Causes of swelling after wisdom tooth removal, how to cope with swelling

From this article you will learn:

• why is my cheek swollen after removal,
• How long does swelling of the cheek or gum last?
• What does the temperature say after tooth extraction?

The article was written by a dental surgeon with more than 19 years of experience.

If your cheek is swollen after tooth extraction, this in most cases is an unfavorable symptom of the development of inflammation, for example, this may indicate the development of alveolitis (suppuration of a blood clot in the socket of the extracted tooth). Swelling of the cheek can also be caused by the formation of a hematoma along the transitional fold, the formation of a purulent abscess on the gum in the area of ​​the extracted tooth, and other reasons.

However, in some cases, swelling after tooth extraction may be natural, without requiring a second visit to the doctor. As you probably know, swelling of the soft tissues after an injury or surgery is the norm, and therefore it is logical after a complex tooth extraction (for example, when the extraction was carried out with an incision in the gums and sawing out the roots of the tooth with a drill).

Swelling of the cheek after wisdom tooth removal –

Moreover, some patients complain only that their gums are swollen after tooth extraction, and they do not have visible swelling of the cheek. The appearance of swelling of the gums has the same reasons (as with swelling of the cheeks), it’s just that there are features of the course of the inflammatory process - depending on the location of the inflammatory focus. For example, if the inflammatory focus is located closer to the transitional fold (i.e., the place where the mucous membrane of the gums enters the cheek), then this is more likely to lead to swelling of the soft tissues of the face.

Below we will examine in detail the cases - when the appearance of edema is quite natural and does not pose a danger, as well as situations in which you urgently need to contact a dental surgeon for a re-examination.

What to do after wisdom tooth removal

On this day, it is better to go home and relax: sleep, read a book, watch your favorite show or movie. It is not recommended to move a lot and intensively, or engage in physical labor.

Starting from the second day, it is necessary to rinse your mouth with antiseptics and take antibiotic medications to prevent the development of infectious and inflammatory diseases. The doctor decides which antibiotics to take after wisdom tooth removal. If there are no recommendations, then you can choose any medications with a wide spectrum of action.

Intense rinsing is not recommended, licking the blood clot is strictly prohibited, otherwise this will lead to the effect of a dry socket. A plug of clotted blood protects the resulting cavity and jaw bones from food particles and bacteria getting inside.

Do not consume hot or too cold foods, drinks, or overheat the body. Visiting the beach, baths, saunas is prohibited.

Smokers will have to give up cigarettes for 2, 3 days, or better yet for a week. Nicotine does not allow the wound to heal quickly, as it constricts blood vessels. Tissues are poorly saturated with oxygen and nutrients, and are more easily susceptible to infection.

A repeated visit to the doctor is necessary, even if the stitches do not need to be removed. The doctor will examine the wound, be able to identify complications in time and prescribe the correct treatment. You should not wait until the date of re-appointment if there is severe, ongoing pain, or the appearance of pus in the socket.

In what cases can swelling of the cheek be normal?

Please note that swelling of the cheek may appear not only immediately after tooth extraction (or the next morning), but only a few days later. The last scenario will definitely indicate the development of inflammation. Therefore, the norm may be the occurrence of swelling of the cheek or gums - in the first hours after removal, or the next morning. When it might be normal:

1. After a complex tooth extraction – in this case, tooth extraction is often accompanied by incisions in the gums, cutting out bone tissue with a drill, and dislocation of tooth roots with special elevators. All this leads to significant trauma to bone tissue, as well as soft gum tissue. And therefore, it is quite natural that after a complex extraction you may experience swelling, and this happens especially often when it comes to the complex removal of wisdom teeth.
   What does a complex wisdom tooth extraction look like?

   Moreover, if your cheek is swollen after the removal of the 8th tooth, then the appearance of swelling of the surrounding soft tissues can gradually lead not only to facial asymmetry, but also to temporary difficulty opening the mouth, as well as painful swallowing. Therefore, according to the rules, after a complex tooth extraction, the doctor is always obliged to schedule the patient for a second examination (the very next day) so as not to miss the development of inflammatory complications.

2. After the removal of wisdom teeth , swelling can appear not only after a complex wisdom tooth removal, but also if the removal of the 8th tooth was relatively simple. The fact is that with a small length of the body of the lower jaw, with a small size of the upper jaw, the wisdom teeth may be partially located in the depths of the soft tissues (moving soft tissues of the oral cavity). Such a tooth can be removed easily, but with such localization of 8 teeth, swelling of the soft tissues can easily occur.
3. When a tooth was removed due to inflammation - if the tooth was removed due to purulent inflammation (i.e. at the time of removal you could have symptoms such as swelling of the gums, pain when biting the tooth, the presence of a fistula on the gum with purulent discharge).
   According to the rules, in this case, after removal, the doctor must wash the wound with an antiseptic, put medicine (Alvogel) into the hole of the extracted tooth, and also prescribe antibiotics to prevent suppuration of the blood clot in the hole. The development of soft tissue edema in this case is due to the fact that any surgical operation on inflamed tissues always leads to more pronounced edema. Those. in this case, swelling will not necessarily indicate the development of a complication. But on the other hand (even with prophylactic antibiotics) increasing swelling of the cheek may also indicate a complication that requires a visit to the doctor.
4. If you have had a gum incision made – if the tooth was removed due to pain and inflammation, then an inflammatory infiltrate (slight swelling) could be present on the gum or in the area of ​​the transitional fold. Making an incision in this case has the purpose of 1) releasing pus if a purulent abscess has already formed, 2) preventing the formation of an abscess after tooth extraction. An incision is made in the center of the infiltrate; usually a thin rubber drainage is inserted inside it.
   Making an incision in the area of ​​the transitional fold (i.e., where the gum meets the cheek) can always lead to the appearance or increase of existing swelling of the cheek. According to the rules, if a doctor opens an abscess along a transitional fold, the patient should always be scheduled for a re-examination the next day. If the infiltrate was opened, but no pus was obtained, then in the absence of complaints from the patient, the latter is sometimes recommended to independently remove the drainage from the wound after a few days (24stoma.ru).

   Opening an abscess along the transitional fold -

5. Complaints that the cheek is swollen after tooth extraction occur very often in certain groups of patients. For example, hypertensive patients, as well as people with a significant amount of subcutaneous fat on the face, are predisposed to the appearance of edema after tooth extraction. In these patients, swelling of the cheek may appear after a simple simple removal.

What symptoms in this case will indicate the absence of inflammatory complications -

As we said above: swelling after tooth extraction usually appears either within a few hours after the intervention, or the next morning. Accordingly, only over the next day will it be possible to draw timid conclusions about whether there is a reason to worry or whether you need to urgently run to the doctor for a second examination. Let's look at the signs that indicate that the development of edema does not require urgent intervention -

• The swelling that appears is not too pronounced and does not tend to increase. The latter means that the swelling that occurs the next morning after tooth extraction should not increase further in the evening. But if the swelling tends to further increase, this is a bad prognastic sign. Also not a very good sign is hardening of soft tissues, i.e. Normally, edematous tissue should be soft, but if tissue compaction (infiltrate) appears in the center of the edema, then this is a sign of suppuration.

• If you do not have a fever, especially an increasing one - if you did not have an elevated temperature at the time of tooth extraction, then normally it should not be elevated the day after the extraction.
  At the same time, a slight temperature of up to 37.5 in the evening on the day of removal (after a complex removal or removal due to inflammation) is considered normal. If you had a high temperature before removal, then from the next day it should begin to decrease progressively. If an elevated temperature after tooth extraction appears only the next day or even later, this most likely indicates the development of complications and requires immediate consultation with a doctor.

• If you do not have severe pain, especially increasing pain, after a simple removal you may feel pain for only 1 day, after a complex removal it is normal for only a few days. The appearance of severe pain and prolonged pain for 4-7 days only indicate that the removal is excessively traumatic, and this is a question for the doctor’s skills. In any case, normally the pain should progressively decrease every day, but if the pain does not decrease or occurs, this is a symptom of the development of complications.

• The hole must be closed with a dense blood clot - after removal, the hole is filled with blood, which immediately coagulates, forming a blood clot in the hole of the extracted tooth. In some cases, the clot may not form, or it may fall out due to the patient rinsing the mouth too much. The absence of a blood clot in the socket will inevitably lead to the development of alveolitis (inflammation of the socket of an extracted tooth).
  A fresh clot normally has a dark burgundy color, but after some time a whitish or grayish-yellow fibrinous coating will appear on its surface (this is normal and does not indicate inflammation). The clot should be dense, without an unpleasant odor. Pay attention to how the blood clot should look on the day of removal and a few days after (Fig. 6-7).

  What should a blood clot normally look like?

  Read also:  Hydrogen peroxide is an affordable assistant for oral hygiene.

After tooth extraction, the cheek is swollen: what to do in this way, let's summarize... if the resulting swelling of the cheek is 1) soft to the touch and does not tend to increase and harden, 2) if there is no temperature, difficulty opening the mouth and painful swallowing, 3) if the hole is closed by a dense blood clot, 3) if there is no severe or constant aching pain in the area of ​​the socket of the extracted tooth, then, in principle, we do not see any indication for an urgent visit to the dentist for a second examination.

How long does swelling last after tooth extraction?

There is no average answer to this question, because... much depends on the degree of trauma of the removal and the characteristics of the body. In some patients, swelling of the cheek may last only a few days, while in others it can last for a week. The problem here is that after a traumatic extraction (especially with cutting out the roots with a drill), very often a sluggish inflammation can occur in the socket of the extracted tooth for a very long time.

In this case, there may be only slight discomfort or no pain at all, but the swelling in this case can last quite a long time. Therefore, after a complex extraction, it is always worth going to the doctor for a second examination to see if the socket of the extracted tooth and the blood clot in it are normal. By the way, you can also make the swelling go away faster.

How to relieve swelling after tooth extraction -

So, if the appearance of edema is associated with traumatic removal or making an incision along the transitional fold, we can significantly increase the rate of its reduction. This can be done at home using compresses with a dimexide solution (diluted 1:4 or 1:5, i.e. to obtain a 20 or 25% concentration). Dimexide is diluted with lukewarm boiled water.

A gauze bandage is soaked in the diluted solution and applied to the site of swelling for 20 minutes. A layer of cling film is placed over the gauze bandage, and then secured to the head with a bandage. The procedure can be done 1-2 times a day, the duration of the procedure is 20 minutes. An important point - in this case, you cannot place a thick cloth or towel on top of the cling film (this is usually done to make a thermal compress). If there is inflammation, a heat compress can be harmful.

If your temperature rises after wisdom tooth removal

The symptom may occur immediately after extirpation. This is due to the action of the immune system in response to tissue injury and invasion of foreign elements into the body.

Doctors recommend taking antipyretics and using cold compresses to remove heat locally.

If the patient then develops a fever several days after extirpation, this may indicate the presence of an inflammatory process. The most common is alveolitis. It is accompanied by acute pain, which can radiate to the throat, temple, ear, depending on where the hole is located. If, when you probe the hole with your tongue, you feel an empty cavity, then you need to urgently go to the dental clinic where the surgery was performed.

How to relieve pain after wisdom tooth removal

The doctor prescribes drugs for pain relief to the patient. If there is no list, but the pain is severe, then you can buy Tempalgin, Baralgin, Ketanov and similar medications. Medicines must be taken according to instructions. If you take too many tablets, it will lead to side effects. One tablet is usually enough to stop an attack. Take three times a day.

In addition to medications, pain can be reduced with cold. A cold compress is applied to the cheek for 15 to 30 minutes up to four times a day. You can use pieces of ice or frozen food from the freezer. They are placed in a plastic bag and a towel, and then applied to the sore spot.

What can you eat after wisdom tooth removal?

It is forbidden to put anything in your mouth for two hours after extraction. During this time, a plug of condensed blood is formed and fixed on the socket, which is necessary to protect against the entry of various elements, including pathogens. If you are very thirsty, you can do this through a straw or in small sips.

On the first day, you can drink non-hot drinks and eat liquid porridge, yogurt, and soups. Over the next few days, you should adhere to the following recommendations:

• food must be at a comfortable temperature; hot and too cold food is prohibited, including drinks;
• it is necessary to exclude solid foods that can injure the gums;
• You need to chew food on the side that has not undergone surgery;
• After each dose, you need to rinse your mouth with a warm saline solution;
• If your immune system is weakened, you can take additional multivitamins.

It is better to refuse or limit sweet, spicy foods, alcohol, and carbonated drinks.

Complications of edema and methods of dealing with them

Often, swelling is accompanied by one or more complications from the list below:

• bleeding. A little bleeding is normal. If there is more blood, the wound can be pressed with a gauze pad moistened with an antiseptic (for example, Chlorhexidine). If bleeding does not go away for more than 2 days, you should not delay visiting a doctor;
• numbness. After any dental procedure, the area around the mouth may lose sensation. There is nothing wrong with this if the side effect goes away within 12 hours;
• the occurrence of pain, which is acceptable even after surgery. The main rule is that pain should decrease within a couple of days. In some cases, the pain can be so severe that a person cannot chew food (the condition should last no more than 5 days). To alleviate this condition, you can take painkillers (for example, paracetamol);
• the occurrence of a dry socket after surgery (especially important for smokers). In this case, a blood clot, without which the healing process is impossible, does not form. The condition is often accompanied by a feeling of pain and an unpleasant taste in the mouth. The most effective way to combat it is to wash the wound several times a day, followed by applying an antiseptic bandage.

How to rinse your mouth after wisdom tooth removal

The first few hours after extirpation, rinsing is strictly prohibited. This can lead to the natural plug being washed away, exposing the socket and bone. If bacteria penetrate inside, alveolitis or osteomyelitis will develop.

From the second day, carefully, not intensively, rinse your mouth with various antiseptics:

• chlorhexidine;
• miramestin;
• furatsilin;
• diluted potassium permanganate.

At home, you can prepare a solution with salt, soda, and add a few drops of iodine to the water. Herbal decoctions with sage, eucalyptus, chamomile, calendula, and oak bark perfectly relieve swelling and inflammation.

How to prevent complications?

To avoid swelling and subsequent treatment, it is recommended:

• Keep your head held high for at least 12 hours after surgery (or better yet, 24 hours). To do this, while lying down, you need to place several pillows under your head;
• do not touch the hole with your tongue or fingers;
• do not use warm compresses for 36 hours after surgery;
• do not smoke or drink alcohol for 72 hours after surgery.

Correct behavior after surgery is no less important than the procedure itself: if you adhere to the above rules, the swelling will go away either in the shortest possible time or will not occur at all.

How long does it take for gums to heal after wisdom tooth removal?

It is impossible to answer this question unambiguously, since the answer depends on the following factors:

• difficulties of extirpation - with a simple procedure, the tissues are minimally injured, which means the hole will heal within a few days; with incisions in the gums, the tissues heal for several weeks;
• age - faster for young people;
• the presence of complications, inflammatory processes that delay healing indefinitely until the infection is eliminated;
• compliance with doctor's instructions for the rehabilitation period;
• individual characteristics of the body.

When the tumor is predetermined

Everyone knows that you need to go to the dentist when a tooth just begins to bother you. But in real life this does not always happen. The result is tooth extraction as a last resort. And since treatment cannot be carried out, it means that there are serious problems in the oral cavity. Even when absolutely healthy tissues are damaged, for example by a cut or an injection, they swell. Moreover, a tumor occurs if the extracted tooth was adjacent to infections of the oral cavity or there are other dental problems.

Swelling after tooth extraction is inevitable if there are infectious processes in the oral cavity

By the way. The duration and intensity of swelling after extraction directly depends on factors such as the qualifications of the dental surgeon, the choice of anesthesia method, types of anesthesia, the complexity of the surgical operation, and the quality of the antiseptic used.

Table. Causes of soft tissue tumors