Complications may occur after tooth extraction. For example, the jaw may hurt, edema 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, edema 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.
Edema can sometimes 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.
Adjacent 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.
Abscess of the alveolar socket
Suppuration of the alveolar socket and the dental tissues suggest their infection, and it can occur for several reasons:
- when the patient did not comply, the dentist's recommendations regarding individual oral hygiene after surgery;
- if a fragment of the tooth remains in the tissues after removal;
- 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 an 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.
Dry socket (alveolar osteitis)
Dry socket, or alveolar osteitis, is a serious complication after tooth extraction. It has several possible causes: chronic inflammation of the tissues around the tooth, including periodontitis; loss or breakdown of the blood clot in the socket; or a tooth fragment left in the tissues. All of these lead to infection of the socket and inflammation. Pain and a distinctive bad breath appear 1–3 days after the extraction; the symptoms then intensify: the socket becomes covered with a gray coating and the pain becomes severe.
How to treat dry socket should be decided by a doctor. At an early stage, it is treated fairly quickly. The dentist cleans the socket of decaying tissue, treats it with an antiseptic and places a medicated dressing that reduces inflammation and limits the spread of infection. The dressing can be changed at the dentist's office or on your own, as often as your doctor has instructed.
Sometimes the doctor prescribes antibiotics, but they are effective only if the socket has been completely cleaned of foreign bodies, necrotic tissue, pus and food debris, rinsed with an antiseptic solution and covered with a special dressing.
Never self-medicate! Dry socket can progress to acute osteomyelitis, an abscess or cellulitis.
A wisdom tooth was removed. What can be the complications
Dental surgeon Maksym Makarenko will talk about frequent complications after the removal of wisdom teeth: numbness of the tongue, cheeks, bleeding. Also: white plaque on the socket of the removed tooth, swelling on the gums.
Frequently asked questions about tooth extraction
I had a tooth removed 2 days ago and something white has appeared on the gum. What could it be?
— A whitish fibrin coating appears during healing, usually 2–4 days after oral surgery. It is a normal and unavoidable stage in the healing of a socket covered by a blood clot. It is followed by tissue remodeling, coverage of the wound with protective epithelium and restoration of the normal mucosa. The fibrin coating can be white, off-white or even grayish.
There is a putrid taste in my mouth after the extraction. What is it?
— A putrid taste means there are food particles in the socket. From the 9th day after the extraction you can add rinsing with a chlorhexidine mouthwash. A medicinal taste in the mouth is normal: you may notice it for up to 10 days, until the dressing dissolves.
Is bluish tissue around the socket normal after tooth extraction?
— Bluish discoloration around the socket is caused by bruising and is normal. The main thing is that there is no throbbing pain.
I had a tooth removed 3 days ago and the adjacent tooth has started to hurt. Is that normal?
— Yes, this is possible in two cases:
- if the extraction was traumatic, it is better to take an X-ray and see a doctor to rule out complications in the adjacent tooth;
- if the extraction was simple, the adjacent tooth most often hurts because the root cementum has been exposed and reacts to hot and cold. In this case, the sensitivity goes away within a week.
A lymph node hurts after wisdom tooth removal. Is that normal?
— A lymph node may be painful after a surgical extraction (anti-inflammatory drugs should be prescribed), and this is normal as long as there is no pain when swallowing or difficulty opening the mouth. If these symptoms are present, see a maxillofacial surgeon urgently.
I had a wisdom tooth removed 5 days ago. How long do the stitches take to dissolve, and is it normal that the socket is very large?
— Sutures dissolve within 7–21 days, depending on the suture material.
Complete healing of the socket takes up to 3 months. A large socket after wisdom tooth removal is normal; it will close over time. It is important to keep up oral hygiene so that no food gets trapped in the socket.
How long does the gum take to heal after tooth extraction? Two months have passed. It doesn't hurt, but the socket hasn't closed.
— Full recovery after tooth extraction takes 3–4 months, and a small defect still remains. It depends on the type of extraction (simple or surgical) and how much bone was damaged.
A few days after the extraction, something like mucus formed at the site, and a bad smell and taste appeared in my mouth.
— This happens after the extraction of a tooth with a cyst. The mucus-like substance is the contents of the cyst: most likely the cyst ruptured during removal, its contents got into the socket and began to come out a few days later. If there is no discomfort or pain, everything is fine.
After wisdom tooth removal, a hard lump formed on my lower jaw. Two weeks have passed, but it hasn't gone away. What is it?
— After tooth extraction, an exostosis (a sharp bony edge) may appear, especially after a difficult removal of impacted or malpositioned wisdom teeth, because of the high likelihood of bone trauma during surgery.
If the lump causes no pain, discomfort or swelling, it does not need to be removed and will disappear on its own over time.
But it could also be a hematoma, which will either heal (as long as it doesn't hurt and there is no fever) or fester and become inflamed.
What should I do if I had a tooth removed today and my lip is swollen?
— The extracted tooth itself has nothing to do with the swollen lip.
If it is the lip and not the gum, you may have bitten it while the anesthesia was still working, or the doctor may have injured it with an instrument during the extraction.
How long does it take to treat dry socket?
— Dry socket diagnosed at an early stage is treated fairly quickly, on average in about a week.
The dentist cleans the socket of decaying tissue, treats it with an antiseptic and places a medicated dressing that reduces inflammation and limits the spread of infection. The dressing can be changed at the dentist's office or on your own, as often as your doctor has instructed.
If the dry socket has become purulent, treatment can take up to a month.
In that case the doctor will prescribe antibiotics, but they are effective only if the socket has been completely cleaned of foreign bodies, necrotic tissue, pus and food debris, rinsed with an antiseptic solution and covered with a special dressing.
Summary
To sum up, some pain after tooth extraction is inevitable. But remember: if the pain intensifies, complications should be treated by a specialist. Do not put off visiting the dental clinic by masking the pain with painkillers. Proper and timely treatment will help you avoid more serious complications.
