Submandibular lymphadenitis in adults and children: causes, symptoms, treatment and prevention

In the jaw lymph nodes, the lymph circulating in the cells and capillaries of the oral cavity and head area is processed. Submandibular lymphadenitis is a polyetiological disease: its development can be caused by both chronic diseases and infections in the acute stage. The disease requires mandatory treatment from a specialist; it is impossible to cure lymphadenitis on your own

What is submandibular lymphadenitis, stages of development

Submandibular lymphadenitis is inflammation of the cervical and submandibular lymph nodes

, which can be acute or chronic. Often the disease is secondary, that is, it does not occur independently, but as a symptom of a primary infection.

Acute stage

In the acute form of the disease, one lymph node or several may become inflamed. Depending on what kind of exudate is contained in the inflamed node - pus or serous fluid - lymphadenitis is divided into purulent and non-purulent. The acute form of the disease is treated by removing pus from the lymph node and eliminating the root cause of inflammation.

If there is pus inside the lymph node, there is a danger of it breaking through and infecting surrounding tissues.

Chronic stage

The transition of the disease to the chronic phase is a consequence of the lack of adequate treatment. The node no longer increases in size and hardens. The pain syndrome intensifies, and severe intoxication of the body occurs. The skin around the node becomes purple.

Compared to the acute phase of the disease, with chronic lymphadenitis there is a clearly noticeable increase in the area of inflamed tissue around the lymph node

. The danger of this form of pathology is that it may require removal of the lymph node.

Why can a lymph node become inflamed after tooth extraction and what to do about it?

An enlarged lymph node signals the occurrence of an inflammatory process in the body. Typically, during inflammation, the lymph nodes increase in size and some pain appears. Swelling of the lymph nodes of the neck, head and lower jaw is associated with the development of inflammation in the area of the extracted tooth. In this article you will learn how to avoid complications and how to help the body cope with infections faster.

Lymph nodes and where they are located

Let's start with the lymphatic system. It is represented by a collection of vessels of various diameters that permeate our body. The lymphatic system is closely related to the circulatory system (this plays an important role in the development of complications). Lymph, the fluid that flows through the lymphatic vessels, transports tissue fluid and protein molecules. There are large numbers of lymphocytes and granulocytes - cells that are the first to fight pathogens. They are produced in the lymph nodes; when an inflammatory process occurs in the body, the lymph nodes work more intensely, increasing in size.

Photo 1 shows inflammation of the lymph node

But how does this relate to tooth extraction?

Most of the lymph nodes are concentrated in the head and neck area. Surprisingly, it is true: inflammation in the lymphatic system in 60% of cases occurs due to dental pathologies. The process of tooth extraction is a very traumatic event. In addition, a large number of opportunistic microorganisms live in the oral cavity.

Attention: Opportunistic pathogens are those that are normally present on the surface and inside the human body, but do not cause harm to it. However, when conditions change, they can become pathogenic and lead to the development of diseases.

So, bacteria entering the wound formed after tooth extraction can cause an infectious process. The nearby lymph nodes of the jaw, neck and head will react most quickly to it, actively producing cells of the immune system. Therefore, the patient can feel enlarged lymph nodes, which in some cases can be painful.

Why does the problem occur after tooth extraction?

After tooth extraction, in 99% of cases the lymph node swells. Dentists identify two main reasons:

1. This is a defensive reaction to interference, and it is the norm. As a rule, after tooth extraction, the lymph nodes in the neck or under the jaw become enlarged.

Attention: When wisdom teeth, or numbers of eights, are removed, the lymph nodes in the neck become enlarged. The procedure is quite traumatic and affects a large number of tissues, so in 90% of cases the lymph node becomes enlarged. It may also be accompanied by fever, soreness, inability to open the mouth wide, and general malaise.

Tooth extraction was carried out against the background of an existing purulent-inflammatory process. In some cases, tooth extraction is a necessary step in solving advanced dental inflammatory diseases of the oral cavity, which include:
fistula;
periodontitis;
flux;
granuloma;
cyst.
In this case, the inflammatory process can result in a number of complications, so it is recommended to fight the infection with the help of antimicrobial drugs, rinsing with furatsilin or chlorhexidine, potassium permanganate or salt solution, as well as applying lotions.

Attention: Prevention is easier than cure!

Reasons for the development of lymphadenitis.

So, we have already found out that when teeth are removed, especially wisdom teeth, the lymph nodes become inflamed. This process is called lymphadenitis. The development of lymphadenitis in the head and neck area is promoted by:

tonsillitis (inflammation of the tonsils);
laryngitis (inflammation of the larynx);
stomatitis (damage to the oral mucosa);
gingivitis (inflammation of the gums).

What to do if the lymph node under the jaw is inflamed?

When the lymph node under the jaw becomes inflamed, the following symptoms occur:

a significant increase in the size of the inflamed lymph node;
when pressed, a dense movable tubercle is felt;
severe pain in the gums and inflamed lymph nodes, which can spread to the head and neck;
limited jaw movements;
difficulty chewing and swallowing;
general weakness, malaise;
sleep disturbance;
chills, increased body temperature up to 40 ◦C.

In such cases, the doctor identifies the degree of inflammation and prescribes appropriate treatment.

The dentist identifies the source of pathology by palpation (feeling with fingertips) of an enlarged lymph node, which is easily detectable. In some cases, pressure even causes pain. It is interesting that the skin first acquires a reddish tint due to increased blood flow in the area of inflammation, and then changes to bluish.

The body’s immune capabilities play a major role in activating the lymph nodes under the chin and in the lower jaw area. Lymphatic tissue, as the main part of the immune system, protects the body from pathogenic environmental factors. However, there are some diseases in which the immune system itself suffers. They are called autoimmune.

Such diseases include, for example, systemic lupus erythematosus, rheumatoid arthritis and serum sickness. With these pathologies, the protective function of the body is sharply reduced and, for example, if a child suffers from this serious illness, the lymph nodes under the lower jaw can increase even when baby teeth erupt.

What complications may arise?

Complications of an inflamed lymph node can be:

angina;
In the photo on the left - healthy tonsils, in the photo on the right - inflammation of the tonsils
laryngitis or pharyngitis;
The photo shows dental flux
laryngitis or pharyngitis;
In the photo on the left - healthy tonsils, in the photo on the right - inflammation of the tonsils
The photo shows laryngitis
otitis.
Otitis. The photo shows an inflammatory process in the ear

They occur when pathogenic microflora spreads to other nearby areas. There is no way around this without a course of antibiotic therapy. In order not to struggle with complications later, it is necessary to diagnose and properly treat inflammation in a timely manner.

Complications of extraction

A separate group of complications are those that arise during tooth extraction. There may be, for example,

alveolitis;
flux;
abscess;
phlegmon;
osteomyelitis.

The most insidious of them is considered to be alveolitis, or inflammation of the socket of an extracted tooth. It develops due to a dentist’s mistake or when the patient’s postoperative regimen is violated. The cause of the development of alveolitis is the destruction of a blood clot that should form at the site of the extracted tooth. Without it, the hole becomes as if unprotected and pathogenic microorganisms enter it. This is how alveolitis develops.

The photo shows alveolitis (inflammation of the socket of an extracted tooth)

In addition, the tooth socket may begin to fester. Severe pain, swelling, uncharacteristic discharge and bad breath occur. It is necessary to treat the inflammation, since with its further progression, nearby tissues suffer: gums, periosteum, mucous membrane and others.

To treat alveolitis, you must immediately seek medical help. The dentist will clean the hole, removing all foreign elements, and treat it and other foci of infection that may also arise in the oral cavity with an antiseptic solution.

Dentists also consider dry socket to be a complication of extraction. As mentioned above, a blood clot must form, which will promote tissue restoration and wound healing. If the hole remains dry, then the risk of infection in the wound increases, the pain intensifies and an unpleasant taste appears.

With wisdom teeth, things are even more complicated - due to their distant location, the patient cannot always see that the blood clot has disappeared. Therefore, he seeks help only when pain develops. In the case of a dry socket, the doctor places a cotton swab on the wound, soaking it with antiseptics and an antibiotic solution. That is, a cotton swab literally replaces a blood clot. Thanks to this, the hole is protected and its regeneration is accelerated. The cotton swab must be changed every day until the hole is completely healed.

Treatment of lymphadenitis

Diagnostic measures aimed at eliminating the problem include:

dental treatment
drug therapy
special regime.

1. Dental treatment involves getting rid of the causes that cause the lymph nodes to enlarge. The doctor may suggest:

professional teeth cleaning;
treatment or filling of root canals;
sanitation of abscesses;
cleaning the hole;
resection of damaged parts of teeth;
replacement of fillings and crowns.

Attention: After appropriate treatment, the lymph nodes do not return to normal immediately. Their increased size can last up to 2 weeks. If enlarged lymph nodes cause pain and discomfort to the patient, he may additionally be prescribed physical therapy, as well as choose medications.

2. Drug therapy consists of the dentist prescribing medications when inflammation is detected. Typically it is:

antibiotics to eliminate pathogenic bacteria;
immunostimulants and multivitamin preparations (to speed up the body’s recovery);
home treatments in the form of lotions and rinses.

In case of fever, antipyretic drugs are prescribed, and in case of severe pain, which often accompanies dental surgery, analgesics are prescribed. Thus, etiotropic (antimicrobial drugs) and symptomatic (to relieve symptoms) therapy is carried out.

3. To speed up the relief of inflammation, the patient should follow a special regimen. These include:

reduction of physical activity;
in case of severe lymphadenitis, even bed rest is recommended; the need to drink up to 3 liters of warm liquid (herbal teas, fruit drinks and plain water help well - they help get rid of intoxication caused by inflammation as quickly as possible);
rinsing (you can rinse your mouth with a decoction of chamomile or calendula);
salt lotions (a concentrated salt solution is prepared, a large piece of cotton wool or a cotton pad is soaked in it, and it is placed behind the cheek where the dental procedure was performed. The hypertonic solution will help the cotton wool absorb metabolic products during inflammation).

Patients will have to make extensive adjustments to their teeth brushing. If there is inflammation in the oral cavity and, as a result, in nearby lymph nodes, it will not be enough to use only a brush and paste. It is recommended to use an irrigator and dental floss, and after all these procedures, use a mouth rinse.

Caution: Buy a paste that contains antiseptics such as chlorhexidine, chlorine, silver and zinc. It will provide you with additional sanitation of the operated area and will not allow inflammation to develop.

The basic principles that ensure effective treatment of inflamed lymph nodes are:

good timely diagnosis;
bed rest;
the use of alternative medicine methods in the form of lotions and rinses;
antibiotic therapy;
adequate sanitation of the oral cavity.

Attention: Treatment of inflamed lymph nodes should not be delayed, as pathogenic organisms can enter the circulatory system, which will cause sepsis.

What medications are prescribed?

Often, antibiotic therapy for enlarged lymph nodes and inflammation includes penicillin antibiotics, for example, Amoxiclav, Ampicillin or Amoxicillin. In case of allergy to antibiotics of the penicillin group, antibiotics of other groups may be prescribed. The most effective of them are macrolides and fluoroquinolones.

Attention: The course of antibiotic therapy should not exceed 5, and in some cases – 7 days. Carefully read the instructions prescribed for this antibiotic and follow them! To avoid developing resistance, follow your doctor's recommendations.

Causes of submandibular lymphadenitis

Inflammation of the cervical and jaw lymph nodes is associated primarily with diseases of the oral cavity and respiratory system.

The main causes of submandibular lymphadenitis are:

An acute respiratory infection of viral or bacterial origin without a characteristic localization.
Dental diseases. Especially often, the cause of the inflammatory process in the submandibular lymph nodes is advanced caries or one of its complications: pulpitis, periodontitis, gingivitis, periodontitis, periodontal disease.
A history of throat diseases: tonsillitis, chronic sore throat, pharyngitis, adenoiditis.
Acute otitis.
Chronic or acute inflammation of the nasal sinuses: frontal sinusitis, sinusitis, sinusitis.
Mechanical damage to the submandibular lymph node caused by trauma.
The presence in the body of foci of chronic inflammation, characteristic of rheumatoid arthritis, STDs, HIV.
Infection of the body with Koch's bacillus. The presence of a microorganism does not necessarily entail the development of a tuberculosis process, so the patient may not be aware of the infection. But even in a depressed state, Koch's wand can affect the lymph nodes.

How to cure an enlarged lymph node in the submandibular area

Therapy must be carried out under medical supervision. Its main goal is to eliminate the infection that caused the disorder. If the root cause of the condition is not established, it will not be possible to be completely cured.

If the problem is related to an oral disease, mandatory treatment is carried out. For severe inflammatory pathologies of internal organs, antibiotic therapy is carried out. For pathologies of a viral nature, patients are prescribed antiviral drugs.

If the examination reveals that pus has accumulated inside the tissues, it is drained using a drainage tube. Additionally, a puncture is taken to recognize the pathogen and understand whether the disease has a benign or malignant course.

As soon as the infectious focus disappears, the lymph nodes begin to shrink, stop hurting and gradually reach their normal state.

Symptoms, photos and diagnosis of submandibular lymphadenitis

Submandibular lymphadenitis can be distinguished from the usual enlarged lymph nodes, which occurs with reduced immunity, by the presence of pain and compaction. If there is no pain when you touch the node and the lump is not palpable, its enlargement may be caused by decreased immunity. A compacted lymph node can signal the development of oncology, so if it is detected, it is necessary to urgently be examined by a doctor.

Submandibular lymphadenitis is characterized by enlarged lymph nodes, but it is not the main symptom. For a doctor to suspect lymphadenitis, at least one of the following signs must appear:

Pain syndrome. In the early stages of the development of the disease, aching, nagging pain of high intensity is noted in the lower part of the head - under the lower jaw. Severe pain is felt when lightly pressing on the lymph node, during chewing, when yawning, or turning the head. As the disease progresses, pain during palpation increases, and then at rest. Patients are unable to relieve pain on their own.
Significant enlargement of the lymph node and severe swelling, which makes swallowing difficult and provokes a feeling of fullness in the sublingual area. When swallowing, there is a feeling that a piece of food is too large. Speech becomes difficult.
Labored breathing. It occurs gradually and is accompanied by cyanosis of the nasolabial triangle and pallor of the skin of the face.
Visually noticeable swelling under the cheek. The size of the compaction depends on the severity of the ongoing pathological process, the amount of serous fluid and pus.
An increase in body temperature to 39–40 °C, which may be accompanied by severe headache and sweating. This temperature is difficult to reduce with conventional antipyretics.
Redness of the skin above and around the node. If pus has accumulated in the node, the skin around it will acquire a pronounced purple tint.
An accumulation of pus can be detected by palpation; pus can be felt even through the texture of the skin and node.

If there are signs of inflammation of the submandibular lymph node, you should seek help from a doctor. The treatment of lymphadenitis is carried out by therapists, otolaryngologists and surgeons.

Photo: chronic inflammation of the lymph node

Photo: acute inflammation of the lymph node

In addition to visual inspection and palpation of the node, doctors use several other clinical diagnostic methods:

General blood analysis. With the development of submandibular lymphadenitis, there is a significant increase in the level of leukocytes in the blood.
Ultrasonography. Allows you to detect the presence of pus and serous fluid inside the lymph node.
Bacteriological analysis of fluid from a lymph node. Allows you to determine the type of bacteria that caused the inflammation and select the most effective antibiotics.
Carrying out a complete differential (excluding other diseases) diagnosis. It is necessary due to the similarity of the symptoms of submandibular lymphadenitis with other diseases: inflammation of the salivary glands, adenoiditis.

To prescribe the correct treatment, it is necessary to identify the form of the disease and determine the severity of the pathological process.

Signs of inflammation of the submandibular lymph nodes

How the disorder manifests itself depends on how far the disease process has progressed. If you do not carry out the necessary therapeutic measures, one stage will quickly pass into another.

First stage

The size of the lymph nodes changes very slightly, but the person already feels that they hurt when pressed. Discomfort occurs when turning the head. Body temperature often rises and a sore throat appears. A tickle or dry, unproductive cough is annoying. Pain occurs only on one side of the neck or on both sides at once. The first case is more likely if it is a viral disease.

Second stage

It is called “acute lymphadenitis”. Now the lymph node can be distinguished visually - it becomes convex and protrudes forward. Externally it resembles a subcutaneous ball. Its diameter reaches three centimeters, but can be more impressive.

The node is painful to the touch. Because of this, it is difficult for the patient to turn and tilt his head, and open his mouth wide. The mobility of the upper and lower jaw is significantly limited.

The pain may radiate to the cheek or ear. Body temperature increases. Overall performance decreases.

Third stage

Called purulent lymphadenitis. Here, the inflammatory process even affects structures adjacent to the lymph node. The patient complains of pain in the throat, collarbone, armpit, and head. The nerve endings of the teeth may become inflamed. Then acute toothache occurs.

Pus formed in lymphoid tissues consists mainly of necrotic cells. If it gets into the blood (and such a possibility always exists), the outcome can be extremely unfavorable, so the inflammatory process should not be started.

Patients can understand that the submandibular lymph node is inflamed and needs treatment as soon as possible by the following signs:

the “ball” enlarges and becomes red or bluish;
every day it becomes more dense and solid;
the skin located above the lymph node takes on a red tint and is hot to the touch;
the lower jaw area swells.

How to treat submandibular lymphadenitis

Inflammation of the submandibular lymph nodes can be completely cured only with an integrated approach

. The doctor determines the treatment regimen for submandibular lymphadenitis in a child or adult after studying all the symptoms and medical history of the patient.

The first stage of treatment is carried out by dentists and surgeons and may include medical and surgical therapies. At this stage, two main tasks must be solved - sanitation of the source of infection and relief of pain. The main groups of prescribed drugs are:

Antibiotics. In the vast majority of cases, the disease is bacterial in nature, so treatment of submandibular lymphadenitis requires antibiotics
. Penicillin antibiotics are usually used, since the typical causative agents of the disease are streptococci or staphylococci. To select the most effective drug, the doctor may prescribe the patient to take a puncture to determine the resistance of bacteria to a particular drug. Ampicillin, Ampiox, Oxacillin, Bicillin, Amoxicillin or Ticarcillin are usually prescribed.
Anti-inflammatory drugs. Used to relieve inflammation. The medicine should be selected by the attending physician, taking into account the course of the disease and medical history.
Analgesics. Necessary solely to eliminate acute pain syndrome. Analgesics are a concomitant medication; the main medicine for submandibular lymphadenitis in adults is antibiotics.

In parallel with drug therapy, the doctor sanitizes the foci of infection. If the cause of the disease is inflammation of the oral mucosa, then it will be treated by a dental surgeon.

To quickly relieve inflammation and speed up the recovery process in the purulent form of lymphadenitis, the node is surgically opened, after which the accumulated pus is removed from it.

When the original source of inflammation has been eliminated and the acute period of the disease has passed, the doctor will prescribe physiotherapy to the patient. Electrophoresis is especially effective. At this stage of treatment, you can use folk remedies for a speedy recovery.

Submandibular lymphadenitis in children

In children, submandibular lymphadenitis occurs less frequently than in adults. In children under three years of age, the disease cannot develop at all, which is due to the peculiarities of the formation of the lymphatic system.

Photo: submandibular lymphadenitis in a child

If a child is bothered by pain in the neck or jaw area, parents should carefully palpate the nodes. Healthy lymph nodes are quite soft and mobile, and the procedure itself is absolutely painless. If pain occurs or a lump is detected, you should immediately contact your pediatrician.

The main cause of inflammation of children's lymph nodes is diseases of the teeth, gums and infection in the nasopharynx. The doctor determines the treatment regimen for submandibular lymphadenitis in a child individually, taking into account the patient’s age and the admissibility of taking medications.

Prevention of the inflammatory process

To reduce the risk of developing lymphadenitis, you must strictly follow the recommendations:

Have annual preventive examinations at the dental clinic. Treat all emerging oral diseases in a timely manner. Avoid caries and take care of your gums.
Do not ignore the presence of infections and treat them. During therapy, strictly follow all medical prescriptions.
For any damage to the skin, treat wounds with antiseptics. This minimizes the risk of contracting an infectious disease.
If you feel unwell, consult a doctor and get laboratory tests. This simple measure allows you to detect violations at the earliest stages.

It is necessary to understand that using “grandmother’s” methods for inflamed lymph nodes is dangerous. So, under no circumstances should you heat the inflamed area or apply cold compresses to it. It is unacceptable to massage him or put pressure on him. All of these actions can make the situation worse. Then it will be much more difficult to reverse the disease.

Prevention of submandibular lymphadenitis

Prevention of submandibular lymphadenitis involves taking measures to prevent the development of diseases that can cause an inflammatory process in the lymph nodes:

During periods of acute respiratory infections epidemic, you should avoid crowded places and take all measures to prevent respiratory diseases.
It is necessary to undergo a timely examination by a dentist and carry out all necessary treatment measures.
It is necessary to properly and completely treat diseases of the nasopharynx, to prevent acute forms of ENT pathologies from becoming chronic.

Is it possible to use traditional methods for treatment?

The craze for traditional medicine is bearing fruit. People are trying to replace pills with natural remedies. Alas, advanced lymphadenitis cannot be cured by this. Traditional methods can become an additional way to treat the disease in the initial stages of lymphadenitis and only in consultation with a doctor.

If you are undergoing treatment at the dentist, then take on board the following remedies to help cope with inflammation:

ginger tea;
compress with echinacea tincture;
blueberry drink before meals;
beet juice;
vitamin C.

These remedies will help strengthen the body and activate forces to fight the disease. At least they won't do any harm.

Important: do not use traditional medicine without medical supervision. Not a single folk remedy can cope with purulent inflammation. As a result, you will still see a doctor, but it will take longer to be treated.

In the worst case, self-medication will lead to the appearance of chronic lymphadenitis - the accumulation of disease in the lymph nodes. In this case, the lymph nodes will become dense and painless. But the inflammation has not gone away - it is “dormant” and waits for the hour to strike the body with an acute attack under favorable conditions.