Why does the cheek swell after tooth extraction

After tooth extraction, patients closely monitor the healing process of the hole. And usually everything goes well - the wound heals, new tissues form, redness in the area of the injured gum disappears. But sometimes frightening formations appear - lumps, hematomas, compactions. Of particular concern is the white growth after tooth extraction. In this case, consulting a doctor is advisable, since the growths can be both safe and requiring treatment.

Reasons why the cheek swells after tooth extraction

After tooth extraction, an inflammatory process occurs in the soft tissues of the oral cavity - this is the main cause of edema and swelling. If the operation is performed correctly and the patient has followed all the dentist’s recommendations, the non-infectious inflammation will go away on its own, without antibiotics or complications, and along with it, pain and swelling will go away.

The duration of swelling varies depending on the surgical technique, which tooth was removed, the condition of the oral cavity, and finally, the physical condition of the patient and his immune system. On average, swelling lasts 3-4 days, but can last for 7 days. If after a week the swelling has not subsided, this is a sign of the development of complications and a reason to consult a specialist.

Swelling appears a few hours after surgery (after the anesthesia wears off). At the same time, the patient may feel aching pain, and ichor is released from the wound. A slight increase in temperature is allowed. All these symptoms are considered natural and do not pose any danger. And to relieve pain, you can take painkillers analgesics.

Maximum swelling is recorded on days 3-4, from this moment it begins to decrease and by the seventh day it completely disappears. But the cheek can swell immediately after depulpation; this happens if the patient had gumboil and the tumor developed even before the operation.

How to relieve cheek swelling after dental treatment?

In order to relieve pain in the tooth, gum and cheek after treatment, as well as relieve swelling, DD Clinic specialists recommend their patients to do simple procedures at home.

Rinsing the mouth with an antiseptic, which will be prescribed by the attending doctor depending on the cause of the swelling;
In case of an allergic reaction, take antihistamines, such as tavegil, suprastin, Erius, etc.;
In case of infectious inflammation of the cheek, take antibiotics. Here it should be recalled that medications should be used only those recommended by your doctor.

When you have a toothache or need a preventative examination, come to DD Clinic - our specialists will painlessly solve any dental problems.

Cheek swelling during wisdom tooth removal

Extraction of extreme molars (wisdom teeth) is considered one of the most difficult tooth extraction operations. It is accompanied by an incision of soft tissues and suturing, so inflammation after it is inevitable. Swelling after wisdom teeth removal lasts longer and is accompanied by pain.

Moreover, an elevated temperature may persist for several days, the patient may have difficulty swallowing, and experience pain when opening the mouth and during speech.

In this case, there is a risk of infection and serious inflammation, therefore, after depulping the extreme molars, it is necessary to take antibiotics and rinse the mouth with antiseptic solutions.

Why does swelling occur after dental implantation?

In general, swelling is a completely normal reaction of the body to injuries. All this is nothing more than an influx of lymph to damaged tissues (i.e., accumulation of fluid in a certain area). This way the body’s natural defenses are activated. Swelling forms within 2-3 days - it reaches its peak on the third day after surgery. After this, the swelling of the tissues should gradually decrease and disappear completely within a week.

When installing classic two-piece implants, when the flap method with gum peeling is used, the likelihood of tissue swelling is much higher. Patients with pathologies of the cardiovascular system and diabetes mellitus are also at risk.

Other causes of cheek swelling

Along with natural, so-called non-infectious inflammation, there are other causes of cheek swelling:

tooth extraction due to gumboil;
extraction with complications - in case of incorrect inclination or direction of tooth growth, when removing massive teeth and teeth with long roots;
the presence of infection and inflammation in soft tissues;
allergic reaction to medications or anesthesia;
individual intolerance to components in medications or anesthetics;
errors during extraction, insufficient antiseptic treatment of the oral cavity and residual infection;
the presence of chronic diseases – hypertension, neuralgia, psycho-emotional pathologies;
failure by the patient to comply with the recommendations of the dental surgeon, refusal of prescribed antibiotics or reduction of their dosage.

Most often, the tumor is caused by improper oral care, lack of disinfection with antiseptics, and skipping medications.

How to reduce swelling after implantation

The main thing you need to do after implantation is to rest well and expect the outcome to be favorable. Your doctor performed the operation successfully, so now how the rehabilitation period goes depends only on you. Read our useful guide after dental implantation, which details what you need to prepare at home in advance and how to solve any problems that arise.

How to apply compresses? This is the most basic method that allows you to relieve tissue swelling. It is especially effective in the first day and even in the first hours after installation of implants.

Proceed as follows: use ice, a heating pad with ice water, or any food from the freezer. But don't overdo it, i.e. do not cause frostbite and tissue necrosis. The procedure is as follows: wrap ice in a towel or 2-3 layers of gauze/thin fabric, apply to the cheek on the side of the surgical intervention, hold for 5-10 minutes. The duration of the compress is 5-10 minutes, breaks are 3-5 minutes. The number of approaches is 7-10 times, for approximately 1.5-2 hours. Such courses can be repeated periodically during the first day.

How to eat properly to avoid swelling? In addition to solid foods (for any implantation protocols, even if the prosthesis was installed immediately), you must exclude excessively hot, spicy and salty foods, coffee, and spices from your diet. Caffeine, for example, increases blood pressure, which contributes to an even greater rush of blood to the head and, accordingly, increased tissue swelling.

Hot foods and drinks are prohibited, as they can lead to increased swelling. Hard - because they can injure the operated area and displace the installed implants. All of the above restrictions are in effect for a week.

Andrey Nikolaevich, 45 years old

“The operation went quickly for me, under anesthesia. I went home fully conscious and without much pain. I expected that when the anesthesia wore off, the pain would be unbearable, there would be severe swelling... Having covered myself with the recommended pills, I waited while I made compresses. The tablets were bought in vain. At night I slept as usual. In the morning I also didn’t experience anything special, there was almost no swelling. On the evening of the first day I came for my first fitting. On the third day, the prosthesis was installed - everything went perfectly!”

“If the doctor is a professional, then rehabilitation will take place very quickly, without pain and without swelling. Tested for myself! "

watch a video with the patient

How should you sleep after implantation? It is necessary to ensure the outflow of blood from the head; it is better to sleep with your head elevated. You can place several pillows under or on the mattress, thus increasing the angle of inclination. Many patients note that after surgery there is a feeling of pulsation in the head. Such a measure will also relieve such a symptom.

Is it possible to visit swimming pools and saunas? To relieve swelling, you need cold. Therefore, not only saunas and swimming pools are prohibited in the first week after installation of implants, but also long stays in a hot bath. It is better to limit yourself to a warm shower.

What medications will help against tissue swelling? After installation of the implants, the patient is prescribed drug therapy. We deliberately do not indicate the names of medications, because in each specific case medications are prescribed individually. But the complex necessarily contains anti-inflammatory and antihistamine drugs, which help reduce tissue swelling. Patients who have problems with the heart and blood vessels, high blood pressure, are also recommended to take appropriate medications.

On the 3rd day after implantation, the patient is scheduled for a preventive examination: the doctor will assess the condition of the tissues, the dynamics of healing and give the necessary recommendations. If you have doubts earlier, you should not wait for a scheduled visit; you can see a doctor earlier.

Possible complications

If after seven days the tumor not only has not gone away, but has also grown and become denser, this indicates a progressive inflammatory process.

At the same time, other symptoms may appear: pain in the gums and cheeks (aching, cutting, throbbing), redness of the cheeks and gums, fever, weakness, loss of appetite, headache.

What complications can inflammation lead to:

Alveolitis or “dry socket” - after a tooth is removed, a blood clot forms in the resulting socket. It serves as a protection and barrier to bacteria and protects the wound from infection. If it is somehow removed, the soft tissues are left without protection, pathogenic bacteria penetrate into them and suppuration begins. In advanced cases, inflammation spreads to other areas of the jaw; not only the cheek, but also the cheekbones and even the eye area swell.
If, in addition to the tumor, the patient experiences severe pain in the jaw, this may indicate the development of osteomyelitis - inflammation of the bone tissue. The swelling on the cheek grows, spreading to the cheekbones and other parts of the face, the pain spreads to both jaws, the patient experiences pain when opening the mouth. If you do not consult a specialist in time, the disease can lead to blood poisoning.
A gum abscess is a purulent inflammation inside the gum tissue. It is dangerous due to the spread of inflammation to other tissues, loosening and loss of teeth.
Periostitis of the jaw (flux) is an inflammation of the jaw, characterized by increased temperature and severe pain in the jaw and temporal part. If left untreated, the flux can spread to the infraorbital area. In chronic form it can develop into osteomyelitis.
Neuritis is damage to the facial nerve, accompanied by severe pain and swelling. A distinctive symptom is swelling of the larynx, palate, tongue, and cheeks.

Each of these complications can cause serious consequences, which is why it is so important to diagnose and treat in a timely manner.

Blackening of the gums

A change in gum color does not always indicate the onset of inflammatory processes. If the gums at the site of the incision become whitish, this is considered one of the normal variants. This is how fibrin manifests itself, which tightens the wound and protects it from bacteria getting inside.

However, if the bed and adjacent fabrics have turned dark blue or black, this is a cause for concern. Blueness indicates the transition of inflammation to the third stage, which can lead to complete atrophy of the gum tissue.

The gums begin to turn black already when the irreversible process of decay has begun. This is usually accompanied by purulent discharge, a strong and very unpleasant odor from the mouth, and severe pain that cannot be controlled with conventional painkillers.

How to eliminate cheek swelling

It is impossible to completely remove the tumor until the inflammatory process stops, but you can reduce it and minimize discomfort and pain. This can be done with ice and cold compresses. You need to apply a compress every half hour, but no longer than 10-15 minutes, otherwise it can cause hypothermia and tissue necrosis.

In addition, you can drink painkillers, analgesics, take baths and rinses with an antiseptic solution. Take antibiotics if prescribed by your doctor. This will eliminate the infection and speed up tissue healing.

In general, swelling of the cheek is a normal phenomenon if it occurs a couple of hours after tooth extraction and goes away no later than the seventh day after it. In all other cases, immediate specialist consultation, diagnosis and treatment are required.

Local complications arising after tooth extraction surgery.

Bleeding

Tooth extraction, like any other operation, may be accompanied by bleeding. After a few minutes, the blood in the hole coagulates and the bleeding stops. However, in some cases it does not stop on its own and continues for a long time (primary bleeding). Sometimes the bleeding stops within the usual time frame, but after some time it appears again (secondary bleeding). Prolonged bleeding is most often caused by local causes, less often by general ones.

Local reasons.

Bleeding can occur after tooth extraction when an acute inflammatory process has developed in the surrounding tissues, since the vessels in them are dilated and do not collapse. Late secondary bleeding from the socket occurs a few days after tooth extraction. It is caused by the development of the inflammatory process in the wound and purulent melting of the organizing blood clots in the vessels damaged during surgery.

Common reasons

. Prolonged bleeding after tooth extraction occurs in diseases characterized by impaired blood clotting or damage to the vascular system. These include hemorrhagic diathesis: hemophilia, thrombocytopenic purpura (Werlhof's disease), hemorrhagic vasculitis, hemorrhagic angiomatosis (Ren-du-Osler's disease), angiohemophilia (Von Willebrand's disease), C-vitaminosis; diseases accompanied by hemorrhagic symptoms (acute leukemia, infectious hepatitis, septic endocarditis, typhus and typhoid fever, scarlet fever, etc.).

The blood clotting process is disrupted in patients receiving indirect anticoagulants that suppress the function of prothrombin formation by the liver (neodicoumarin, phenylin, syncumar), as well as in case of an overdose of the direct anticoagulant - heparin. A tendency to bleeding is observed in patients suffering from hypertension.

Local methods to stop bleeding.

The blood clot is removed with tweezers and a surgical spoon, and the socket and surrounding areas of the alveolar process are dried with gauze swabs. After examining the wound, determine the cause of bleeding, its nature and location.

To stop bleeding from the hole, tamponade is performed using various means. The simplest and most accessible method is tight tamponade with iodoform turunda. After removing the blood clot, the hole is irrigated with a solution of hydrogen peroxide and dried with gauze swabs. Then they take an iodoform turunda 0.5-0.75 cm wide and begin to tamponate the hole from its bottom. Pressing and folding the turunda tightly, gradually fill the hole to the brim (Fig. 6.24). If bleeding occurs after the removal of a multi-rooted tooth, the hole of each root is tamponed separately.

To bring the edges of the wound closer together and hold the turunda in the hole, sutures are placed on top of it, retreating from the edge of the gum by 0.5-0.75 cm. Removing the gurunda prematurely may lead to re-bleeding.

In addition to iodoform turunda, the hole can be tamponed with absorbable biological hemostatic drugs (hemostatic sponge, fibrin film, hemostatic collagen sponge, gelatin sponge “Krovostan”, antiseptic sponge with gentamicin or kanamycin, hemostatic sponge with Ambien). In case of late secondary bleeding, the disintegrated blood clot is removed from the socket, irrigated with an antiseptic solution, dried and filled with some hemostatic drug. In these cases, it is preferable to use an antiseptic sponge with kanamycin or gentamicin, which has hemostatic and antimicrobial properties.

General methods to stop bleeding.

At the same time as stopping bleeding, agents that increase blood clotting are used using local methods. They are prescribed after determining the state of the coagulation and anti-coagulation systems of the blood (detailed coagulogram). In emergency cases, before obtaining a coagulogram, 10 ml of a 10% calcium chloride solution or 10 ml of a 10% calcium gluconag solution, or 10 ml of a 1% Ambien solution are administered intravenously. Simultaneously with these drugs, 2-4 ml of a 5% solution of ascorbic acid is administered intravenously.

Prevention of bleeding.

Before tooth extraction, it is necessary to find out whether the patient has had prolonged bleeding after accidental tissue damage and previous operations. If there is a tendency to bleeding, before surgery, a general blood test is performed, the number of platelets, blood clotting time and duration of bleeding are determined, and a detailed coagulogram is drawn up. If hemostasis parameters deviate from the physiological norm, measures are taken to increase the functional activity of the blood coagulation system, and the patient is consulted by a hematologist or therapist. For patients with blood disease, teeth are removed in a hospital setting. They are prepared for surgery together with a hematologist.

Socket postoperative pain

After tooth extraction and the cessation of the anesthetic, slight pain occurs in the wound, the severity of which depends on the nature of the injury. Painful sensations most often pass quickly. However, sometimes 1-3 days after the operation a sharp pain appears in the area of the socket of the extracted tooth. Patients do not sleep at night, take analgesics, but the pain does not stop. Such acute pain is most often a consequence of disruption of the normal healing process of the tooth socket and the development of inflammation in it - alveolitis.

Alveolitis

- inflammation of the walls of the socket - often develops after a traumatic operation that reduces the protective properties of tissues. The cause of alveolitis can be an infection in the socket when a tooth is removed due to acute and aggravated chronic periodontitis or complicated periodontitis. A predisposing factor is a decrease in the general immunological reactivity of the patient’s body in old age and under the influence of previous common diseases. Clinical picture. In the initial stage of alveolitis, an intermittent aching pain appears in the socket, which intensifies while eating. The general condition of the patient is not disturbed, body temperature is normal. The tooth socket is only partially filled with a loose, disintegrating blood clot. In some cases, there is no clot in it at all. The hole contains food debris, saliva, and its walls are exposed. The mucous membrane of the gum edge is red, touching it in this place is painful. With further development of the inflammatory process, the pain intensifies, becomes constant, and radiates to the ear, temple, and the corresponding half of the head. The patient's general condition worsens, malaise and low-grade body temperature appear. Eating is difficult due to pain. The tooth socket contains the remains of a disintegrated blood clot, its walls are covered with a gray coating with an unpleasant putrefactive odor. The mucous membrane around the hole is hyperemic, swollen, and painful on palpation. The submandibular lymph nodes are enlarged and painful. Sometimes there is slight swelling of the soft tissues of the face. In turn, alveolitis can cause a number of complications: periostitis and osteomyelitis of the jaw, abscess, phlegmon, lymphadenitis.

Treatment.

After local anesthesia or anesthetic blockade with lincomycin has been performed, the wound is treated. Using a syringe with a blunt needle, a stream of warm antiseptic solution (hydrogen peroxide, furatsilin, chlorhexidine, ethacridine lactate, potassium permanganate) is used to wash out particles of a disintegrated blood clot, food, and saliva from the tooth socket. Then, using a sharp surgical spoon, carefully (so as not to injure the walls of the socket and cause bleeding) the remains of the decomposed blood clot, granulation tissue, bone fragments, and teeth are removed from it. After this, the hole is again treated with an antiseptic solution, dried with a gauze swab, powdered with anesthetic powder and covered with a bandage. The bandage protects the socket from mechanical, chemical and biological irritants.

In the initial stage of alveolitis, after such treatment, pain in the socket does not recur. The inflammatory process stops after 2-3 days.

Sharp edges of the alveoli.

Socket pain can be caused by protruding sharp edges of the socket, which injure the mucous membrane located above them. Sharp edges of the alveoli most often form after the removal of several adjacent teeth or a single tooth (due to bone atrophy in adjacent areas). Pain appears 1-2 days after tooth extraction, when the edges of the gums above the socket begin to approach each other. Bone protrusions injure the gum mucosa located above them, irritating the nerve endings located in it. The pain intensifies during chewing and when touching the gums. This pain can be distinguished from the pain of alveolitis by the absence of inflammation in the socket area and the presence of an organizing blood clot in it. When you feel the hole with your finger, a protruding sharp edge of the bone is detected, and a sharp pain occurs.

To eliminate pain, an alveolectomy is performed, during which the sharp edges of the socket are removed (Fig. 6.25).

Computer anesthesia

In order to eliminate the possibility of developing complications after an injection, modern dentistry uses computer anesthesia.

Advantages of the technique:

There is no numbness of soft tissues. Computer anesthesia only numbs the area where the anesthetic is injected.
Computer anesthesia is painless.
The pressure of the anesthetic is controlled by a computer, so it is administered at the desired speed and in smaller quantities.
There is no feeling of gum swelling.
The influence of the human factor is eliminated due to the fact that the computer controls the entire process.
The tip is shaped like a pen, which is less intimidating for patients who are afraid of injections.