Swelling that occurs after tooth extraction: how to remove it and how much it lasts

One of the most frequent problems faced by patients after tooth extraction is the appearance of significant swelling of soft tissues in the vicinity of the hole. Such edema can occur during the removal of any tooth, but most often they are most pronounced in the removal of chewing teeth (molars), including wisdom teeth.

Further we will talk about this problem in more detail and consider the most exciting questions in this situation:

• Whether it is worth worrying at all and whether it is urgent to run to a doctor if, after an tooth is removed, the gums near the hole or even the entire cheek are very swollen;
• How to prevent the development of serious edema, which without additional intervention could significantly complicate a normal life;
• What accompanying symptoms should be considered as very alarming, in which it is desirable to quickly seek medical help from a doctor;
• How much does the swelling usually hold after tooth extraction and how exactly does your situation fit into the concept of the norm;
• What complications can arise if you incorrectly assess the situation and put the problem to chance;
• And also we will look, what exercises will help at the difficult opening of a mouth (it is often observed after difficult removal of the lower wisdom teeth).

 

In which cases, after tooth extraction, edema most often occurs.

To better understand how and how you can remove swelling after tooth extraction, it is important to first understand the nature of the appearance of the edema itself.

Interestingly, many people who came to see a dentist-surgeon, strangely forget that they came to the doctor with edema, but they are waiting for his immediate disappearance, almost on the first day after a tooth is removed. After all, it would seem that the problem tooth has already been removed, why then did the edema not only not disappear, but also seem to have increased?

A swollen cheek or lip (even before a tooth is removed) may result from the development of periodontitis (in the acute stage), periostitis, or odontogenic osteomyelitis. Quite a few people come to the doctor with the already neglected state of the tooth, which is manifested by the so-called "flux".By its nature, flux is a purulent inflammatory process under the periosteum of the alveolar process or the jaw body of infectious origin, the focus of which is almost always localized in the root region of a neglected tooth.

On a note

When a tooth thoroughly destroyed by caries has not been cured for many years, it continues to “rot” gradually, and inflammatory processes occur on its roots. The body for some time restrains the onslaught of infection and limits its spread, surrounding the capsule-capsule - granuloma or cyst.

The photo below shows the extracted tooth with cysts on the roots:

However, the resources of immunity are not limitless, and the balance of power can be disturbed under a variety of circumstances: with an excessive load on the tooth, concomitant disease (ARVI, for example), stress - all this can trigger the spread of infection in the jaw tissue, which will be accompanied by the accumulation of purulent exudate. And in such an amount that the asymmetry of the face due to edema can be very pronounced.

As a result, in practice, it turns out that in most clinical situations, people at least turn to a dentist-surgeon for tooth extraction.with infection surrounding the root, as a maximum - with limited or diffuse purulent inflammatory processes (that is, in the acute phase). And although the main problem is eliminated during the extraction of a tooth, the infectious focus and edema can still be felt for a long time.

Meanwhile, it is worth noting that sometimes relief comes immediately after a tooth is removed: the feeling of bursting disappears, swelling subsides, pain stops. After extracting the ill-fated tooth with cysts on the roots, the person begins to live again (as patients say).

From the practice of the dentist

A number of dentists sometimes practice work without “incisions” to reduce the pus in the wound after an extraction. In this case, the symmetry of the face due to swelling is restored by squeezing the liquid out of the gums onto a sterile gauze ball. Yes, it is sometimes painful, but it is possible to remove the swelling very quickly - the patient can immediately see in the mirror how much everything has become better. Swollen swollen face (cheek, lip) for some 5 minutes will decrease in volume by 2-3 times. "

Not all people have an organism after the removal of the roots of a tooth with granulomas, cysts, or even without them, equally quickly copes with an infection that continues to be in the hole for some time.No tweezers can remove millions of bacteria, both harmless and pathogenic, from the wound.

After the tooth is removed, the wound is filled with a blood clot, which should allow immunity factors to deal with traces of the infection and start the mechanism of safe healing of the hole. For many, this mechanism is triggered by a cascade of inflammatory reactions - as a result, quite often on day 2 after tooth extraction, pain, swelling, fever and other unpleasant symptoms not only do not go away, but can even intensify somewhat, causing anxiety in the patient.

Often this can be observed after the removal of the lower wisdom teeth: with difficulty in their eruption, exacerbation of chronic periodontitis, periostitis, etc. In the region of the mandibular teeth, there is a large volume of loose tissues that are well supplied and innervated. That is why the inflammatory reaction here is often accompanied by severe edema, fever and pain, especially when swallowing.

A completely reasonable question arises: can the face swell develop if a “calm” tooth is removed? Indeed, not only dilapidated rotten pigs come to the dentist-surgeon,but also quite strong teeth with no infection on the roots.

And remove them, for example, for the following reasons:

• Due to a violation of bite or injury to the cheek mucosa;
• Due to interference with orthodontic treatment (for example, on braces);
• Due to interference with a successful prosthesis (for example, an unnecessary root of a tooth or a mobile tooth is required to be removed);
• Or at the personal request of patients who refuse to treat a tooth in principle, which could still be saved.

In such cases, swelling after tooth extraction also occurs, but they are usually much less pronounced compared with the removal of teeth against the background of purulent exacerbation. However, even in this case, especially if the patient acts incorrectly to care for the hole, the wound can become infected with the subsequent development of significant edema, pain and putrid breath from the mouth. We will talk about these alarming symptoms below.

In the meantime, let's see how you can initially prevent the development of severe edema after tooth extraction, thereby making the postoperative period more comfortable. And what mistakes should not be allowed ...

 

How can you prevent the development of severe swelling after tooth extraction?

There are many techniques that allow you to make the swelling on the face after the extraction of the tooth does not show up at all - the resulting edema will be small and will affect only the gums within the well.

It should be noted three main points that give a good effect in the complex:

• The use of cold on the first day after tooth extraction;
• Refusal of hot, hard and spicy food, as well as vigorous physical activity and warming up (bath, sauna, steam room, solarium, hot bath);
• Taking drugs (nonsteroidal anti-inflammatory drugs, antihistamines, sometimes - hemostatics).

To prevent severe swelling after tooth extraction, most dentists recommend applying cold to the cheek area on the side where the hole is located. Again, not all dentists advise this method, as they are well aware that patients can perform the same instruction in very different ways. If the doctor tells the person on the track: “In order not to have a swollen cheek, use cold during the day,” then anything can be expected.

As a result, in winter, the snow can become that saving “cold”: at best, 1-2 minutes at worst, an hour or more at the worst. In the summer, such a patient will be attracted to the freezer and the freezing in it (chicken, berries, dumplings), which, like snow, can cause severe frostbite on the face.

Not every dentist for a limited time will be able to convey to the patient that this is a cold compress. That is, it is not required to freeze the face until whitening, but it is important that there is a slight effect of cold on the skin. If there is a pack of frozen dumplings, then it should be wrapped in a towel, if the towel is thin - in several layers. Etc. That is, common sense is important.

A cold water bottle is the best option. Again, if the water is ice - you need to wrap a heater with a towel, and when the water warms up - remove the towel or change the water. Retention time - 15-20 minutes every 2 hours.

Cold, as a local decongestant, is certainly effective, but only in combination with common sense and detailed instruction.

It is important to know!

The use of cold is relevant only in the first day after tooth extraction. To remove the cold swelling on the second day will be much less effective.

If the cold constricts the blood vessels and reduces the blood flow in the wound area, then everything that relates to the heating of the body contributes to the development of strong edema (hot food and drinks, physical activity, a bath, etc.). It is necessary to refuse warming up procedures for 3-4 days after tooth extraction.

On a note

It is quite possible to take a shower and wash your hair, but you should adjust the water to a temperature of about 36-37 ° C so that the water is warm, not hot.

What else can prevent the appearance of edema after tooth extraction?

Those patients who suffer from diseases of the cardiovascular system, should closely monitor blood pressure and take medication recommended by your doctor, reducing it. After all, edema and hematoma, which occur after tooth extraction in such cases, are largely the result of alveolar bleeding against the background of hanging pressure. Stable blood pressure is a guarantee of comfort in the postoperative period.

As for drugs, there are a lot of tools that prevent pronounced edema, and even reduce them, if they have already formed. These include antihistamines.People know them, first of all, as antiallergic drugs, but they can also be called anti-edematous, too.

When choosing a drug, take into account contraindications to its use (for example, pregnancy, lactation, childhood, a number of diseases, etc.), as well as drug interaction, while using it with other drugs. Deal with how this or that antihistamine drug in your situation will be effective and safe, should a doctor at the reception.

The same applies to nonsteroidal anti-inflammatory drugs, hemostatic agents, glucocorticoids, and other drugs, on which it depends how comfortable the postoperative period is. Such medication should be carried out under the supervision of a physician.

It should be noted that despite the efforts taken to reduce the severity of edema, it can still appear and cause discomfort. Especially often this is observed after the removal of the impacted wisdom teeth in the lower jaw. Post-traumatic inflammatory process in connection with the anatomy and peculiarities of the location of wisdom teeth, even despite the efforts made by the doctor and the patient, often leads to the appearance of quite pronounced edema.

The picture below shows a polyurethane wisdom tooth:

Do not immediately panic. Usually, the swelling reaches its maximum within 2-3 days after the removal of a wisdom tooth, and here it is important to monitor the condition as a whole, and not just one symptom. If there is a serious deterioration in health (temperature rise to high values, intolerable pain, not relieved by analgesics, suppuration, or bleeding from the hole), then you should consult a doctor immediately.

Now a few words about the appearance after the removal of a bruise on the whole cheek, neck or jaw.

Do not panic when such a bruise appears, even if it looks ominous. After removal of the lower molars, education is often observed along with swelling of an extensive hematoma (especially in patients with arterial hypertension) - first the hematoma may have a bluish color, after 3-5 days it becomes yellow, and then disappears completely without a trace. The appearance of a hematoma after tooth extraction does not indicate any complications or errors of the dentist-surgeon, being quite a common phenomenon.

It is interesting

Hematoma can even occur due to the needles piercing the gums during anesthetic injection.To prevent the appearance of an unwanted bruise after anesthesia, before removing the tooth, a number of dentists ask you to press the injection site with your hand for 1-2 minutes through the cheek. Some doctors believe that this is a relic of the past: modern techniques of working with imported anesthetics have almost no risk of developing extensive hematomas when vessels are injured. However, if there is a risk of hematoma due to the individual characteristics of the patient, this technique of “pressing the injection site” can be considered relevant in our time.

 

What symptoms may be followed by edema, and when it is worth running as soon as possible to a doctor

Even if, thanks to the methods described above, it is possible to significantly remove the edema after tooth extraction, this is not yet a complete guarantee of a safe postoperative period.

The most frequent manifestations that accompany edema are:

• Fever;
• Impairment of well-being;
• The appearance of pain (especially when swallowing, chewing, and even during a conversation);
• Difficult mouth opening;
• Paresthesia.

Increased body temperature most often occurs on the very first day after tooth extraction.This is a normal reaction of the body in response to surgery, but only in this context: by evening it is as high as possible (up to 38.5 ° C), and by the morning it is either 36.6 or slightly higher (not more than 37.5 ° C ). In this case, we can say that the body fights in the normal mode, coping with the inflammatory process.

The more teeth were simultaneously removed, the stronger the response of the body can be.

In the photo below - fresh holes after removing two teeth at once:

Thus, an elevated temperature of 1-2 days after removal should not be considered as pathology, but it should be monitored 2 times a day at the same time (for example, early in the morning at 8 o'clock and then later in the evening at 20:00). If the temperature is above 38.5 ° C, or it lasts for more than 2 days, having high morning rates, then this is a reason to consult a doctor.

The degree of deterioration of health after tooth extraction depends largely on the individual characteristics of the organism of each person. If the body is weakened against the background of other diseases, there are immune pathologies, or an older age, then the state of health can deteriorate significantly, and the help of a doctor will be required.About any disability speech and can not be. The doctor is only able to assess the condition after the examination, and if necessary, a sick-list will be issued for the required number of days so that the patient can recuperate at home.

On a note

Some people are so “eager to fight” (that is, to get a job as soon as possible) that they don’t want to spend a couple of days at home treatment. Quickly remove the swelling, swallow a couple anesthetic pill, if the hole is sore - and go! However, it is important to understand that after surgery (and the removal of a tooth is an operation) the body needs to be given time to recover. Otherwise, non-compliance with the recommendations of the doctor may lead to a series of progressive serious complications.

The appearance of severe pains on the background of developed edema is a frequent and perhaps the most unpleasant phenomenon, especially when pain is not relieved by analgesics. Doctors almost always include painkillers in the recommendations to cope with the painful period in the first days after tooth extraction. However, with the development of tissue edema, both slack and arching pains may arise, tearing and not relieving pain painkillers, which are not possible to cope with on their own.

With the development of acute pain for 2-3 days and the next after the removal of the tooth against a background of fever, severe swelling, putrid breath and other alarming symptoms, you should immediately contact your doctor for help.

Edema may be accompanied by difficulty opening the mouth (often observed when removing the lower wisdom tooth). It sometimes hurts to open your mouth even a couple of centimeters. There is a strange sensation of pain when swallowing, as with sore throat, and on the one hand. This is due to the anatomical location of the eighth teeth: the spread of edema captures the chewing muscles of the jaw.

An improvement usually comes within 3-4 days - the pain when opening the mouth decreases, and other symptoms (if any) also gradually disappear, that is, positive dynamics are determined. If this does not happen, and the mouth is still barely open, or it has become worse, then you need to consult a doctor.

More rarely, neurological problems occur - in particular, paresthesia, that is, loss of sensation in the area of ​​the extracted tooth, as well as in the area of ​​the lip, cheek, chin. This most often applies to cases of removal of the lower wisdom teeth (eights), less often - the lower sixth and seventh.

The reason may be excessive invasiveness in the intervention zone with damage to the mandibular nerve, less often paresthesia is a consequence of the development of edema, in which compression of the nerve trunk occurs. In the latter case, the loss of sensitivity is self-eliminated as the edema (hematoma) in the area of ​​the extracted tooth decreases.

The terms of restoring the damaged nerve trunk are rather long: from 2-3 weeks to 1-2 years, depending on the severity of the violation. However, it is possible to speed up this process somewhat - it is important to consult a doctor with this problem in time, determine the cause of paresthesia and start rebuilding procedures (physiotherapy) in a timely manner.

Feedback:

“I deleted 3 months ago a wisdom tooth that could not cut through the gums. I was immediately told that after such a complex removal there will be swelling and it can get very sick in the first days. After removal, I was prescribed antibiotics and mouthpans with an antiseptic, and also levomekol to the gum. I deleted on Wednesday, and the biggest swelling pouted on Friday, well, that for the weekend.I thought that I would not go to work, but on Sunday he disappeared completely, only a small yellowish bruise was left on his cheek ... "

Oksana, St. Petersburg

 

How much does swelling usually last after tooth extraction?

If the doctor, after the extraction of the tooth, did not pay enough attention to the patient and did not inform him about the basic recommendations for caring for the hole (this is often the case in polyclinics), then even minor problems arise, a person often has panic fear. This is especially true of the appearance of edema and severe pain: because of the stress experienced after severe tooth extraction, the patient is simply afraid to go to the doctor again, does not know whether the current situation is dangerous and what to do.

So, in this case it is useful to know how much the swelling of the tooth extraction field lasts on average, as well as how long other unpleasant symptoms manifest themselves.

According to the research, it turned out that the edema can reach its maximum by 2-3 days, and this is not a deviation from the norm, as well as a slight increase in body temperature, some deterioration in the general condition, the appearance of pain.All these are completely natural and regular manifestations of the post-traumatic inflammatory process.

However, patients often cannot independently decide how many days they can tolerate swelling or swelling of the face while it subsides, and when the dentist is still to be disturbed. Meanwhile, a number of dentists insist that patients bother them even with small deviations from normal health (with the appearance of swelling, aching pain, temperature rises to 38 ° C).

So what to do - go immediately to the doctor if something starts to disturb after tooth extraction, or wait? The answer is: never interfere with reinsurance, and you should not wait for the swelling to spread to the neck or take up half of the face (sometimes even the eyes due to puffiness can not be opened). If something is bothering, then it makes sense, at least, to call the doctor and ask for advice, or to make an appointment for an examination.

However, when there is a clear positive trend (edema is insignificant and started to take place for 3-4 days, there is almost no temperature, severe pain, impaired mouth opening, paresthesia, putrid breath), it’s understandable that you shouldn’t regularly go every two days to the doctor with questions why the temperature is 37.2 and the gums ache a little.

The postoperative period lasts on average from 3 to 10 days. The main symptoms (edema, pain) can be severely pronounced up to 3-4 days. Usually all unpleasant phenomena pass in a week, and in difficult cases - in two weeks. And the main rule here is no self-treatment without recommendations and control from the dentist.

 

About possible complications

Now let's look at situations where edema accompanies possible complications after tooth extraction. In such cases, the edema does not subside until the underlying disease is eliminated.

Let's start with the most common complication - alveolitis. Alveolitis is a consequence of infection of the well, that is, simply put, it is its inflammation. The degree of edema may be greater. Often, during the alveolitis, gingival suppuration occurs around the hole of the extracted tooth, sometimes suppuration develops under pressure.

Independently treat alveolitis is not worth it, you need to consult a doctor. It is important to understand the main causes of this pathology:

• Fragments of a tooth or its root could remain in the hole;
• A granuloma or cyst remains at the bottom of the well;
• The so-called “dry hole” (that is, without a blood clot protecting it);
• Ingesting food residues and rotting there;
• A gross violation of the doctor's recommendations (attempts to pick a hole with a toothpick, warm it, etc.)

A more serious version of the complication is limited osteomyelitis of the tooth cavity. In rare cases, when alveolitis is neglected or its treatment is unsuccessful, purulent-necrotic inflammation of the bone walls of the hole develops - osteomyelitis.

Its symptoms are strongly pronounced: a throbbing pain may appear in the hole, extending into the adjacent teeth, the person stops sleeping normally, eating, cannot work. The temperature reaches high values, a strong edema develops, moving onto the gum bordering the adjacent teeth, as well as on the soft tissues of the face. A fetid smell from the mouth begins to disturb the person, an increase in the lymph nodes occurs.

In such cases, as a rule, specialized assistance is required in terms of maxillofacial surgery.

Among the possible complications after the removal of the tooth is also worth noting an abscess and phlegmon.

An abscess is a limited purulent inflammation, and phlegmon is diffuse (and may even threaten the patient’s life). Often, with such severe complications, children go to operating surgeons.

In a child (especially a weakened one), a few days can pass from the development of edema to an abscess and phlegmon. Unlike adults, children are not always formed factors of protection against fulminant infection. Therefore, parents should remember that the formation of strongly pronounced edema in a child after the removal of a tooth (even milk) is a reason to sound the alarm and run urgently to a doctor.

 

Special exercises for difficulty opening the mouth after removal of the molar teeth

After removing a molar tooth (often in the lower jaw, especially the wisdom tooth), many people are seriously worried about the fact that it is simply impossible to open their mouth normally. Problems with opening the mouth (trizm) can be observed both against the background of pronounced edema, and without it. Sometimes the mouth fails to open even 1-2 centimeters, which creates great problems not only with speech, but, above all, with food intake.

What can you do to quickly get closer to the state of the norm?

First of all, you need to keep in mind that removing edema does not guarantee a successful solution to the problem of opening the mouth. If the trism is “fresh”, then the jaw must be developed, otherwise, surgical intervention may be necessary. The terms of the disappearance of the trisism are purely individual - from a week to 1-2 months (much depends on how difficult the tooth extraction was).

From the very first days after the extraction of the tooth, it is possible to independently conduct gymnastics, using a chewing gum, or without it. Frequent and minor chewing movements accelerate the development of a joint even against the background of the inflammatory process in the area of ​​the masticatory muscles. It is important to exercise without fanaticism, to the feeling of light pain, otherwise such exercises will only be harmful.

As for the more complex set of exercises, it is necessary to consult a dentist who deals with diseases of the TMJ. It will take physical therapy - therapeutic physical culture for the maxillofacial area.

Here are examples of several exercises to improve mouth opening:

1. Without muscular tension, calm opening of the mouth (as far as possible) at a slow pace in a position with the head thrown back;
2. Lowering the jaw and with a little effort pushing it forward;
3. With an open mouth (as far as possible), raising the voice with pronouncing the sound "a";
4. Slight pulling down of the lower jaw with both hands, using the thumbs of the chin with the head thrown back.

The alternation of tension and relaxation of the muscles of the maxillofacial region has a significant therapeutic effect with proper and systematic performance of each exercise.

In severe cases, especially when the trisism has been around for several months or more, mechanotherapy is required - a set of exercises with the use of special devices. Most often, mechanotherapy is carried out in conjunction with physiotherapeutic procedures (electrophoresis, ultraviolet radiation, thermal mouth baths, paraffin therapy, and others).

 

What you need and do not need to do after tooth extraction

 

Video review of the consequences of wisdom tooth extraction (by day)