Condition of the gums after tooth extraction

16.11.2019

Such a complication as stomatitis after tooth extraction is well known in dental practice. Moreover, the source of inflammation can appear not only on the gum, where the tooth used to be, but also on other places on the mucous surface of the oral cavity. The cause of the disease may be the unscrupulous work of the dentist. The patient himself can influence the formation of ulcerative defects. In any case, it is necessary to carry out full treatment of the disease.

Carrying out the procedure

The tooth extraction procedure is carried out using effective, modern painkillers, so, as a rule, there is no pain during the operation itself.
The operation begins immediately after the anesthesia takes effect. A scalpel is used to loosen the ligament supporting the tooth.

If the procedure was traumatic, or the edges of the wound are too wide, the dental surgeon may use self-absorbing sutures. But most often, the wound is simply closed with a gauze pad with a special hemostatic agent. To stop bleeding, you need to lightly but firmly press the tampon onto the wound with closed jaws. After 20 minutes, the gauze can be spat out.

Description of the disease

Not all dental surgeon patients know that inflammation may develop after removal, so they often ask the question: “Alveolitis - what is it, and why does it occur?” Other names for the disease: “dry socket”, “alveolar local osteitis”. The pathogenesis of the condition is based on a violation of the formation of a physiological clot or its loss from the socket after tooth extraction, which most often occurs due to a violation of the postoperative regimen or low human immunoresistance.

Inflammation of the alveoli is possible only due to removal of the segment. Alveolitis cannot develop after tooth treatment, since the hole is formed only as a result of extraction of the unit.

Gum condition

Pain in the gums may occur after the anesthetic drug wears off, that is, after 3-4 hours. After the procedure, the patient is often worried about the return of painful sensations and the release of ichor (for 4–6 hours. After the operation, the wound looks quite scary, especially if a wisdom tooth was removed.

In the absence of pathology, the healing process occurs in several stages.

Day after the procedure

At the initial stage, the hole remaining in the place of the pulled out tooth is filled with a scarlet blood clot. It is not recommended to remove it, as it performs several functions:

protects the wound from infections;
eliminates bleeding from blood vessels;
promotes the formation of new tissue that will fill the empty space.

To avoid breaking up the blood clot, it is recommended not to brush your teeth on the day of surgery. Smoking is accompanied by inhalation of smoke, which creates negative pressure in the oral cavity. This may help pull the clot out of the socket. It is not recommended to blow your nose or spit. Rinsing your mouth should also be avoided; you can simply put the solution in your mouth and hold it for a while without rinsing. Gentle rinsing can be indicated only in the presence of inflammatory and purulent processes.

Therapeutic treatment

Treatment is carried out according to a standard scheme and it is important to start it in a timely manner:

Cleaning the hole from food debris, plaque, and dead tissue;
A thorough inspection of the hole, checking for the absence of roots and foreign elements;
Washing the wound with hydrogen peroxide;
Drying the wound;
Putting anti-inflammatory drugs into the hole.

After treatment, the doctor gives recommendations to the patient on oral care. A few days later, the patient comes back for an examination to make sure that the treatment has given positive results and the wound is healing. It is important to rinse your mouth with herbal decoctions at home. Do not eat hard foods. For pain relief, you can use Nimesil or Ketanov.

After three days

The blood clot begins to change and thicken. Gray and white fibrin stripes appear on it, after which the formation of new gum tissue begins. Painful sensations may still occur. But they are much weaker and have a pulling character. The patient may experience bad breath. This is considered normal and is due to the formation of a blood clot. Failure to brush your teeth also leads to the formation of bacteria and an unpleasant odor.

To rinse the mouth, you must use special solutions recommended by your doctor. The appearance of pain from touching the gums, increased pain during eating, serves as a signal for the need to return to the dentist's office. If the tissue of the edges of the hole has acquired a red tint, you should also immediately consult a specialist.

After 2–3 months and beyond

The gum gradually hardens, and the space remaining from the tooth is filled with maturing bone tissue. By the beginning of the 4th month, the gum bone tissue completes its formation. The gum can be called completely healed.

If the wound heals with suppuration, then healing of the wound can last up to six months.

Gum healing process

The speed of gum healing depends on several factors:

individual characteristics of the patient’s immunity;
the success of the operation;
location of the extracted tooth.

If the tooth is in a hard-to-reach place, has crooked roots, or its crown has been significantly damaged, then the removal procedure becomes more complicated. During manipulation, the tooth may begin to crumble, leaving fragments in the gum. In this case, it is necessary to cut the gum tissue, detach it from the bone, remove the tooth in parts, and use a drill. These traumatic procedures prolong the period of gum healing after surgery.

Slight swelling of the gums is considered normal. The temperature may rise slightly (due to an immune reaction). The swelling usually subsides within three days.

Noticeable swelling of the gum is also observed after cutting it. This swelling goes away in about one week.

Vitamins are the key to health

At the same time as using disinfectants, it is necessary to strengthen the immune system. This can be done with a diet rich in vitamins, macro and microelements. On the recommendation of a specialist, you can take a vitamin and mineral complex: “Alphabet”, Vitrum, “Multi Tabs”, “Centrum”.

Decoctions or extracts of echinacea, eleutherococcus, ginseng, and Schisandra chinensis will help. If necessary, the doctor prescribes drugs to enhance immunity: “Ribomunil”, “Imudon”, “Irs-19”, “Likopid”, “Derinat”, “Timaktide”.

If stomatitis occurs due to problems with the gastrointestinal tract, complex treatment should include drugs containing beneficial microorganisms - probiotics. They will help restore the microflora of the digestive tract. These include “Bifidumbacterin”, “Lactobacterin”, “Acilact”, “Bifilong”, “Narine”.

To speed up the healing of damaged mucosal surfaces, sea buckthorn or rosehip oil, vinylin, and propolis preparations are prescribed.

Possible complications

Signs of alarm should be considered an enlargement of the cheek, further spread of swelling, a persistent increase in temperature, increased pain, nausea, and weakness. If the healing process is disrupted, the following complications may occur:

Cyst formation. It is a fibrous neoplasm filled with fluid.
Flux. Formed after infection penetrates into the socket and then into the periosteum. The resulting inflammation is characterized by severe swelling of the cheek on the side of the diseased gum. There is severe pain and redness of the gums. The formation of flux requires immediate medical attention. Therefore, it is necessary to carefully protect the site of the extracted tooth from possible infection.
Alveolitis. This is a complication that occurs during the inflammatory process of the hole in the jaw bone. The infection occurs due to a violation of the integrity of the protective blood clot. The onset of the disease is characterized by inflammation of the outer layers of the socket, spreading into the deep layers of the bone. Alveolitis is accompanied by aching pain during eating, swelling and redness of the gums. There is a putrid odor from the mouth. The patient feels chills, headache, and fever. The occurrence of the disease most often occurs during the extraction of molars located on the lower jaw. It is necessary to obtain medical attention in a timely manner to avoid the spread of infection to other organs. One of the dangerous complications of the disease is osteomyelitis.

Removing wisdom teeth is a more complex procedure, so gum inflammation often occurs after surgery. At the same time, discoloration or swelling of the gums should not cause concern to the patient. Often after surgery there are difficulties opening and closing the mouth. This is a consequence of surgery. To get to a hard-to-reach place, the doctor asks the patient to open his mouth as wide as possible. The pressure exerted on the tissues leads to their swelling. On the 3rd day, the discomfort usually goes away completely. The appearance of purulent contents in the hole, increased temperature, acute pain, heavy bleeding - all these signs require immediate contact with the dentist.

The consequences are dangerous

Without timely treatment, seemingly harmless stomatitis can bring many negative consequences. Pathogenic microorganisms begin to secrete toxins - poison of biological origin.

Once in the blood or stomach, toxins poison the body. Intoxication leads to deterioration of health. Headaches and joint pains appear, appetite disappears, lethargy, nausea are felt, diarrhea begins, and the temperature may rise.

Other pathologies may develop: from inflammation of the throat or respiratory tract to destruction of the jaw bone or general infection of the circulatory system.

Comprehensive treatment of stomatitis will help to avoid complications. But before you begin self-therapy, you need to contact your dentist again. Or visit a therapist for adults, or a pediatrician for children. Only a doctor can determine the type of disease and prescribe appropriate medications.

Recommendations after tooth extraction

There are recommendations that, if followed, significantly speed up the gum healing process. Not only the speed of wound healing depends on them, but also the absence of possible complications. The doctor’s main recommendations in the postoperative period may be the following:

you need to avoid foods that are too hot, spicy, or irritating to gum tissue;
in the first days you need to carefully avoid damaging the clot; It is necessary to be extremely careful in maintaining oral hygiene;
about 3 hours after the tooth extraction procedure you need to refrain from eating;
in the next three days you need to eat only soft food, without consuming sweets, alcohol, or hot drinks;
on the first day after the procedure, it is recommended to sleep on a high pillow;
During the week, it is recommended to avoid visiting the sauna, solarium, sunbathing on the beach, and reduce physical activity;
on the first day, it is forbidden to brush your teeth to avoid damaging the blood clot;
Do not try to pick the clot with your finger, toothpick or tongue;
a cold compress should be applied to the surgical area for 20 minutes, every 2 hours;
It is recommended to use oral baths and then rinse with antiseptic agents.

The postoperative period requires careful attention to the patient's health status. A complication resulting from neglect of the rules will require much more time, money and effort to heal the wound.

Causes of stomatitis in adults

Pathogenic bacteria, viruses. Inflammation begins due to the action of pathogens of viral or infectious diseases. Normally, they are located in the oral cavity and do not cause irritation. The mucous membrane is protected from inflammation by the immune system. If it is weakened, viruses or bacteria can cause stomatitis.

Deficiency of vitamins and microelements. If the body receives little zinc, iron, folic acid, or B vitamins, the risk of stomatitis increases. Such a deficiency occurs due to irregular or unbalanced nutrition and consumption of foods with low nutritional value.

Injuries to the mucosal surface. The mucous membrane can be injured mechanically, by temperature or chemical irritants. Mechanical injuries occur when biting the cheek, damaging its inner surface with the edge of a crown, prosthesis, or hard food. When injured by a chemical irritant, contact occurs with acids, alkalis, and salt. Thermal injuries occur when consuming hot food or drinks. Minor and irregular injuries heal without stomatitis. It develops if injury to a certain area occurs regularly or when the immune system is weakened. In particular, when smoking, the surface of the mucous membrane is constantly injured both thermally and mechanically.

Insufficient hygiene. This reason is more typical for children. The risk also exists for adults. It is associated with insufficient personal hygiene. Inflammatory agents enter the oral cavity if you do not wash your hands before eating or eat unwashed foods.

Improper oral hygiene. Too frequent brushing or rinsing, constant brushing of teeth with a paste that contains sodium lauryl sulfate, reduce salivation, which causes the mucous membrane to become dehydrated and vulnerable to irritants.

Drug treatment. Taking diuretics and some other drugs can reduce salivation and provoke dehydration of the mucous membrane. If the mucous membrane is dry, the risk of mechanical injuries and accumulation of pathogenic microorganisms increases.

Accompanying illnesses. If the body is weakened, the risk of developing an inflammatory process increases. Stomatitis can be provoked by cancer, systemic diseases, HIV, gastrointestinal diseases, hormonal imbalances, diabetes mellitus, candidiasis, helminthic infestation, and bronchial asthma. Often, inflammation of the mucous membrane is provoked not by the disease itself, but by the use of medications that are used in its treatment.

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