Complications after tooth extraction: there is something white in the socket, the wound is bleeding, the gums hurt, a growth has formed on the gum, the cheek is swollen

After the end of exposure to anesthetic substances, the pain syndrome returns to the patient who has survived tooth extraction. Pain can be a natural reaction of tissues to tooth extraction surgery, or a symptom of complications. To avoid a negative scenario, you should carefully prepare for the operation. Even successful treatment leaves the patient with many questions.

Preparing for tooth extraction

To avoid complications after dental procedures, simple preparation for tooth extraction is recommended.

Do not delay going to the dentist: an inflammatory process quickly develops in the gum tissue, which stimulates increased blood supply to the sore spot, which is undesirable for surgery.
Tooth extraction is not recommended for women during their menstrual period. On critical days, blood clotting is reduced, which leads to additional blood loss.
It is better to contact the surgeon in the first half of the day, so that if unforeseen circumstances arise, you do not have to look for 24-hour dentistry.
If an adult patient is going to the dentist, and the manipulation does not involve general anesthesia, then you need to eat first. The operation implies a mandatory reduction in the level of glucose in the body, which is already low in a hungry person. Lack of glucose causes a decrease in the rate of blood clotting, and after eating, the reverse process occurs.
If general anesthesia is likely, contact your doctor in advance for an examination and consultation with an anesthesiologist. During general anesthesia, you cannot eat too much; the last meal should be taken no later than four hours before the operation. If this rule is not followed, the patient may vomit during anesthesia, and the vomit will enter the respiratory system, which will greatly complicate the work of doctors.
Be sure to tell your dentist if you are allergic to certain medications.
If you have heart disease, tell your doctor; this point is especially important if you are taking blood thinners. It is better to discuss this issue in advance with a cardiologist; sometimes taking medications that reduce blood clotting is temporarily discontinued.

The rules are simple, but this does not mean that you can ignore them. Tooth extraction is also an operation that sometimes leads to serious complications, especially if the patient and the surgeon are careless.

What to do if a blood clot falls out on day 3, is washed out or does not form at all

A blood clot falls out for various reasons: if the patient rinsed the mouth, accidentally touched the place with a fork or spoon, moved it out of place with his tongue, if for some reason the clot did not settle in the hole, and so on.

If a clot falls out, consult a doctor as soon as possible . To treat such situations, dentists use the method of reappearing a blood clot.

Important! Under no circumstances should you repeat this method yourself. This can lead to severe inflammation or damage to the gums. In any case, it will only get worse.

The dentist must confirm or deny the loss of a blood clot.

If it falls out, the doctor will treat the wound and remove food particles from there . And then he will fill the wound with iodoform turunda. Alternatively, the dentist can simply treat the wound and leave it to heal.

If the inflammatory process has not yet begun, then the doctor will specifically cause blood from the hole , thereby starting the healing process from the very beginning. After the blood has almost stopped, a new clot will begin to form.

If formed too large

If your overall health is good, then there is no need to worry . But it’s still better to visit a dentist, he will examine the oral cavity and give an accurate diagnosis. If the hole often bleeds, hurts or swells, then this is a direct reason to consult a doctor.

There's something white in the hole

During tooth extraction, little depends on the patient. The doctor amputates the tooth and places a tampon in the wound; the patient has to hold it for at least 15 minutes. If the bleeding stops after this, the person is released. The dentist warns that pain for four hours after this is normal. From the hole left by the tooth, white ichor with streaks of blood comes out. This process is especially intense when a wisdom tooth is removed; discharge is sometimes observed within 24 hours.

It is normal if a bloody clot remains in the socket. It does not need to be removed; the clot performs important functions:

prevents bleeding;
protects the body from the penetration of pathogenic bacteria that live in the oral cavity;
forms the basis for new tissue to replace the tooth.

Bleeding may last longer if the operation is not performed carefully or the patient takes certain medications or suffers from liver disease.

If the bleeding stops, and after a couple of hours it appears again, this is a variant of the norm, indicating the cessation of the effect of the vasoconstrictor drug.

Healing of the hole: how many days does a blood clot last?

Healing of the hole occurs within 5 months . In the process of wound healing, a blood clot plays an important role.

Day 1 - a blood clot forms at the site of the hole.
2-3 days - new epithelium begins to appear on the blood clot. As a rule, it is white. However, if the epithelium is gray-green or yellow , then this is a reason to visit the dentist.
3-4 days - granulations appear. They cover the blood clot. This is normal, do not be scared and try to somehow influence the healing process. Usually this phenomenon looks like a red ball covered with white threads.
Day 8 - granulations almost completely replace the blood clot. At the same time, bone tissue begins to develop.
2nd week - the clot completely disappears, since the wound has already been covered with new tissue. Therefore, the clot is no longer needed.
2nd month - the socket is almost completely filled with bone tissue.
5th month - bone tissue becomes denser and merges with the jaw.

Reference! These stages are inherent only in normal, natural healing . If any deviation develops, the hole will be tightened according to a different pattern characteristic of a certain pathology.

The wound is bleeding

In dental practice, there is only one known case in which a patient died after the removal of three adjacent teeth. The cause of death was not blood loss at all. The patient could not think of anything better after the operation than to drink a fair amount of alcohol and go to bed. Alcoholic drinks affect the liver, which increases bleeding. Due to alcohol intoxication, the sleep was sound, blood entered the respiratory tract, and the poor man choked.

In any case of bleeding due to an extracted tooth, the patient should calm down.

You only need to seek medical help in one case, if blood flows out of the wound in a stream.

If the patient is worried about bleeding, it is enough to make a tampon from sterile material and press it with your teeth to the wound for half an hour. If necessary, the doctor will prescribe special medications to stop bleeding. Doctors do not recommend using hydrogen peroxide in such cases.

If bleeding continues for more than a day, this is a symptom of a complication. Only a dentist, upon examination, will determine the cause of these complications and prescribe further treatment.

Gums hurt

Often, after tooth extraction, the patient's gums hurt. Experts are confident that this is a natural reaction of the body to surgical trauma. In this case, the pain is moderate, but sometimes it indicates not only gum injury, but also inflammation. Medical statistics note that inflammation after tooth extraction occurs in 4% of operations. Gum pain as a result of inflammation becomes even more likely if not just one, but several hours of removal. How to determine whether a wound is healing? How to act in case of inflammation?

Normally, after a tooth is removed, a clot of dark blood forms in the socket, which over time acquires a white-yellow hue.

The duration of the pain depends on the level of injury and the appearance of inflammation; it usually hurts for no more than two days. The pain is much more serious if the inert tissue is severely damaged, which inevitably happens when cutting out bone using a bore. This surgical technique is used when it is necessary to remove a crown or extract a tooth in parts. In all other cases, prolonged pain indicates a medical error or problems in the body.

To relieve pain, the use of analgesics is allowed. Normally, they help a lot, but if the pill doesn’t work, this is evidence that the operation was performed incorrectly. Medical errors during tooth extraction occur frequently, especially in the following cases.

When sawing out bone using a drill. Modern dental standards require the use of drill tips with a cooling component. But in domestic dentistry, most dentists use tips without cooling. As a result, the patient receives a burn, as a result of which superficial necrosis develops, accompanied by acute pain. If the pain does not go away after using NSAIDs, and a blood clot does not form in the socket, you will have to go to the doctor again. The doctor will clean the hole from dead tissue, after this manipulation the patient’s condition will return to normal.
If there are sharp bones protruding from the socket. Such edges of protruding bones often injure the mucous membrane, especially if the bone is not completely covered by a clot in the socket. Most often, this problem occurs due to the fault of the surgeon who did not apply stitches to close the wound. The patient can independently determine the presence of cutting fragments by touching the tongue, as well as in case of severe pain when drinking drinks. In rare cases, bone fragments can be seen when examining the wound in the mirror.
With mobility of parts of the bone in the wound. Sometimes the dentist does not notice significant pieces of bone that were formed when the tooth was rocked. Such pieces often cause pain and inflammation in the socket. The problem can only be corrected with a second visit to the dentist.
Incorrect removal method. This is a common cause of complications after tooth extraction. Dentists have different experiences, so two doctors remove the same tooth in different ways. So, when removing, you can use forceps, but another doctor, to speed up the process, will divide the tooth into two halves and only then remove them.
Excessive use of anesthetic, leading to spasm of the blood vessels of the gums. As a result of such an error, the hole after the operation does not fill with blood and a clot does not form. In an empty socket, the bone is exposed and reacts painfully to touch.
The dentist did not apply stitches, which should be done even when removing some teeth with a single root. In the case of teeth with several roots, a suture is required in the vast majority of cases. A properly sutured wound reduces the intensity of pain and the likelihood of complications by half. With stitches, the wound heals much faster.
The dentist did not prescribe antibiotics. These drugs are not always prescribed, but in difficult cases, inflammation and acute pain cannot be avoided without them.

Do not start taking medications without discussing with your doctor, relying on the recommendations of friends or the Internet. The pain normally lasts no longer than a couple of days and should be moderate. If the pain does not subside, bone particles are felt in the hole, the wound reacts to liquid, or an unpleasant taste appears in the mouth, you should immediately contact the dentist who performed the operation or any other similar specialist.

Why is clot formation so important?

The presence of a blood clot that looks healthy, without signs of inflammation or the onset of a pustular process, is a necessary formation after a tooth has been pulled out.
The blood must eventually coagulate and form a small clot that covers the entire wound. This is one of the most important stages in the normal biological process of healing an open wound - a blood clot protects the wound from germs and pathogenic bacteria entering it. If further dental treatment is required, it is best to wait until the wound has healed by at least half (50%) or more (70-85%). And for this, more than one day will pass until the frozen blood plug gradually resolves itself and disappears from the protracted hole. Additional information: On average, the wound should heal well within 3 days, although the hole will not heal immediately, it needs more time. And the blood flow should stop after a few hours with the formation of a corresponding clot.

A growth has formed on the gum

After tooth extraction, there is often a complication such as the appearance of a lump on the gum. A growth in such a place indicates the onset of dangerous inflammatory complications. An infection can be caused if the clot is removed carelessly. Another source of infection is leftover food, so dentists prohibit patients from eating for several hours after surgery. During this time, a clot should form in the wound, protecting the gums from infection.

If a growth has formed on the gum, it may be an allergy to the anesthetics used or mechanical damage. Often a growth forms where the injection was given; such a new growth contains liquid inside, which in its structure is no different from a hematoma.

Such a lump will resolve in three days, unlike an infectious one, which often does not go away on its own and requires treatment.

How does the healing process work?

Even if there are no complications, the wound heals completely within four to six months.

On the 2nd day, a blood clot appears in the socket - a protective gate against mechanical damage and infections.
If healing proceeds normally, on the third day you can already see granulation tissue at the operation site.
In the second week, the epithelium actively grows, and granulation tissue appears instead of a clot. Primary restoration of bone structures occurs.
In 2-3 weeks, it displaces the blood clot and bone tissue is visible around the perimeter.
Recreation of new tissues takes 30-45 days.
In about 60 days, the hole is closed by osteoid tissue impregnated with calcium.
After 4 months, the bone becomes an “adult”, with a porous structure.
When the bone is fully formed, the wound should resolve to a third of the length of the root.
After extraction, the gums atrophy and the process of subsidence continues for 6-12 months.

Stages of tissue healing after tooth extraction

Swollen cheek

Not all dentists tell patients what to do if their cheek is swollen after tooth extraction. Even in the doctor's office, some patients notice swelling on their cheeks. Anesthetic drugs cause not only numbness of the nerve endings, but also swelling - this is normal if the discomfort quickly passes after the end of the operation.

If a tumor appears after dental procedures, about a day or later after surgery, this is a dangerous sign. Pain, swelling and redness are caused by the presence of many blood capillaries in the oral mucosa. But the recovery process in the mouth is also much faster than in the arm or leg. If this does not happen in a timely manner, then the tumor is caused by one of the following reasons.

Swelling of the cheek tissues that began even before the visit to the dentist. After surgery, such swelling only intensifies, although surgery in this case is not the main reason that the cheek is swollen.
Removal of a wisdom tooth that has not yet fully erupted. The removal operation severely injures the gums, even if the surgeon is experienced. During the operation, the doctor cuts the tissue deeply, sometimes he has to further expand the wound to get to the tooth. When a wisdom tooth is removed, there is often profuse bleeding below, causing swelling of the cheek within a day.
High blood pressure. Patients suffering from hypertension are more susceptible to edema than others.
The patient is overweight. The thick layer of fat on the face is well supplied with blood, which contributes to swelling.
Suppuration of the walls of the socket and blood clot also lead to swelling of nearby tissues.

If your cheek is swollen after tooth extraction, this does not always threaten your health. If this happens within 24 hours of surgery, it is likely not a problem and will go away on its own. To verify this, the patient only needs to measure his temperature. If it does not exceed 37.5°C, experts consider this a normal reaction to injury caused by surgery. In case of swelling, it is advisable to measure the temperature several times a day to ensure that there is no severe infectious inflammation. The second option is to examine your mouth with a mirror to make sure there is no worsening of the condition.

With the current level of technology development, experts recommend photographing the swelling every day to monitor its dynamics. The following are considered alarming factors:

long-lasting bleeding;
bad breath that was not there before;
the appearance of pus from the wound when pressing on it;
severe pain when swallowing.

Dentists recommend observing swelling of the cheek for the first 24 hours, but if the condition does not improve the next day, you need to contact the dentist again.

Complications during extraction

All unfavorable conditions lead to alveolitis - inflammation that develops after infection of the wound. Most often, problems begin after a blood clot falls out. Sometimes a clot does not form at all.

Ear hurts after wisdom tooth removal

Alveolitis of the tooth socket

If you rinse your mouth, alveolitis is diagnosed after 1-3 days. The water pressure washes away the protection and inflammation is guaranteed. Its signs:

increasing pain, gradually affecting neighboring areas;
as inflammation spreads, general signs of intoxication intensify: fever, aching joints, loss of strength;
swelling spreads to nearby areas;
the mucous membrane turns red-blue due to impaired blood supply;
bad odor from the problem area in which food debris accumulates.

All other complications also develop after the wound becomes infected. It is convenient to present their features in a table.

Type of complication	Description
Dry socket	The blood clot has not formed, recovery time is delayed, and there is a risk of alveolitis. Most often it happens during active rinsing. A dry socket should be shown to the dentist.
Osteomyelitis	A serious consequence when alveolitis spreads to the jaw bone. Inpatient treatment is required.
Nerve damage	If the tooth has massive roots, there is a possibility of nerve damage. All tissues near the tooth lose sensitivity. For treatment, a vitamin complex and medications are used that accelerate the transmission of nerve impulses to muscle tissue.
Cyst	A serious complication requires surgical methods of elimination.

After recovery, there is no need to delay prosthetics, since the absence of any unit of the dentition has a bad effect on the condition of the entire oral cavity.

Prosthetics

Recommendations after tooth extraction

To reduce the likelihood of complications, the patient needs to follow simple rules at home.

The gauze swab applied by the surgeon must be removed from the wound as carefully as possible so that the clot covering the bleeding wound does not accidentally come off. If you carelessly remove the tampon along with the clot, the wound may become infected, which will cause inflammation. It is recommended to remove the tampon 20 minutes after surgery, but not earlier. If the gauze has dried to the wound, you need to soak it with a chlorhexidine solution.
Pain after tooth extraction is normal. To reduce pain, you can cool your cheek with an ice cube or a cold water bottle. A good folk remedy is to place a coin on the outside of your cheek. The cold cannot be kept for long, 10 minutes is enough. After an hour break, the cold manipulation can be repeated.
It is not recommended to rinse your mouth immediately after surgery. You can resort to rinsing no earlier than 6 hours after tooth extraction.
You should not eat for 2 hours after surgery. Until the wound has completely healed, food taken should be warm. You need to refrain from spicy and salty foods - this causes irritation of soft tissues.
On the day of surgery, you should not drink alcohol, which dilates blood vessels and increases bleeding.
You can smoke only three hours after surgery.
Any medical procedures in the mouth can be resumed no earlier than 8 days after tooth extraction.
After surgery, it is not advisable to touch the wound with your fingers or tongue, visit the sauna, or take a hot bath. Heavy physical activity and stressful situations are undesirable during the rehabilitation period.
It is prohibited until the wound has healed to brush your teeth on the side of the dentition where the amputation was performed.

No dentist guarantees 100% that the patient will not have complications after tooth extraction. The result depends not only on the professionalism of the surgeon, but also on the characteristics of the patient’s body. If there is prolonged (more than a day) swelling, redness, severe pain and bleeding, you should seek medical help.

Recommendations for healing

The main thing is to follow all the doctor’s recommendations and instructions . You also need to protect yourself as much as possible from blood clots. To do this, you should not rinse your mouth for the first few days . The wound site should not be touched with your tongue or other objects.

You should not visit saunas and steam baths, and it is also better not to apply hot compresses to your cheek.

If healing a wound causes severe pain, the area often bleeds and swells, then do not even try to self-medicate . This will only damage your gums and make things worse.