Sometimes after tooth extraction, after about 1-3 days, inflammation and suppuration of the hole (alveolitis) begins - a rather dangerous complication, which is accompanied by a number of unpleasant symptoms. Alveolitis can occur after the removal of any tooth, disrupting the normal healing process of the hole and often creating a serious threat to human health in general.
If, after the removal of a tooth, it is not possible to treat the alveolitis-affected hole in time, then there are risks of severe complications. For example, with the further development of a purulent-necrotic process, limited osteomyelitis can form in the wound, which creates prerequisites for the development of life-threatening abscesses and jaw phlegmon. The rapid spread of infection in the deep spaces of the lower jaw can provoke blood infection (sepsis), in which a person sometimes dies in a matter of days.
The photo below shows an example of odontogenic phlegmon:
That is why it is so important to recognize the problem in time. If after you have pulled out a tooth, the hole for some reason has festered, then you should not wait when everything resolves itself - you need to use all possible means to relieve this complication.
And then we will consider in detail the main causes of inflammation of the tooth hole, which home remedies can be used to treat alveolitis, and in which cases the help of a dentist is indispensable for solving the problem.
It is interesting
According to statistics, alveolitis most often develops after removal of the molars of the lower jaw (molars), including wisdom teeth. The fact is that the structure of the lower jaw, as compared to the upper one, has a number of important features that create inconveniences in the work of the dentist-surgeon: it is more difficult to extract complex roots (for example, curved ones) from the “thick” bone and, moreover, the infection quickly goes to deep spaces with the development of purulent inflammation.
Therefore, objectively there is a greater chance that after removal of large molars of the lower jaw, alveolitis will occur. In this regard, wisdom teeth are particularly problematic.
What does a well look like after tooth extraction?
After tooth extraction, bleeding from the hole usually occurs immediately (but sometimes the adrenaline from the anesthetic narrows the vessels so much that at first the hole is almost “dry” and bleeding develops only later when the patient is already at home). Normally, the blood stops for 3-30 minutes, forming a blood clot in the hole that protects the wound from adverse external influences.
The photo below shows what the hole looks like immediately after the removal of a wisdom tooth that was previously hidden under the gum:
The blood clot that has formed after the extraction of a tooth changes its color from burgundy to lighter with a yellowish tinge in a couple of days. The color in this case is determined by the natural physiological processes: the red component from the erythrocytes (hemoglobin) is gradually washed out by the liquid from the oral cavity, but the so-called fibrin skeleton is preserved, which serves as the structural basis of the thrombus that prevents bleeding from the hole of the extracted tooth.
If the healing of tissues passes without complications, then a normal well in 1-2 days should look something like the one shown in the photo:
Despite the characteristic color, do not confuse a normal thrombus with pus and fear that a change in color from burgundy to lighter is already a sign of alveolitis. Moreover, you do not need to climb into the wound, as this can seriously harm the normal healing of the hole.
The process of normal healing (overgrowth) of the hole after tooth extraction should proceed smoothly. The wound heals on the principle of secondary tension, in other words - there is a gradual convergence of its edges. The main healing factor is the growth of granulation tissue, which is soon replaced by young bone tissue.
The photo shows what the hole looks like after tooth extraction after 3 weeks:
If the process is not complicated by alveolitis, then usually on about 7 days after tooth extraction, granulation tissue almost completely replaces the blood clot, and young bone is actively formed. How long the hole will be overgrown after tooth extraction, in order for a smooth gum to fully form, depends on the nature of the intervention. The rougher the removal and the more damaged the surrounding tissue, the longer the wound will heal.
According to statistics, normal healing should end in 2-3 weeks, but this does not mean that nothing happens in the hole. The complete formation of bone tissue under the gum usually completes only after 2-3 months, and then there is no trace of the former hole in which it was previously sick.
Photo of a fully healed gum (after 2 months):
The main causes of inflammation of the hole and gums
Let's imagine a bad tooth, on the roots of which there are foci of inflammation. Such foci are usually isolated by the body in the so-called granulomas (cysts) - simply speaking, these are sacs filled with infection and pus.
When the tooth is removed, the bacteria partly remain in the hole - in this case they speak about the primary infection of the wound. Even if the dentist-surgeon removed all the roots of the tooth with or without granulomas (cysts), the infection that provoked inflammation in the tissues surrounding the root cannot be completely eliminated, although it can and should be controlled. Whether it provokes alveolitis, depends, among other things, on human immunity.
There are also risks of secondary infection of the wound, that is, when the infection gets from the outside, which can also lead to alveolitis.
For example, alveolitis after tooth extraction may develop in the following cases:
- In the absence of a normal blood clot in the hole. When the effect of a dry hole occurs immediately or after a tooth is removed, the result is an empty wound that is not filled with a protective blood clot and is open to any infections in the mouth.
- When pushing during a tooth extraction procedure deep into the well of infected objects: tartar, carious tooth walls, bone fragments, etc.
- With poor care of the hole by the patient. Moreover, the development of alveolitis can be triggered not only by the refusal to follow the doctor’s recommendations, but also the unauthorized use of methods that are not acceptable in this clinical situation (for example, intensive mouth rinsing, leading to leaching of the protective blood clot from the hole).
Against the background of reduced immunity, a number of comorbidities and in elderly people, the risks for the development of alveolitis, even with a simple tooth extraction, are elevated.
So, after a tooth is pulled out, the hole, especially if it is dry (without a blood clot), can fester already on day 2 after the procedure.In this case, at first there is no acute pain, and there is only a weak aching pain, aggravated during the meal.
At the same time the remains of food and saliva are often determined. The edges of the gums at the site of the extracted tooth are red, when you touch them there is pain. The general condition of a person is satisfactory, there is no temperature.
With the further spread of purulent infection, more characteristic symptoms of alveolitis develop:
- severe persistent pain at the site of the extracted tooth;
- the spread (irradiation) of pain to neighboring areas - from the maxillofacial area to the head area;
- increase in body temperature to relatively high values (up to 38) and the appearance of associated chills, body aches and deterioration of general well-being;
- the appearance of putrid odor from the mouth as a result of suppuration of the hole;
- the absence of a blood clot in the wound (dry hole);
- the presence of a dirty gray plaque on the surface of the healing gums (sometimes there is a black hole);
- enlarged submandibular lymph nodes;
- One of the most important and characteristic signs of suppuration of the hole at the site of the extracted tooth is the appearance of purulent exudate from the wound, especially when the gum is pressed.
“On Wednesday I went to the removal of the lower molar, since there was only one stump left from it, which was no longer suitable for a crown. Removal was quick and almost without pain, was assigned to rinse your mouth and sent for treatment at home.
Already on Thursday, in a place where there used to be a tooth, severe pain began and the gums swelled. Another horrible bad breath appeared. In the end, I came to the doctor who pulled my tooth the day before. She looked and advised me to “fasten” and put a hot water bottle with ice on my swollen cheek. After a couple of days, the swelling slept, but the gum did not hurt less. I drank several times a day Nurofen. But the pain never stopped, so I went back to that aunt.
They took a picture of me and said that everything is fine, but there are sharp bones from the place where my tooth used to be. So they decided to remove. It was very painful when they were picking at my gums again and removing these “bones”, then putting gauze, making me bite and sending me home.
After a couple of hours, hellish throbbing pains began, so I decided to go to the next private clinic, where they explained everything to me. It turns out that I had a bad tooth removed, a lot of lumps from the destroyed tooth and bones from the jaw remained, so it all mixed with infection and gave pus.With an injection, I cleaned all this away with absolutely no pain, put a gauze napkin with ointment on top and gave recommendations. On the same day, I felt better, so more about that doctor who removed the tooth I didn’t have with my foot. ”
What can be done at home for emergency treatment of a festering hole
If after removing a tooth, the hole began to fester or other alveolitis symptoms described above appeared, and it is not possible to get a doctor for a consultation in the near future, you can try to relieve the condition yourself at home.
However, it is important to keep in mind that not all seemingly effective methods are harmless. Some lotions and rinses only exacerbate the situation, creating prerequisites for an even greater progression of inflammation.
For example, most caring friends can advise you soda solution and 3% hydrogen peroxide for rinsing - it would seem, time-tested folk remedies to relieve inflammation. But most doctors are unequivocally opposed to such a mockery of the body,after all, soda and peroxide, despite their antiseptic effect, can also flush out a protective blood clot, leaving the empty black hole in the future defenseless against infection.
Natural antiseptics — for example, chamomile and sage decoctions, which are quite suitable for home use, can become relatively safe and effective treatments for alveolitis. But here there are important nuances:
- it is impossible to rinse the mouth intensively so as not to wash the blood clot. It is enough just to take water in your mouth and hold the solution at the sore spot for 2-3 minutes.
- During the procedure, it is impossible to suck the remnants of a decaying blood clot from the wound, even if it smells bad and looks black. And even more so it is impossible to pick out a clot with a toothpick or a cotton swab.
- It is important to arrange such antiseptic rinses as often as possible (10-12 times for an hour, until there is a clear improvement).
After prior consultation with a doctor (at least by phone), analgesics can be used, such as Pentalgin, Ketorol, Ketanov, Naiz, Baralgin, or others.However, you need to understand that these drugs only relieve pain, but do not cure alveolitis and related inflammatory processes.
Now let's assume that you still managed to stop the symptoms of alveolitis on your own - the acute pain disappeared, the suppuration of the hole seemed to have subsided, the swelling of the gums and cheeks subsided. What to do next?
First of all, it is not worthwhile to be greatly deceived and relaxed, hoping that the hole will not fester anymore. Often, in such cases, the process is only transferred from the acute to the chronic form. Therefore, as soon as it becomes possible to get an appointment with a dentist, this must be done in order to prevent the occurrence of further exacerbations.
Professional treatment of alveolitis: what can you expect in the dentist's office
When patients visit a dentist-surgeon about the inflammation of the hole after the tooth extraction procedure, the doctor usually sees the following picture in the oral cavity: a blood clot in the hole is either completely absent, or there are disintegrating residues; with pressure on the gums can be pus with an unpleasant odor. This is usually enough to diagnose alveolitis and proceed with its immediate treatment.
Treatment of alveolitis after tooth extraction consists of several stages:
- First, a good anesthesia is done;
- Curettage (cleaning) of the extracted tooth is performed - its scraping with careful mechanical treatment of necrotic tissues with simultaneous washing of the wound with antiseptic solutions from food residues, saliva, disintegrated clot, etc .;
- Then the refreshment of the well is carried out with a scalpel;
- According to the indications, sutures are put on the hole, a gauze napkin is installed with or without the preparation;
- Recommendations for the care of wounds are given and antiseptic rinses and medications for topical administration in the form of gels or ointments are prescribed.
Installation of any drugs in the well itself is an outdated technique, but for public institutions it is currently one of the most effective in the treatment of alveolitis, although it is not without certain drawbacks.
The following drugs can be used as antiseptics for further home treatment of alveolitis (as agreed with the doctor):
For application to the gum, Metrogil Dent gel and Solcoseryl dental adhesive paste are sometimes used.
I snatched the remnants of the tooth 6 days ago. At first they made injections throughout the gum, and then with a forceps for a long time they could not pick up the root, as it constantly crumbled. But, thank God, pulled out.
Already at home, when the frost passed, it became so terrible to hurt that I had to swallow painkillers. Literally a day later, it seemed that a smell arose from the mouth, and the hole began to hurt even more. I had to not go to work, I decided to be treated at home with gargles with chamomile. At first, it became easier, but closer to evening, the gums began to pulsate, and the body began to ache. And the temperature is 37.8 ° C. For two days I stayed behind, but the temperature and pain in the gums, where there used to be a tooth, did not pass. Terribly I didn’t want to go again to the secondhand, but there was no way to go, all the more it seemed that the cheek began to swell. I was just scared that I would die ahead of time, so I went for a checkup.
The doctor said that I had alveolitis, but a little more and it would be much worse. She cleaned the wound from the pus and prescribed medications for the treatment of gums. At the moment, the gum has not yet fully healed, but the temperature and pain are gone, and the swelling becomes less every day. So if you want to have more grandchildren, it is better not to delay as I am.
Nadezhda, 45 years old, Moscow
Physiotherapeutic procedures are sometimes used to treat alveolitis after tooth extraction:
- Microwave therapy;
- Treatment with helium-neon laser;
Prevention of alveolitis
So that after the tooth is pulled out, the hole does not fester, you should carefully consider the recommendations of the doctor for the care of the wound. Do not use those funds that have not been assigned.
If you have any doubts about the competence of the doctor and the correctness of the recommendations, you can seek advice from other clinics. No one forbids getting professional advice even in three medical institutions, especially since these consultations are almost always free.
In order for the healing process of the hole to go through normally, one should not pick a wound, scrape the gum without permission, squeeze out a blood clot, suck it out and damage it. It is especially important for at least several days not to chew food on the side of the jaw where the tooth was removed, so that the blood clot is kept intact.
If the doctor has stitched a hole after a tooth has been removed, then the suture cannot be injured, since the wound edges can disperse and the hole will become an object for secondary infection.It goes without saying that with any hands (neither clean nor dirty) you can not check the wound for soreness or clean it from plaque of any color.
Implementation of these simple rules will allow not to appear again at the surgeon’s appointment and will make the process healing of the hole after tooth extraction comfortable and safe for your health.
Interesting video: what is important to know about alveolitis and how to treat it
What to do after tooth extraction to prevent complications