a therapeutic application (bandage),
- will prescribe certain drug therapy: antibiotics, medications.
Following the following preventive recommendations will help you avoid serious consequences after surgery:
- remove the gauze swab no later than after 20 minutes,
- refrain from eating for about 3 hours,
- exclude hard, spicy foods, hot dishes from your diet for three days,
- brush your teeth gently, do not rinse,
- temporarily exclude sports activities and thermal procedures.
To reduce the risk of serious complications, you just need to carefully monitor your well-being, and if alarming symptoms occur, consult a specialist. And if you had to deal with tooth extraction, then it’s time to think about restoring your smile, the most the best option however, today it remains .
Video on the topic
Despite high level modern dentistry, sometimes it becomes necessary to remove one or even several teeth.
In essence, this procedure is a real surgery. During or after it, certain unpleasant problems may arise. consequences and complications.
The occurrence of complications is influenced by quite a few reasons. For example, the actions of the patient himself, incorrect manipulations by the doctor, diagnostic deficiencies or factors independent of this.
It is useful for patients to know about the types of possible consequences of exodontia (tooth extraction) and methods to counteract them.
Root remains inside the gum
Incomplete tooth extraction is the most common problem with such dental surgery.
In severe cases, surgery has status "difficult". This formulation means that a root or a fragment of it remains inside the gum after tooth extraction.
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 of the foreign body, which, when removed, can lead to infection or damage to the nerve.
To remove the fragment it is necessary to perform a second operation. Before the procedure, the patient must undergo an 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.
Bleeding from a tooth socket after surgery
The reasons for this may include some accompanying illnesses(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 stop the bleeding, apply cold (ice) to the affected gum or cheek.
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 difficult cases will additionally clean the hole and close it 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.
If after two or three days the temperature continues to rise or exceeds 39 degrees C, you need to contact your dentist.
Alveolitis
The main indicator of alveolitis is pain that occurs after a few days which can be very distressing to the patient.
Changes in the gums that occur with postoperative alveolitis
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;
- temperature increase;
- 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 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.
If treatment for alveolitis is not started immediately, this can cause inflammation and infection to spread into the deep layers, which is likely to lead to osteomyelitis.
Treatment can be either surgical, when incisions are made in the periosteum, or classical medication. This should only be done by a professional.
During rehabilitation period the patient may be prescribed not only symptomatic treatment, but also local physiotherapy and antibacterial, antiviral, and detoxification therapy.
Local manifestations of jaw inflammation after tooth extraction
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.
What does the alveolar ridge look like?
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.
Tools can damage your gums or cheek
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 is associated in most cases with anatomical features patients.
Gaimorova or maxillary sinus located directly above the alveolar process in upper jaw.
Location of the maxillary maxillary sinus
In some cases, the dividing edge in the form of an alveolar process practically disappears.
The roots of some teeth may reach the sinus cavity quite a bit and even go directly into it.
To avoid perforation, the doctor needs to conduct thorough and detailed preliminary examinations, including X-ray images or pantomogram.
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.
Photo of tooth extraction with cyst
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 chronic diseases, availability 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.
If you find an error, please highlight a piece of text and click Ctrl+Enter.
What do you do after tooth extraction? In most cases, while still in the corridor of the clinic, the patient begins to examine the postoperative (and tooth extraction is a real operation) wound, and quite often its appearance instills a feeling of fear in the person. But the main questions arise after the anesthesia wears off, when the pain returns: is this normal, could the pain indicate the development of a complication, is the gum in a normal state after tooth extraction and how long can the bleeding last and is this normal? This article will provide materials that will help clarify the situation and answer frequently asked questions.
Preparing for the tooth extraction process
If the patient is interested in the process of tooth extraction even before the manipulation itself, then below is briefly presented information that will allow you to avoid most complications after the procedure:
You should not postpone this procedure until pain occurs. Pain syndrome indicates that an inflammatory process is developing in the tissues and if such pathological process reaches the gum, it swells, loosens and its blood supply increases. Removing a tooth from such a gum will lead to prolonged bleeding, which will differ in intensity from normal. In addition, if the cause of pain is the formation of a cyst (a hollow formation with dense walls, the cavity of which is filled with pus) on the crown of the tooth, then during dental procedures the risk of infection of the jaw bone, gums or tooth socket increases.
If a woman is to undergo a tooth extraction procedure, It should not be planned during menstruation: at this time, bleeding will last longer, since the body’s strength in relation to blood clotting weakens.
It is better to schedule a visit to a dental surgeon for the first half of the day. In such cases, when removing wisdom teeth or other complex manipulations, you can resolve the issues that arise during the day, rather than looking for 24-hour dentistry.
Local anesthesia. If the patient of the dental surgeon is an adult and the manipulation does not involve general anesthesia, it is advisable to eat before performing the procedure. Thus, prevention of a decrease in blood glucose levels during the period surgical manipulation, also in a well-fed person, the blood clotting process occurs faster.
When planning general anesthesia , you need to see a dentist before the procedure itself; the doctor will conduct a general examination and schedule a consultation with an anesthesiologist. Such anesthesia, on the contrary, excludes the consumption of food and even drinking. The last meal should be taken 4-6 hours before surgery, since the administration of drugs can provoke vomiting, and the vomit, in turn, threatens to enter the respiratory tract.
You should tell your doctor if you have any allergies to medications or drugs you are taking. this moment medications. If you are planning to remove a tooth in a person with cardiac pathologies, which involve constant use of blood thinning medications, you should inform the dental surgeon about this, and also consult with your attending cardiologist regarding short-term withdrawal of data pharmaceuticals. In such cases, if you stop taking Cardiomagnyl, Warfarin and do not inject Fraxiparine and Clexane the day before dental surgery and avoid taking them for another 48 hours, you can avoid the development of bleeding in the postoperative period. If the patient did not have time to complete this action, it is necessary to inform the surgeon about the availability of such treatment. It is also necessary to tell your doctor all the specifics of your existing allergies.
Brief information about the extraction procedure
As mentioned above, tooth extraction is a full-fledged operation. It involves the same steps as for other surgical interventions:
treatment of the surgical field;
anesthesia.
Before the intervention, a local anesthesia is used, namely, a local anesthetic is injected into the area where the nerve exits that innervates the required tooth. Modern drugs with this effect are contained in special ampoules - carpules. In addition to the anesthetic itself, such carpules also contain a vasoconstrictor substance. This is necessary in order to reduce the amount of blood lost during the manipulation process.
In some cases, the dentist uses local anesthetics that do not contain such vasoconstrictors. They are added independently, and the doctor may further increase the dose of such drugs. It is also worth noting that when the drug is introduced into the area of inflammation with acidic pH reactions, part of the anesthetic is inactivated, as a result of which additional anesthesia may be required. Both points are very important in the postoperative period.
Direct removal.
After gum numbness and anemization (narrowing blood vessels), the dental surgeon proceeds to the process of direct tooth extraction. This requires loosening the ligament that holds the tooth and in some cases this must be done using a scalpel. The tools and time of manipulation are determined by the doctor and can be different, it all depends on the severity of the situation.
The operation is completed by treating the resulting wound.
If the gum edges are far apart, or in cases of traumatic extraction, a suture may be required to close the wound. If there is no such need, a gauze swab soaked in a special hemostatic solution is placed over the injury, which is pressed into the hole with two jaws. The essence of stopping bleeding lies not only in the hemostatic drug, but also in compressing the wound. Therefore, you should not rush to change the tampon when it is soaked in blood, but rather press it well to the gum with your jaws.
Postoperative period – anesthesia is still in effect
Usually the algorithm is as follows: the doctor removes the tooth, places a gauze swab and orders you to hold it for about 15-20 minutes, then spit it out. In the future, in the best case, the wound is examined for bleeding, and after the doctor is convinced that the bleeding has stopped, the patient is sent home; in the worst, the patient goes home, throwing away the tampon along the way.
Pain– in the first 3-4 hours after the manipulation, the anesthetic still continues to act, so the pain from extraction is either not felt at all or is barely felt. A kind of exudate with streaks of blood - ichor - is released from the hole. Its separation continues for 4-6 hours, and this is visible when spitting and opening the mouth. If a wisdom tooth was removed, then given its abundant blood supply and a significant area of trauma in the area of the operation, ichor may be released within 24 hours.
Hole after tooth extraction it looks like this: there is a clot of scarlet blood in it. This clot cannot be removed because it:
prevents vascular bleeding at the bottom and sides of the socket;
protects the hole from infection;
gives rise to soft tissue that will replace the lost tooth in the future.
Blood after removal it may be released in small quantities (normal) if:
a person suffers from liver pathologies;
takes blood thinners;
the operation was performed on inflamed tissue (the tissue is swollen and the vessels do not collapse well);
the tooth was pulled out traumatically.
Such bleeding should not be profuse and after 3-4 hours it transforms into separation from the ichor wound. If the blood stops and appears again after 1-2 hours, this indicates the onset of the second phase of the action of the vasoconstrictor drug, namely the dilation of blood vessels.
In all of the above cases, you need to perform the following actions:
calm down. It is necessary to know that bleeding from the socket of an extracted tooth was fatal only in one case, and then the deceased woman died not from the bleeding itself, but from blood entering the respiratory tract, when she herself was in a state of strong alcohol intoxication. Her bleeding did not stop as a result of the presence of cirrhosis of the liver, which is known to interfere with the blood clotting process, and the patient had three teeth removed at once;
if the bleeding is quite severe, you need to return to the surgeon who performed the extraction. At night, you can go to the duty room or public clinic, but only if the blood is scarlet or dark color and comes out in a trickle. Otherwise, you must proceed to the following points;
make a tampon from sterile gauze and install it yourself so that the edge of the tampon does not touch the blood clot in the hole, then clamp the tampon with your jaws for 20-30 minutes;
if bleeding develops due to the use of anticoagulants and the patient suffers from chronic pathologies blood or liver, or when a large amount of blood is released, you can use the “Hemostatic sponge”, which is sold in pharmacies. The sponge is also placed over the socket and pressed using the opposite jaw;
Additionally, you can take the drug Dicinon or Etamzilat, 1-2 tablets 3-4 times a day;
Hydrogen peroxide should not be used, since its components react with blood, as a result of which the clot in the socket is also partially fragmented, which can cause increased bleeding.
How many days after tooth extraction should bleeding stop completely? It takes 24 hours for the bleeding to stop completely. Availability of more late bleeding indicates the presence of complications that must be excluded or confirmed during an unscheduled examination by a dentist.
swollen cheek can be observed during this period only if swelling was present before surgery. If there was no flux before the operation, then even if any complication develops, such as swelling of the cheek, it will appear within such a short time can not.
Temperature After the operation, an increase in body temperature of up to 38 degrees may be observed during the first 2 hours. This is how the body reacts to intervention. Most often, the temperature is within 37.5 0 C, and in the evening it rises to a maximum of 38 0 C.
How to rinse your mouth after tooth extraction? In the first couple of hours after the manipulation - nothing, so as not to disturb the integrity of the still loose blood clot in the tooth socket.
Postoperative period after the end of anesthesia
Pain– noticeable because the gums become sensitive and the pain in the socket begins to bother you (normally, the pain can persist for up to 6 days, but does not increase).
Hole looks the same as it did 2 hours ago, the blood clot remains.
Blood– after the end of the anesthesia, it may begin to be released more strongly, most often it is not blood, but ichor. This is due to the fact that there is an expansion of blood vessels that were previously narrowed by vasoconstrictor drugs and adrenaline. If you use the recommendations presented in the previous paragraph: tamponade with gauze or with a hemostatic sponge, you can take a couple of Etamzilate tablets, in most cases this will stop the condition.
How to rinse your mouth? Until the end of the first day after extraction, rinsing is contraindicated; you can use baths; to do this, take the solution into your mouth and tilt your head towards the extracted tooth, without making rinsing movements. Such baths are indicated only if there are inflammatory or purulent processes in the oral cavity (gum suppuration, pulpitis, cysts) before the intervention. During the first day, only salt baths are used: for one glass of water, one tablespoon (tablespoon) of salt. Hold for about 1-3 minutes, repeat 2-3 times a day.
Temperature after removal, it normally lasts for one day, and should not exceed 38 degrees.
Cheek swelling, but if the bleeding does not increase, headache, nausea does not appear, and appetite does not decrease, during the first two days this is one of the normal options. In the future, if there is no increasing swelling over the next 2 days, there is also no need to panic. But if:
the cheek continues to swell;
swelling spreads to neighboring areas;
the pain becomes more pronounced;
nausea, weakness, fatigue appear;
the temperature rises,
this indicates the development of a complication. It is necessary to urgently consult a specialist.
Second or third day
Hole can scare many people. The fact is that gray and white stripes of tissue begin to form on top of the blood clot. Don't be scared - it's not pus. This is the appearance of fibrin, which helps the blood clot to thicken so that the soft tissue of a new gum can then grow in its place.
Pain after removal it is present and requires painkillers. When the healing process has a normal, uncomplicated course, the pain weakens every day, while characteristic feature is its character - aching, pulling, but not pulsating or shooting.
Why do many patients complain of an unpleasant odor after tooth extraction? A similar odor from the mouth may be present and this is normal. The accumulation of blood, which goes through its natural stages of looseness and then a dense blood clot, has an unpleasant sweetish odor. In addition, the patient is usually prohibited from brushing and rinsing his teeth for 3 days as a prescription, so there is an active accumulation of bacteria in the mouth, which increases the unpleasant odor. You should not worry about the smell, especially if your general condition is satisfactory, there is no fever, and the pain gradually begins to subside.
We can talk about an uncomplicated course of the period after surgery if:
when you press on the gum, the exudate does not separate from the socket;
pain – aching, dull, not shooting. It also does not increase during meals;
normal appetite;
there is no constant desire to lie down and no weakness;
no increase in temperature is observed even in the evening;
swelling of the cheek remains at the same level as yesterday and does not increase;
no blood is released after 2-3 days.
You need to see a dentist if:
saliva or food is detected in the hole;
pain increases when eating, even if its character is aching and weak;
when you touch the gum in the area of the hole, pain occurs;
the edges of the gums turn red.
How to rinse your mouth during this period?
decoction of calendula, eucalyptus, chamomile. Prepare according to the recipe presented in the instructions, do baths for 2-3 minutes three times a day;
furatsilin solution - ready-made or diluted independently (boil 10 tablets per 1 liter of water, or 2 tablets per glass of boiling water): perform 1-2 minute baths, the manipulation can be repeated up to 2-3 times a day;
soda-salt solution (a teaspoon of salt and soda per glass of water): bath for 2 minutes, just hold in your mouth, repeat 2-3 times a day;
Miramistin solution: baths for 1-3 minutes, 2-3 times a day;
aqueous solution of chlorhexidine (0.05%): keep in mouth for at least a minute. Rinse three times a day.
Third or fourth day
There is no blood or other discharge from the wound. The gums hurt slightly, there is no temperature, the swelling of the cheek subsides. A yellow-gray mass forms in the center of the hole; on the sides of this mass, areas of new gum mucosa appear, which are pink in color.
At this time, you can already rinse your mouth: decoctions, aqueous solutions, the solutions discussed above (herbal decoctions, miramistin, furatsilin, chlorhexidine) can also be used, but not actively.
Seventh-eighth days
Postoperative pain should completely resolve, as should swelling of the cheek. The hole looks like this: it is almost completely covered with reddish-pink tissue, in the center there is a small area of yellowish-gray color. Exudate does not separate from the wound. Inside the hole, the process of bone formation begins, at the location of the tooth root (this process is not yet visible).
If the postoperative period is uncomplicated, the patient’s condition corresponds to that before the operation. Separation of blood or ichor, increased body temperature, presence postoperative edema are a reason to visit the dentist.
14-18 knocks
If the tooth was completely removed, and there were no fragments left in the socket, the postoperative wound did not fester, then by 14-18 days the hole can no longer be called a hole, because it is completely covered with new pink epithelial tissue. In the area along the edges and inside the socket, socket cavities made of histiocytes and fibroblasts are still present, and bone tissue is actively developing.
By 30-45 days after surgery There are still noticeable defects on the gum, which indicate that a tooth was located in this place, since the process of replacing the former hole with the help of bone tissue has not yet been completely completed. The microscopic wound contains finely looped bone tissue with the presence of connective tissue in the spaces.
In 2-3 months The bone tissue is fully formed and fills all the space that was previously occupied by the tooth, but is still at the maturation stage: the intercellular space in the bone tissue decreases, the cells become flat, and the process of deposition of calcium salts actively occurs in the bone beams. By the 4th month, the gum has the same appearance as the other areas; above the location of the mouth of the socket, the shape of the gum becomes wavy or concave, the height of such gum is less in comparison with areas with teeth.
How long does it take for a wound to heal?? If no complications arose in the postoperative period, then 4 months are needed for complete healing. If the wound festered, took a long time to heal, and had to be cleaned with dental instruments, this process can drag on for up to six months.
Removing the gauze pad.
Can be done in 20-30 minutes. If the patient suffers from arterial hypertension, uses blood thinners, or suffers from a blood clotting disorder, it is better to hold the gauze firmly pressed against the gum for about 40-60 minutes.
Blood clot at the site of tooth extraction.
Removing this clot is prohibited. Its formation serves as a kind of protection, which was developed by nature itself and should not be violated. Even in cases where food gets on the clot, you should not try to get it out with a toothpick.
In order not to destroy the formed clot, during the first day:
don't blow your nose;
do not smoke: the clot can be pulled out by the negative pressure that is created in the mouth when inhaling smoke;
do not spit;
do not brush your teeth;
do not rinse your mouth, the maximum is a bath, when the solution is taken and held in the mouth near the hole, after which it is very carefully spat out;
follow the rules of nutrition (discussed below) and sleep.
Nutrition:
alcohol;
spicy food: it can provoke an increase in blood flow to the socket, which leads to increased swelling and increased pain;
hot food: also increases blood flow and leads to post-operative inflammation;
rough food: crackers, chips, nuts. Also, such products can lead to the development of inflammation of the socket;
in the first 2-3 hours after surgery you should not eat or drink;
on the first day you need to exclude:
in the next three days you should eat only soft food, you should avoid sweets, alcohol and not drink hot drinks.
In addition, in the first week it is necessary to avoid drinking drinks through a straw; you should not chew on the side where the clot is located. It is also necessary to exclude the use of toothpicks: all food residues after eating should be rinsed with herbal decoctions; on the first day, instead of rinsing, use baths.
Behavior rules.
You can wash your hair and take a shower. It is better to sleep on the first day after tooth extraction on a high pillow (or simply add an extra one). The following are excluded for a week:
hot bath;
bath/sauna.
going to the beach;
work in a hot shop;
physical exercise;
People who suffer from arterial hypertension or diseases of the blood clotting system need to mandatory take a course of medications according to a previously selected regimen. In 90% of cases, late swelling of the cheek and the appearance of bruises, bleeding from the socket appear in the presence of increased blood pressure. If anything worries you, it is better to call the surgeon who removed the tooth or go to an appointment than to search for answers on the Internet.
Oral hygiene measures.
During the first day, you should not rinse or brush your teeth.. Such activities can be started from the second day after tooth extraction, but contact with the socket must be avoided. If the dentist’s recommendations included antiseptic treatment of the wound, then during the first 3 days such treatment involves performing baths (take a solution into the mouth and tilt the head towards the defect, hold the head in this position for 1-3 minutes and carefully release the solution without spitting ). From the second day, baths should be done after every meal.
It is also necessary to resume brushing your teeth from the second day.: twice a day, with a minimal amount of toothpaste or without it at all, without touching the socket. You cannot use an irrigator.
Picking the clot with your tongue, finger, or even more so with a toothpick is prohibited. If deposits have accumulated in the area of the clot, it is better to consult a doctor.
How to rinse your mouth? These are solutions (preparation recipes are described above):
soda-salt;
aqueous solution of furatsilin;
miramistin;
chlorhexidine;
decoctions of chamomile, eucalyptus, sage.
Pain in the postoperative period.
Painkillers. During the first two days, pain will definitely be present, because the operation was performed. You can relieve pain with the help of drugs Ibuprofen, Ketanov, Diclofenac, Nise, since they have an additional anti-inflammatory effect. Therefore, you should not endure it, it is better to take the pill prescribed by your doctor, but you should not exceed the permissible dose.
Cold– for additional pain relief, you can apply cold to the cheek. Foods that are in the freezer are not suitable for this. The maximum is a plastic container with ice cubes or water, wrapped in a towel, or even better, in a cotton cloth soaked in water. A similar compress is applied for 15-20 minutes.
Duration of pain after removal. In the absence of complications, pain can be felt up to 7 days from the moment of tooth extraction. It becomes less intense every day and becomes aching in nature, but it should not intensify when eating. Depending on the complexity of the operation, the level of the patient’s pain threshold and the experience of the doctor, the time of pain after extraction will vary.
Cheek swelling.
The cheek always swells after tooth extraction. The reason for this is inflammation after injury. The swelling reaches its maximum volume by 2-3 days, with:
the cheek skin is not hot or red;
the pain does not get worse;
there is no increase in body temperature (the “behavior” of temperature is described below);
swelling does not extend to the neck, infraorbital area and chin.
What to do if your cheek is swollen after tooth extraction? If this condition is not accompanied by the symptoms listed above, then you can apply a cold compress to your cheek for 15-20 minutes; a similar procedure can be performed 3-4 times a day. If an increase in swelling is accompanied by an increase in body temperature or a general deterioration of the condition, it is necessary to consult a dentist, since this may be allergic reaction on drugs used during surgery, insufficient sanitation of the oral cavity and wounds after surgery, early heating of the cheek in the postoperative period.
Temperature.
The temperature curve should behave like this:
after surgery (on the first day) it rises to a maximum of 38 0 C in the evening;
the next morning - no higher than 37.5 0 C;
on the second day in the evening - the norm.
Symptoms that differ from those described should be a reason to visit a doctor. It is prohibited to prescribe antibiotics on your own; this can only be done by a specialist.
The mouth is difficult to open.
After tooth extraction, the jaw may open poorly and hurt even normally. This happens when, during the process of tooth extraction, the dentist has to put pressure on the tissue or the patient has to open his mouth wide to provide maximum access to the operation site (usually this happens when extracting a wisdom tooth), which results in tissue swelling. If such a condition is not a complication of the operation, then such a condition occurs without increasing swelling of the cheek, increasing pain in the jaw, or increasing temperature. On the contrary, the situation with excessive mouth opening goes away in about 2-4 days.
Bleeding.
Bleeding can normally be observed during the day. If the patient is concerned about its intensity, then the following measures should be taken:
Press a sterile gauze swab or a ready-made hemostatic sponge onto the wound for 20-30 minutes. After a while, you can repeat the manipulation;
You can take 2 tablets of Dicinone/Etamsylate. The tablets can be taken 3 times a day;
you can use a cold compress soaked in cold water towels Apply the compress to the cheek for 20 minutes, after 3 hours you can repeat the procedure.
If the discharge of ichor or bleeding continues for more than a day, it is imperative to visit a dentist. Most likely, such manifestations indicate the presence of an infectious complication.
Hematoma on the skin of the cheek.
This phenomenon is not a complication in postoperative period. Bruising most often occurs in cases of traumatic tooth extraction, especially in people who suffer from arterial hypertension. A hematoma is the release of blood from the vessels into the tissue where post-traumatic swelling was previously located.
Other questions.
Can your health worsen after tooth extraction?? On the first day after surgery, stress can cause lack of appetite, headache, and weakness. In the future, such manifestations disappear.
How long should it take after tooth extraction to return to the usual rhythm of life?? Within a week, the pain disappears, swelling and bruising also disappear, the clot at the bottom of the hole begins to be covered with epithelial tissue.
Complications
After tooth extraction, various complications can develop. The vast majority of them are infections that require the simultaneous administration of antibiotics or, in extreme cases, surgical sanitation of the source of infection.
Dry hole.
This name refers to a condition in which, under the influence of vasoconstrictor drugs that are present in the anesthetic, or in case of non-compliance with medical recommendations after surgery (for example, active rinsing or eating solid food), a blood clot does not form in the socket. Such a complication does not pose a threat to the patient’s life, but can cause the development of alveolitis - inflammation of the tooth socket, since the clot serves the function of protecting the gum tissue from infection and accelerating wound healing; accordingly, when it is absent, there is nothing to perform its function.
This condition appears long term healing postoperative wound, the occurrence of an unpleasant odor from the oral cavity, long-term persistence of pain. The patient himself can, by looking in the mirror, determine that there is no clot in the socket and the socket is not protected.
Having discovered such a condition, you should consult a doctor on the first day to correct the situation. Most likely, the dentist will perform a repeated, less painful intervention on the wound, which aims to form a new clot in the hole. If the presence of a dry socket was noticed later than the first day, then it is necessary to consult a doctor directly during the appointment or by telephone, he will explain what measures (in most cases these are dental gels and rinses) need to be taken to prevent the development of alveolitis.
Alveolitis.
This name refers to a condition in which inflammation develops in the mucous membrane that lines the cavity in the jaw where the tooth was located before surgery. This condition is dangerous because it can cause suppuration in the socket and the transition of an infectious purulent inflammation on soft fabrics and jaw bone. Alveolitis in most cases develops after the removal of molars, especially for wisdom teeth located on the lower jaw, which are surrounded by a large amount of soft tissue.
Causes of alveolitis:
decreased general immunity;
removal of a tooth on the root of which a suppurating cyst was attached;
unsatisfactory treatment of the tooth socket after its extraction;
violation of the integrity of the clot in the hole, most often, if desired, rinse your mouth intensively or clear the hole of food using toothpicks.
Symptoms of alveolitis development:
the pain that began to subside after the operation increases again;
unpleasant appears putrid smell from mouth;
pain radiates to both jaws, in some cases to the head area;
submandibular lymph nodes enlarge;
when you press on the gum in the area of the operation, pus or liquid begins to ooze from the hole;
after removing a tooth, the pan looks like this: the edges of the wound are reddish, the clot may have a black tint, the hole is covered with a dirty gray coating;
body temperature rises to 38 0 C and higher with a feeling of aching, chills;
a headache appears, one feels sleepy, the person gets tired quickly;
it hurts to touch the gum.
At home you can help yourself:
rinse your mouth, but not intensively, often up to 20 times per knock, using antiseptic solutions (for example, miramistin, chlorhexidine), salt solution for rinsing;
you should not remove the clot from the hole even if there is an unpleasant odor coming from it;
you can drink non-steroidal anti-inflammatory drugs Ibuprofen, Nise, Diclofenac;
contact your dentist. Only he is able to cure alveolitis by curettage of the wound, inserting a tampon with an antiseptic into the wound and selecting the most suitable antibiotic for the patient. This may be Colimycin, Neomycin, Lincomycin. The doctor can also refer the patient to physiotherapeutic procedures: helium-neon laser treatment, fluctuarization, microwave therapy, Ural Federal District.
Complications of alveolitis can be:
abscesses - an accumulation of pus, limited to a capsule, in soft tissues;
osteomyelitis – inflammation of the bone tissue of the jaw;
phlegmon - the spread of a purulent process that is not limited to the capsule and provokes the melting of healthy soft tissues of the jaw;
periostitis - inflammation of the periosteum of the jaw.
Osteomyelitis.
Purulent inflammation of the jaw bone, which is the most common complication of alveolitis. It may, in turn, be complicated by blood poisoning, so treatment of this complication must be carried out in a hospital. Osteomyelitis manifests itself with the following symptoms:
loss of appetite;
increased fatigue;
headache;
increased body temperature (above 38 degrees);
swelling of the cheek develops in the projection of the extracted tooth;
touching the jaw bone causes pain, and the further the process spreads, the larger areas of the jaw are affected;
Severe pain in the jaw develops, which increases.
Treatment of this complication is performed in the department of maxillofacial surgery. The wound is drained, necrotic areas of bone are removed, and antiseptic drugs are injected into the wound. A course of systemic antibiotics is prescribed.
Nerve damage.
If the extracted tooth had a complex root system or was positioned incorrectly, the operation in such cases may damage the nerve that runs nearby. This complication has the following symptoms:
the presence of “running” goosebumps;
the area of nerve damage becomes insensitive;
numbness in the area of the cheeks, palate, tongue in the projection of tooth extraction.
Pathology is treated on an outpatient basis. Physiotherapy is used, a course of vitamin B and drugs that improve the conduction of impulses from nerve endings to muscles are also prescribed.
Sharp edges of the alveoli.
After tooth extraction on the second day, when the edges of the gums begin to move closer to each other above the socket, pain occurs in this area. It is possible to distinguish such pain from alveolitis during the examination: pus does not separate from the socket, the edges of the gums are not red, the socket is still closed with a clot. Treatment of this complication is surgical - using special instruments, the sharp edges of the hole are excised, the wound is treated and a biomaterial is applied on top, which compensates for the lack of bone.
Exposure of the alveolar zone.
If the postoperative course is within normal limits, but pain occurs in the socket area when eating warm food or mechanical irritation, this may indicate that the bone area is not covered with soft tissue.
This diagnosis can only be made by a dentist. Treatment of the pathology is surgical: the exposed area is removed, covering it on top with your own gum tissue, and sutures are applied.
Postoperative cyst.
The development of a cyst after tooth extraction is a fairly rare complication of the operation. This is a kind of cavity near the root of the tooth, which is filled with liquid, thus the body independently limits infected tissues from healthy ones. Such a cyst can increase in size and completely cover the tooth root, it can also spread to neighboring tissues, so this complication must be treated.
Such a cyst becomes noticeable after the development of periostitis, which is popularly called “flux.” In such cases, a person goes to dentistry, where the disease is diagnosed and treated surgically, excising the pathological formation.
Perforation of the floor of the maxillary sinus.
This complication is the result of the manipulation itself, when during the process of tooth extraction a pathological connection is formed between the maxillary sinus and the oral cavity. This complication is possible when molars are removed. Pathology can be diagnosed using x-rays, and the dentist can check for the presence of a message by asking the patient to exhale, then pinch his nose with his fingers and inhale. If there is a perforation, foamy (presence of air) blood will begin to appear from the hole.
Odontogenic phlegmon.
This name has purulent melting of soft tissues (spaces between fascia, subcutaneous tissue, skin), which develops as a complication of osteomyelitis of the jaw.
The disease manifests itself as painful and increasing swelling of the cheek in the area of the lower or upper jaw. The skin over the swelling is tense, very painful, and it is quite difficult to open the mouth. In addition, headaches, malaise occur, and body temperature rises. There is a decrease in appetite.
Treatment of this complication is carried out only by surgery. Therapy consists of opening the infiltrate and washing the damaged areas with antibiotics; systemic antibiotics are also prescribed.
Odontogenic periostitis.
This complication is a complication of osteomyelitis or alveolitis and is manifested by the spread of inflammation to the periosteum. Popularly, such a pathology should be called “flux.” A complication appears:
increased body temperature;
constant toothache;
swelling of the cheek on one side.
Abscesses of soft tissues of the jaw.
This disease in its early stages is not particularly different from phlegmon. However, here the tissues melted by pus are limited to healthy ones by the capsule, while with phlegmon the inflammation continues to advance and affect more and more new areas of tissue.
The manifestation of odontogenic abscesses is pain in the entire jaw, weakness, increased body temperature to high levels, difficulty in opening the mouth, increased local temperature in the area of skin swelling, and the development of significant swelling of the cheek.
Treatment of the complication is carried out in a hospital and is surgical - the resulting abscess is opened and drained, and washed with antiseptic solutions. In addition, systemic antibiotics are injected into a vein or muscle.
Antibiotics for tooth extraction
Cases of appointment.
When teeth are removed, antibiotics are not always prescribed; it all depends on each specific case. If, after tooth extraction, during a follow-up appointment the doctor finds signs of inflammation, then in most cases antibiotics are prescribed. There are also a number of factors that imply the prescription of antibiotics for complications of tooth extraction:
- if during the process of tooth extraction its socket was damaged, which resulted in the penetration of infection further into the tissue;
- if after tooth extraction the wound does not heal for a long time due to weakening of local immunity;
- if a blood clot does not form in the hole or it is insolvent. In such cases, antibiotics are prescribed to protect the socket from infection.
Requirements for drugs
After tooth extraction, you need to prescribe those antibiotics that meet a number of requirements:
low level of toxicity;
minimal number of side effects;
the drug must have the ability to quickly penetrate soft and bone tissues;
the drug must have the ability to accumulate in the blood in certain quantities and maintain a local effect for 8 hours.
What drugs should be prescribed.
It is quite difficult to give a definite answer to the question of which antibiotics should be prescribed after tooth extraction, because each patient’s body can react differently to them, so the doctor decides this question directly during the appointment. The only thing that can be done regarding the definition of antibiotics for tooth extraction is to indicate which of them are used most often. Modern dentistry most often uses Metronidazole and Lincomecitin. These drugs are often even prescribed in combination to ensure better effect. Thus, Lincomecin should be taken two capsules with an interval of 6-7 hours, the course of therapy is up to 5 days. At the same time, Metronidazole acts as a maintenance drug and is taken one tablet three times a day, the course is 5 days.
Contraindications.
When prescribing antibiotics after tooth extraction, the doctor must be warned about the presence of characteristics of the body. Thus, the dentist should be informed about pathologies of the gastrointestinal tract, liver, and heart. It is also worth providing all the information regarding the use of other medications.
If the patient has a gastrointestinal pathology, the doctor should prescribe antibiotics effervescent form. Such products dissolve much faster and do not cause severe irritation to the stomach and intestines. The main thing that needs to be understood once and for all is that only a doctor can prescribe any medications, and then only after a thorough examination.
