Alveolitis after tooth extraction - symptoms and treatment

Alveolitis is an inflammation of the socket (alveoli) left after tooth extraction. This pathology does not always develop; its development depends on many factors. The disease is characterized by severe pain in the area of ​​the hole formed after surgery, general weakness, fever, headache, enlarged submandibular lymph nodes, bad breath and other unpleasant symptoms.

Alveolitis is not only physically painful, but also a dangerous disease. In the absence of proper treatment for several days, the inflammatory process can result in limited osteomyelitis, purulent melting of the jaw bone, and then surgical intervention will be required again.

With timely diagnosis of pathology and proper sanitation of the socket, the treatment prognosis is favorable. The main thing is to detect the symptoms of the disease in time and begin to treat it.

Classification

Depending on the nature of the healing of the hole, dentists distinguish several main forms of dental alveolitis:

• Serous. The initial stage of the disease usually appears 2–3 days after tooth extraction. This form is characterized by continuous pain that worsens while eating. Although the patient does not yet complain of feeling unwell, his lymph nodes are not enlarged, but he already feels that the disease is progressing.
• Purulent. If the serous form of alveolitis is not treated, the disease turns into a purulent form. Most often it is diagnosed 6–7 days after tooth extraction. The painful sensations can no longer be ignored, the pain intensifies, radiating to the ear or temple. Exploring the affected area also causes severe pain. Purulent alveolitis is characterized by a dirty gray coating inside the socket, significant swelling around the wound, thickened alveolar process and other problems. The patient's general health deteriorates significantly. Lymph nodes enlarge and become painful on palpation. Often the patient cannot even eat or open his mouth.
• Hypertrophic. At this stage, the symptoms of the disease subside. The patient notes a decrease in body temperature, improved well-being and decreased pain. However, at the hypertrophic stage, dangerous tissue proliferation occurs, which is clearly visible upon examination. When touched, pus is released from the inflamed area, and the mucous membrane acquires a bluish tint.

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Causes of inflammation

The disease can develop only after tooth extraction. Most often, the hole formed after removal heals within a day after the operation, and the patient feels better. But if the blood clot that covers the open wound moves or becomes deformed, an infection can penetrate into the hole, in which case alveolitis of the gums develops. As a result, the surface of the wound heals for a long time, and the patient suffers from complex discomfort.

Predisposing factors for the development of inflammation:

• Surgical injuries during complex removal. The more complex the operation, the more pronounced the postoperative inflammation of the bone tissue will be, and the more likely the release of direct plasminogen activators.
• Complex extractions associated with tooth segmentation, osteotomy, detachment of the mucoperiosteal flap. Complex operations increase the chance of developing alveolitis 10 times.
• Removal of wisdom teeth. The denser, less vascularized bone tissue adjacent to the figure eights is prone to the formation of dry sockets.
• General diseases of the patient. Alveolitis often occurs against the background of concomitant diseases. For example, patients with diabetes mellitus or immunocompromised patients are more susceptible to alveolitis due to impaired healing processes in the tissues.
• Taking oral contraceptives. The estrogen contained in these drugs may indirectly enhance the fibrinolytic process, causing the breakdown of the blood clot.
• Smoking. The direct connection between smoking and alveolitis has been repeatedly proven clinically. According to studies, the risk of socket inflammation in smokers increased 4-5 times compared to non-smokers. The incidence increased by more than 20% in patients who smoked 1 pack per day and by 40% in patients who smoked immediately before and after surgery.
• Dislocation of a bunch. If the socket is handled carelessly and there is negative pressure (for example, due to drinking through a straw), alveolitis may develop.
• Bacterial infections. Dentists agree that bacterial infections are the main risk factor for dry socket.
• Poor oral hygiene. The incidence of alveolitis increases significantly with poor oral hygiene.
• Excessive use of local anesthetics. According to some studies, excessive use of an anesthetic with a high concentration of a vasoconstrictor can provoke ischemia and make it difficult for the socket to fill with blood. This condition also increases the risk of alveolitis.

In fact, alveolitis is a fairly rare disease. According to statistics, it affects approximately 3% of patients who have undergone tooth extraction surgery. More often than not, the socket is not formed properly when lower incisors and molars are removed.

But alveolitis is especially common when removing lower wisdom teeth: according to experts, in approximately 20% of cases, the removal of “eights” with difficult eruption is complicated by alveolitis. In addition, it is believed that the risk of developing the disease is inextricably linked with age. This is explained by the fact that metabolism slows down, immunity is weakened, and the regenerative abilities of the body deteriorate.

Treatment of dry tooth socket at home

If the pain from dry socket inflammation is too severe, you can take painkillers. In the first two days, apply cold compresses to the inflamed side at intervals of 20 minutes, then change to warm ones.

Drink more fluids, especially water. It removes harmful substances from the body. Avoid alcohol.

Rinse your mouth with a salt water solution. This clears the wound of dead cells and relieves inflammation. But you should not apply pressure in the area of ​​the hole - you can provoke the displacement of the blood clot. You should rinse your mouth after every meal and before going to bed.

You can also apply a drop of clove oil to the wound to relieve pain. Rinsing with sage and chamomile flowers, a decoction of burdock leaves and aspen bark, and anise infusion will also have a positive effect.

If after all the treatments the pain has not subsided, the swelling has not subsided, and your health has only worsened, then you should urgently consult a doctor. There is a high probability that the process of rotting has begun.

In the dental office, the doctor, under anesthesia, will clean the hole or prepare the gums - depending on the degree of neglect of the case. Fill it with antiseptic gel.

Symptoms of alveolitis

As a rule, the patient ignores the first symptoms of inflammation without due attention, considering them to be the norm after surgery. After tooth extraction, as already noted, pain within 24 hours is considered normal. As the hole heals, the pain subsides and completely disappears after a few days.

If the patient develops an inflammatory process, then the unpleasant sensations do not subside after a day or two, and 3–5 days after the operation, severe, throbbing pain in the socket occurs, which intensifies as the infection develops.

With alveolitis, patients may complain of both unbearable and moderate pain. Pulsation and pain are focused, as a rule, only in the removal area. However, in rare cases, the pain radiates to half of the face.

Other characteristic symptoms of alveolitis are:

• a sharp rise in body temperature;
• tooth sensitivity to hot/cold food;
• enlargement of the submandibular lymph nodes;
• decreased appetite;
• increased salivation.

In rare cases, the disease causes weakness, increased fatigue, and secondary infectious foci appear on the oral mucosa.

Diagnostics

The main symptom of the disease is the appearance of acute pain, which does not subside either 24 hours or 2–3 days after tooth extraction. Sometimes a dentist can identify chronic alveolitis during routine oral examinations. In this case, an empty socket without granulation tissue appears in place of the impacted tooth. The bone is already visible at the bottom of the hole.

The dentist will be able to determine the presence of tissue changes during the examination; radiography and radiovisiography of the affected area may also be prescribed.

Treatment of alveolitis

When the socket becomes inflamed, the main thing is to eliminate the source of infection, prevent the development of inflammation and preserve the dentition. In order to alleviate the patient’s condition, the dentist uses the following therapy methods:

• Mechanical cleansing of the hole, washing out purulent residues with a solution of nitrofural or hydrogen peroxide.
• Anesthesia of the hole. The pain syndrome is relieved with the help of local applications with anesthetics and analgesics. To do this, the doctor applies the lotion for half an hour and then removes it to prevent the proliferation of microbes in the area. The dentist will advise the patient to repeat the procedure several times a day. Taking painkillers orally is not recommended.
• Taking antibiotics. In the presence of concomitant diseases, alveolitis is treated with antibiotics.

With the right approach, the signs of alveolitis subside 2-3 days after the start of treatment. If therapy was not started on time, residual pain may drag on for 2–3 weeks.

With the permission of the dentist, additional treatment of alveolitis with folk remedies is possible:

• Sage rinses. To prepare the solution, brew a large spoonful of dry sage in 250 ml of boiling water, leave the mixture for an hour, wrapping the container in a towel. After this, the liquid should be filtered and used for rinsing.
• Gargling with chamomile flowers. To prepare the composition, brew a large spoonful of chamomile flowers in a glass of water for 15 minutes, insulating the container with a towel. The infusion should be strained and rinsed your mouth up to 12 times a day.
• Poplar buds. To prepare, take half a glass of buds, pour into a glass container and pour in 500 ml of vodka. The product should be infused for 10 days in the dark and cool, then filtered, soaked in cotton swabs and applied to the inflamed area.
• A soda rinse solution can also be an effective addition in the treatment of alveolitis. You should take a large spoonful of powder in a glass of warm water or mix soda with water to obtain a paste-like mass, which then needs to be used to treat the hole.
• Burdock leaves. To prepare a medicinal decoction of burdock leaves, you need to pour 20 grams of raw material with 2 glasses of water, and then simmer the mixture over low heat for about 40 minutes. The resulting solution should be cooled and filtered, and then used for rinsing.
• Aspen bark. Pour 1 tablespoon of crushed aspen bark into one glass of boiling water. It is important to leave the solution in an airtight container for 3 hours, and then use 100 ml of strained warm liquid at least 3 times a day.
• Anise infusion. To prepare the infusion, pour 1 tablespoon of anise into 200 ml of boiling water, and then keep in a thermos for 50 minutes. The liquid should be filtered and used to rinse 3 times a day.

Reviews

I recently went to have my lower molar removed because all that was left was a stump that was no longer suitable for a crown. The removal went quickly and without almost any pain, they prescribed me to rinse my mouth and sent me to treatment at home.

The very next day, severe pain began in the place where the tooth used to be and the gums became swollen. Another terrible bad breath appeared. In the end, I came to the doctor who pulled my tooth the day before. She looked and advised me to “brace up” and apply a heating pad with ice to my swollen cheek. After a couple of days, the swelling subsided, but the gums did not hurt any less. I took Nurofen several times a day. But the pain never stopped, so I went to that aunt again.

They took a picture and told me everything was fine, but there were sharp bones from where my tooth used to be. So they decided to remove them. It was very painful when they picked at my gums again and removed these “bones”, then they put gauze, forced me to bite and sent me home.

Within a couple of hours, hellish throbbing pains began, so I decided to go to a nearby private clinic, where everything was explained to me. It turns out that my tooth was removed poorly, there were many pieces left from the destroyed tooth and bones from the jaw, so it all mixed with infection and produced pus. With an injection, they cleaned it all out with absolutely no pain, put a gauze pad with ointment on top and gave me recommendations. On the same day I felt better, so I didn’t go back to the doctor who removed my tooth.

Prevention

The best prevention of pathology after tooth extraction is to be attentive to yourself and follow all the surgeon’s recommendations. While the hole is healing, give up bad habits, eating too hot, spicy, sweet foods, and if possible, switch to pureed foods. And if you suspect inflammation, contact your dentist as soon as possible.

Under no circumstances should the first symptoms of alveolitis be ignored. Against the background of inflammation, more serious problems may arise:

• Phlegmon is an acute diffuse purulent inflammation.
• An abscess is a purulent inflammation of tissues with their melting.
• Osteomyelitis is a purulent-necrotic process that can develop in the bone and bone marrow, as well as in the surrounding soft tissues.
• Periostitis is inflammation of the periosteum.
• Sepsis is a severe systemic inflammatory reaction.
• Tissue necrosis is local tissue death.

Modern methods of treating alveolitis make it possible to quickly relieve the symptoms of inflammation and avoid the complex consequences of the disease. The sooner the patient consults a doctor, the less likely it is to develop complications.

COMPLICATIONS

A complication is a secondary (attached) disease that occurs in the absence of proper treatment for the underlying disease. All data is entered by the doctor into the medical register. card and noted in the medical history. Thus, it will be possible to draw up an accurate plan for therapeutic situational treatment.

Complications appear due to the connection between all systems and processes in the body. Due to slight inflammation with low immunity, infectious diseases and internal destructive processes can occur. This is the main aggravation of the pathology.

Advanced disease status with weak immunity can lead to:

• phlegmon affecting soft tissue structures;
• damage to the maxillary sinus;
• periostitis affecting periosteal structures;
• blood poisoning;
• inflammation of the bones of the facial skull;
• local allergic reaction;
• unpleasant, putrid odor from the mouth.

In case of severe complications requiring hospital treatment, the specialist will issue a sick leave certificate.

Treatment of alveolitis in STOMA clinics

Surgeons at STOMA clinics are required to examine patients and give recommendations on how to care for the hole formed after tooth extraction. If problems arise after extraction, the patient can always call the clinic and clarify whether inflammation has really begun and what to do to reduce pain.

At any time after removal, the patient can contact our clinics. The attending surgeon will examine him and prescribe appropriate therapy.

Feel free to call us at any time and consult about your condition. The sooner we start treating alveolitis, the lower the risk of complications.

Folk remedies

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Treatment using traditional recipes is carried out in accordance with the doctor’s recommendations. At the same time, prescribed drugs from official medicine are used. At the pharmacy you can purchase dried and crushed medicinal plants with antiseptic properties. If after tooth extraction the hole becomes inflamed, infusions of the following herbs are suitable for rinsing:

• chamomile;
• sage, plantain;
• marshmallow, St. John's wort;
• big burdock, elecampane;
• oregano, peony.

You can choose other plants that inhibit the proliferation of pathogens. It is not advisable to rinse your mouth with alcohol tinctures; water infusions have a milder effect. How to infuse herbs:

• take 5 ml (teaspoon) of dry raw materials;
• pour 250 ml of boiling water;
• After cooling to a temperature of 38-39 degrees, strain;
• use as a rinse solution.

When rinsing, certain rules must be followed. Do not rinse your mouth vigorously. A blood clot forms in the hole, and if it is damaged, bleeding occurs. You just need to take the liquid into your mouth, hold it for 1-2 minutes and spit. It is forbidden to use solutions that are too hot; they can cause bleeding and contribute to the spread of the inflammatory process.

Along with the recipes listed above, baking soda is used - it draws out pus well and reduces inflammation. The rinse solution is prepared from 5 ml of soda per 250 ml of hot water. You can rinse your mouth every hour. After rinsing, you should not drink or eat food for at least 15 minutes. If inflammation of the hole occurs due to infection, you need to support the immune system. Recipes to stimulate the immune system:

• Rhodiola rosea. The tincture is sold ready-made at the pharmacy, the recommended dose is 15-20 drops three times a day.
• Echinacea purpurea. Pour 10 ml of dry herb with a glass of boiling water, leave for 15 minutes, strain before use. Drink 100 ml throughout the day.
• Ginseng. The tincture is taken 10-20 drops at a time. The product has a tonic effect, so it is used only in the first half of the day.

If the general condition deteriorates, the temperature rises, pain intensifies or changes in localization, or progressive swelling of the face, folk remedies are ineffective. The listed symptoms indicate the spread of infection and the possible development of complications. It is necessary to urgently contact a specialist.

The information is for reference only and is not a guide to action. Do not self-medicate. At the first symptoms of the disease, consult a doctor.