Complications after tooth extraction

Maksym Makarenko

Максим Макаренко Specializes in surgery, implantology, periodontics and prosthetics

Complications may occur after tooth extraction. For example, the jaw may hurt, oedemating may appear, the cheek may swell, and the temperature may rise. Some of these complications go away on their own while others require medical intervention. 

In this article our dentist Maksym Makarenko will talk about the 7 main complications after tooth extraction. At the end of the article he will answer frequently asked questions from patients.

Swollen gum, edema appeared

Patients often complain that after the extraction of a tooth the gum is swollen, oedemating of the cheeks or a dental abscess has appeared - these are caused by the partial destruction of the soft oral tissues. This is unpleasant but if the edema is small it goes away on its own in 2-3 days. To relieve edema after tooth extraction, ice can be applied to the cheek for about 10 minutes.

Sometimes edema can be caused by an allergy to anesthesia. In this case it will help antihistamines (anti-allergic drugs). But if the swelling still increases this may be a sign of inflammation that has arisen after tooth extraction. In this case you should immediately consult a doctor.

Raise the temperature

An increase in temperature is normal, this may be the reaction of the body on a traumatic tooth extraction. It can last for 2 to 3 days rising in the evening. Follow the doctor’s instructions and if the condition does not improve you should visit the dentist.

Аdjacent tooth hurts

Another common complaint: “after tooth extraction, the gums, adjacent tooth, jaw, throat hurt”, as a rule these are common symptoms after a traumatic procedure. They are caused by damage to the dental tissues, nerves, which disappear by themselves after a few days.

For example if temporary pain appears after tooth extraction, this is the norm. You can take painkillers but only those prescribed by your doctor. If nevertheless the painful sensations intensify it is worth visiting a doctor.

Bleeding after tooth extraction 

Immediately after the tooth extraction, blood flows from the alveolar socket - this is normal, since during the operation there is a rupture of the blood vessels. In this case the doctor will provide you, but sometimes it happens a few hours after the operation, in order to stop the bleeding by yourself after tooth extraction, attach a gauze swab to the alveolar socket, bite it lightly and apply an ice on the cheek. After 15 minutes the bleeding should stop but if the bleeding does not stop for a long time you should visit a doctor.

Аbscess the alveolar socket

Suppuration of the alveolar socket and the dental tissues suggest their infection and it can occur for several reasons:

  1. when the patient did not comply the dentist's recommendations regarding individual oral hygiene after surgery;
  2. if a fragment of the tooth remains in the tissues after removal;
  3. after a complex tooth extraction (for example the eighth teeth). If the inflammation is not cured in time, then some time after the removal, suppuration and even osteomyelitis (inflammation of the bone) may appear.

If abscess appears at the site of the operation - visit a doctor. The doctor will find and eliminate the cause of the inflammatory process.

Numbness of tongue, lips, chin

Paresthesia - is a numbness of the tongue, lips or chin after tooth extraction as a result of damage the mandibular nerve. Most often it occurs after the removal of a wisdom tooth, which is located near the trigeminal nerve. This complication resolves within 1-2 weeks after surgery, but if the damage is severe, paresthesia can become permanent. Fortunately this complication is quite rare.

Wisdom teeth usually do not need to be removed unless they are causing any problems. The website of the National Health Service of Great Britain says that the removal of wisdom teeth has no evidence-based benefits, and the removal can cause complications. The American Public Health Association also opposes the removal of wisdom teeth before they cause trouble.

The Cochrane Society - an international non-profit organization that studies the effectiveness of methods of treatment using evidence-based medicine, also believes: scientists do not yet have enough evidence that the removal of healthy eighth teeth will preserve oral health. But if the wisdom tooth is destroyed, hurts or presses on adjacent teeth, thereby interrupting the tooth range - then there is no point to saving it.

Alveolar periostitis

Alveolitis is a complication after tooth extraction. There may be several reasons for the occurrence. This may be the presence of chronic inflammation of the tissues around the tooth, periodontitis and dry socket. Alveolitis can occur after tooth extraction if a tooth fragment remains in the tissues. All these factors cause infection of the socket and inflammation. The pain occurs on the 13th day after the tooth extraction, then occurs a fetid breath, then these symptoms intensify, the socket becomes covered with a gray coating, severe pain appears.

How to treat alveolitis after tooth extraction should be decided by the doctor. At an early stage it is treated quickly and easily.
The dentist treats the socket with antiseptic preparations, then he puts an anti-inflammatory and infection component. You can change the tampon with the medicine at the dentist or on your own (according to the doctor's instructions).

Sometimes with alveolitis the doctor puts on antibiotics, but it will be effective if the tooth socket is completely cleaned of foreign objects, necrotic tissues, suppuration, food debris and washed with an antiseptic solution and protected with a special swab.

In no case do not self-medicate! Alveolitis can develop into acute osteomyelitis, causing an abscess or phlegmon.

FAQ:

A tooth was removed 2 days ago, something white appeared in the gum. What could it be?

- A whitish coating (fibrin) appears аt the stage of healing. It occurs on the 2nd-4th day after surgery in the oral cavity. This is a normal stage in the healing of the alveolar socket that is covered with a blood clot. After this the tissue is restructured, the wound is covered with a protective epithelium, and the mucosa is restored. Fibrin plaque can be white, whitish and grayish.

After tooth extraction, there is a putrid flavor in the mouth, what is it?

- If there is a taste of putrid, it means that there is food leftovers in the alveolar socket. On the 9th day after tooth extraction you can rinse your mouth with chlorhexidine mouthwash. If there is a taste of medicine in your mouth - this is normal. You can feel it for up to 10 days until it dissolves.

Is the norm a blue tissue around the socket after tooth extraction?

- Bluing of the tissue around the socket occurs due to hemorrhage (this is the norm). The main thing is that there is no throbbing pain.

3 days ago the doctor removed a tooth and the adjacent tooth began to hurt, is it okay?

— Yes, it is possible in several cases:

  1. if the extraction was traumatic it is recommended to take a X-ray and visit a doctor to rule out complications in the adjacent tooth.
  2. if the extraction is typical most often there is pain in the adjacent tooth due to the fact that the root cement is exposed and it reacts to temperature stimuli. In this case the sensitivity disappears within a week.
After the removal of the wisdom tooth, the lymph node hurts, is it okay ?

- The lymph node may hurt after an atypical removal (anti-inflammatory drugs should be prescribed) and this is normal if pain when swallowing and difficulty opening the mouth are not added to this. If these symptoms are present you should to urgently contact a maxillofacial surgeon.

A wisdom tooth was removed 5 days ago. How long do the stitches take to dissolve? Is it okay that the alveolar socket is big?

— Sutures dissolve within 7-21 days depending on the material of the sutures.

Complete healing of the alveolar socket occurs up to 3 months. The alveolar socket after the removal of the "wisdom" tooth is large is normal, over time it will close. It is important to follow oral hygiene so that no food remains in the socket.

How long does the gum heal after tooth extraction? Two months have passed. It doesn't hurt but the socket doesn't heal.

- After tooth extraction, full recovery occurs within 3-4 months. A small defect will remain. It depends on what type was of the extraction (atypical or typical) and how much the bone tissue was destroyed.

A few days later mucus formed at the site of the extracted tooth, a bad smell and taste appeared in the mouth.

- It happens after the tooth extraction with a cyst. Formation of mucus is the contents of the cyst (it is possible when the cyst was removed, it ruptured and the contents fell into the socket, after a few days it began to come out). If there is no discomfort / pain, then everything is in order.

After the removal of the wisdom tooth, some kind of hard bump formed on the lower jaw. 2 weeks have passed, but the condensation does not go away. What's this?

- After tooth extraction exostosis (a sharp edge of the bone) may appear. Usually when it comes to the problematic removal of impacted or dystopic wisdom teeth. This is due to the high probability of traumatizing the bone during the operation.

If this "hard bump" does not pain, discomfort and does not cause swelling it is possible to not remove. It will disappear on its own over time.
But it can also be a hematoma which will heals (since it does not hurt and there is no temperature), or fester and inflammation begins.

What should I do if a tooth was removed today and the lip is swollen?

- The extracted tooth has nothing to the swollen lip.
The lip may swell if you bit it while the anesthesia was still in effect. Or the doctor injured your lip with an instrument during tooth extraction.

How long does it take to treat alveolitis?

— At an early stage it is treated quickly and easily.

The dentist treats the socket with antiseptic preparations, then he put an anti-inflammatory and infection component. You can change the tampon with the medicine at the dentist or on your own (according to the doctor's instructions).

In the case when a patient has developed septic alveolitis it treatment can take up to a month.

Sometimes with alveolitis the doctor puts on antibiotics, but it will be effective if the tooth socket is completely cleaned of foreign objects, necrotic tissues, suppuration, food debris and washed with an antiseptic solution and protected with a special swab.

In no case do not self-medicate! Alveolitis can develop into acute osteomyelitis, causing an abscess or phlegmon.

Consequent

As a resume it is worth saying that pain after tooth extraction is inevitable. If these aesthesia intensify a specialist should deal with the treatment of complications after tooth extraction. Do not delay visiting the dental clinic by masking the pain with analgesics. Proper and timely treatment will help to avoid more serious complications.

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sin. 05.01.2021 № 23/21/М