How and how long does the gum heal after tooth extraction: norm and deviations. Alveolitis after wisdom tooth extraction

05.05.2019

What is accompanied painful sensations and a sharp rise in temperature. Such symptoms indicate alveolitis. This article provides information about the main causes of the development of this inflammatory disease, symptoms and methods of treatment.

What is socket alveolitis?

After tooth extraction, many have to deal with such a pathology as alveolitis. This is an inflammatory disease that occurs as a result of penetration into the hole of the infection.

Alveolitis appears when tooth extraction was problematic. The procedure is considered difficult if:

The roots of the tooth are crooked.
The tooth is extremely fragile and crumbles when using dental instruments.
The tooth did not erupt completely.

In these cases, the doctor initially dissects the gum, carefully peels it off the bone, saws the tooth and removes it in parts. All these actions are very traumatic, so the occurrence of complications is no exception. The most common among them is alveolitis after tooth extraction. Treatment at home is highly undesirable. All serious complications that appear after surgical interventions should be eliminated exclusively under the supervision of a physician.

The mechanism of development of the inflammatory process

After direct removal, a small clot with blood impurities forms in the hole. Its main purpose is to protect tissues from infection. In addition, the blood clot contributes rapid healing injured area. If it is not there or the integrity is compromised for some reason, the infection can penetrate into the well and spread to nearby tissues. Thus, alveolitis occurs after tooth extraction. The photos clearly show that this pathology looks like an empty hole. It may contain food debris and particles of dead tissue. If the hole heals without complications, a reddish blood clot can be seen in it.

Clinical forms of alveolitis

Serous inflammation. This form is characterized by constant pain discomfort. The hole remains open. Food particles and saliva constantly accumulate in its cavity. Serous alveolitis after tooth extraction is formed on the fourth day.
Purulent inflammation. With this form, granulations are formed at the bottom of the hole, which grow rapidly. The alveolar process is bluish in color. The mucosa is hyperemic, there is a slight swelling.
Purulent-necrotic inflammation. For this form of pathology, the appearance of severe pain with a return to the temporal zone is characteristic. Constantly comes out of the mouth bad smell. The patient usually has a fever, general malaise appears. face from the side extracted tooth swells.

The main causes of pathology

Since alveolitis after tooth extraction is inflammation, it can be assumed that this disease develops when an infection enters the wound. The appearance of such pathological process in the hole is not a mandatory phenomenon. A combination of a number of circumstances is required in order for this complication to appear.

Among the main reasons for the development of alveolitis, doctors include the following:

What symptoms may indicate inflammation?

The pathological process begins its development from the outer layers that line the tooth socket. The infection then spreads deeper. In addition to inflammation, some patients experience suppuration and tissue death, which can provoke more serious complications (periostitis, osteomyelitis of the jaw, abscess).

How to understand that you have alveolitis after tooth extraction? Symptoms of this problem at the initial stage are implicit. A lot of people don't understand what happened. As the disease progresses Clinical signs become more pronounced. Patients report the appearance aching pain in the hole of the tooth, which increases after eating. General condition and temperature remain normal.

At a progressive stage, the pathology is characterized by the appearance of the following symptoms:

Severe pain in the hole and adjacent gum.
General malaise.
A sharp rise in temperature.
Isolation of purulent contents from the hole.
Swelling of the gums.
Increase submandibular lymph nodes.
Characteristic odor from oral cavity.

The above signs of alveolitis after tooth extraction should alert everyone and become a reason to visit the dentist's office. Some symptoms are inherent in the initial stage of the development of the pathology, but the discharge of pus and sharp rise temperatures indicate its transition to a severe form.

Features of the disease in the case of a wisdom tooth

The so-called third molars give a person a lot of problems. Their eruption is usually accompanied by swelling of the periodontal tissue, severe pain. In what cases is it necessary to remove the rudiment?

Deviation of growth in an unknown direction, contributing to injury to the oral mucosa.
The presence of caries.
Slow teething, the formation of a "hood" and inflammation.
Negative effect on neighboring tissues.

In the process of removing such a tooth, neighboring nerves may be injured, which entails paresthesia of the corresponding part of the face. The most unpleasant complication is the appearance of a "dry hole".

After surgical procedures, a small clot with blood impurities should form in its cavity, protecting it from possible infection. Given the location of such a tooth and the difficulty in removing it directly, slight displacement of the gum tissue may occur. As a result, the protective blood clot is not fully formed.

Alveolitis after the removal of a wisdom tooth is a very common problem that requires competent treatment. Patients with this diagnosis are usually advised to apply a swab with an antiseptic to the affected area daily. The course of treatment continues until the wound is completely healed.

Diagnostic measures

Alveolitis should not be ignored after tooth extraction (a photo of the pathology is presented in this article). When primary symptoms you should immediately consult a doctor. Only a qualified specialist can prescribe competent therapy. This will require an examination of the oral cavity and the area in which inflammation has occurred. Self-diagnosis and treatment is not recommended. This approach can do more harm than good and provoke serious complications.

The grounds for the final confirmation of the diagnosis are:

characteristic clinical picture.
The results of the examination (visual examination, radiography).
Patient complaints.

Treatment at home

Only under the supervision of a qualified specialist can you get rid of such a pathology as alveolitis after tooth extraction. Treatment at home is carried out after visiting the dentist's office and only on the advice of a doctor.

Relatively safe and at the same time effective means natural antiseptics are considered (decoction of chamomile, sage). For cupping pain syndrome the doctor may advise "Pentalgin" or "Baralgin". It is important to understand that all these funds only remove discomfort, but do not treat alveolitis and inflammatory processes. That is why it is better to take a full course of therapy in a specialized medical institution.

Alveolitis after tooth extraction: treatment at an early stage of development

Initially, the doctor performs local anesthesia and makes an anesthetic blockade. Then, using a syringe, the hole is washed with an antiseptic ("Chlorhexidine", "Furacilin"). After that, using special tools, the doctor removes all foreign bodies. These may be fragments of a tooth or remnants of granulation tissue. On the next step the specialist repeats the treatment with antiseptics and drying the cavity with cotton swabs. After that, a bandage with painkillers (Ketorol, Nurofen) is applied to the hole.

If treatment is started in a timely manner, alveolitis after tooth extraction passes very quickly.

Therapy of advanced forms of pathology

Sometimes patients with obvious symptoms of inflammation do not seek medical help due to various reasons. In this case, the pathology passes into the next form, the treatment of which requires the use of more potent medicines.

After antiseptic treatment, the doctor inserts a swab with antibiotics (Karithromycin, Amikacin) and special preparations into the well to normalize the microflora and relieve inflammation. With the onset of necrosis, proteolytic enzymes are used. They allow you to gently clean the surface of the wound from particles of dead tissue. In some cases, additional blocking of the nerve is required. For these purposes, Novocaine or Lidocaine is usually used. If pain discomfort does not stop within 48 hours, the blockade is repeated. As aid use microwave therapy and infrared laser.

After all the manipulations, approximately on the seventh day, the hole begins to gradually heal. Within 14 days, the inflammation disappears, the swelling subsides, the affected area is tightened with new tissue.

Completion of the healing process

With proper therapeutic procedures, alveolitis after tooth extraction passes very quickly. By the end of the first week, you can notice the appearance of a new layer of granulation on the walls of the hole. Pain discomfort gradually decreases, and inflammatory process passes by the end of the second week.

With a purulent-necrotic variant of the pathology, if treatment is started late, drug therapy is usually ineffective. In this case, the disease often passes into a more complex form, namely limited osteomyelitis. Its treatment requires surgery.

Preventive actions

How to treat alveolitis after tooth extraction, we have already told. Is it possible to prevent the development of this pathology?

After surgical manipulations, in order to avoid suppuration of the wound, one should carefully consider the accompanying recommendations of the doctor. It is better not to use those drugs that have not been prescribed by a specialist.

If there are doubts about the competence of the doctor and the literacy of his recommendations, it is better to seek a second consultation with other medical institutions. Nobody forbids getting one more professional advice on the treatment and prevention of such a pathology as alveolitis after tooth extraction. The testimonials of many patients prove that sometimes doctors neglect quality advice or give the wrong recommendations.

In order for the hole to heal quickly, you should not pick a wound or gum, squeeze out blood. During the first day, it is better to try to chew food on the intact side of the jaw.

If, after removal, the doctor sewed up the hole, it is not recommended to damage the material used. Otherwise, the edges of the wound will diverge, and this area will become an object for re-infection. For some time, it is better to stop eating excessively hot food and drinks, as an increase in temperature can provoke the development of inflammation.

Implementation of such simple rules will allow not to appear in the dentist's office again, will make the recovery process more comfortable and safer for health.

Tooth extraction is a very unpleasant procedure, but sometimes inevitable. And after an outpatient operation to extract a tooth from the dental alveolus is performed, quite often people face various problems. Then it is necessary to treat complications after tooth extraction.

Among the most common negative consequences removal of a tooth (or the root left from it) dentists call bleeding, inflammation of the gums, alveolitis, flux, stomatitis and paresthesia. Swelling of the gums and its soreness for several days after tooth extraction are considered a natural phenomenon, since this operation is very traumatic for the gum tissue. Therefore, in most cases, special gum treatment after tooth extraction is not required.

A slight swelling of the gums and pain can disturb patients for two or three days, but then they pass safely. Doctors recommend applying a cold compress to the cheek for 10-15 minutes to relieve swelling - several times a day. Pain can be relieved with conventional painkillers.

Wound treatment after tooth extraction may be necessary in case of bleeding from the hole, which occurred a day or more after the operation. Blood can go if the patient accidentally disturbed the place where the tooth was, or were hurt blood vessels. Enough heavy bleeding from the hole itself happens when the dental branch of the inferior alveolar artery is damaged. Then you should definitely contact a doctor who will make a tight tamponade of the hole with iodoform or a hemostatic sponge, and then the patient squeezes it with a bitten cotton swab. In the hole of the extracted tooth, such a tampon lasts for at least five days, and at this time you can neither eat nor drink hot.

With complicated removal of large molars or their roots (with gouging from the gums and subsequent suturing of the wound), inflammatory edema with a dense infiltrate may appear and the temperature may rise sharply. This indicates the presence of an infection, and in this case, the treatment of inflammation after tooth extraction is to prescribe antibiotics. If the antibiotics do not work, and the infiltrate increases with the release of pus, there is only one way out - the treatment of purulent discharge after tooth extraction. To do this, the wound is opened, the pus is removed, and an iodoform draining turunda is introduced into the wound. In such cases, it is necessary to visit the dentist for examination and adjustment of further treatment.

Treatment of alveolitis after tooth extraction

In the hole of the extracted tooth, a blood clot is necessarily formed - a thrombus, and this is the key to normal wound healing. But when food particles get into the wound, or a part of the tooth remains in it, or when the tooth was removed, it was severely injured dental socket(alveolus), the disintegration of this clot and its suppuration may begin. Problems also arise when the clot is washed out of the wound by excessive rinsing of the mouth after the extraction of the tooth, which leads, as dentists say, to a dry socket.

In both cases, two or three days after the extraction of the tooth, the gum begins to hurt, and the sensation of pain spreads to the entire gum and radiates to the head. This means that inflammation of the walls of the socket of the extracted tooth has begun - alveolitis. First, the inner plate of the alveolus is involved in the inflammatory process, and then the deeper layers of the bone. When the inflammation of the socket of the extracted tooth becomes purulent-necrotic, the above symptoms are accompanied by a putrid odor from the mouth, an increase in the size of the submandibular lymph nodes and their pain when pressed, as well as an increase in body temperature to 37.5-38 ° C.

Treatment of alveolitis after tooth extraction is carried out by mechanical removal (under local anesthesia) of the decomposed contents from the hole, followed by disinfection by washing with a solution of hydrogen peroxide (furacilin, chlorhexidine, ethacridine lactate). For complete cleansing of the alveoli, a swab moistened with special enzyme preparations(trypsin or chymotrypsin) or camphor-phenol composition, under the influence of which necrotic tissues are completely split. After that, an antiseptic swab is applied to the hole, hemostatic sponge or a special paste with antibiotics.

In order for the treatment of the hole after tooth extraction to lead to positive results as soon as possible, patients are recommended to make warm baths of the oral cavity with a solution at home. baking soda(a teaspoon per glass of water) or a slightly pink solution of potassium permanganate (potassium permanganate). Also appointed sulfa drugs, painkillers and vitamins (by mouth).

Flux treatment after tooth extraction

The inflammatory process that began after tooth extraction can also affect the jaw - its subperiosteal or subgingival region. This disease has the official name of periostitis, and we call it flux.

An abscess, that is, a purulent focus, is formed in the tissues of the gums, and its localization will depend on where the extracted tooth was located. Flux symptoms include severe pain(give to the eye or temporal region and in the ear), a noticeable swelling of the cheeks and hyperemia of the mucosa in the area of the extracted tooth. Often there is a chill associated with an increase in body temperature.

Flux treatment after tooth extraction, first of all, involves the immediate removal of the abscess - its opening and washing with antiseptic solutions. As a rule, antibiotics are prescribed, for example, Ampiox or Lincomycin.

Ampiox in capsules of 0.25 g is taken by adults one capsule 4-5 times a day (depending on the intensity of the inflammatory process), the daily dose is not more than 2-4 g. Children from 3 to 7 years old this drug appoint at the rate of 100 mg per kilogram of body weight per day, children 7-14 years old - 50 mg (in 4-6 doses). The duration of the course of treatment is from 5 to 14 days. Side effects include nausea, vomiting, diarrhea, and allergic reactions. Ampiox is contraindicated in case of allergy to drugs of the penicillin group.

Lincomycin (250 mg capsules) active substance) is usually prescribed to adults at 500 mg 3 times a day at regular intervals (half an hour before meals, drinking plenty of water). Children aged 6 to 14 and weighing more than 25 kg daily dose determined at the rate of 30 mg/kg of body weight. When taking Lincomycin, you may experience side effects in the form of headache, dizziness, nausea, vomiting, pain in the upper abdomen, stool disorders, skin rashes and itching. Among the contraindications of this medicinal product: increased individual sensitivity to antibiotics of the lincosamide group, severe violations of the liver and kidneys, childhood up to 6 years, pregnancy and lactation.

Treatment after wisdom tooth extraction

The removal of a wisdom tooth may be accompanied by symptoms such as pain (including when opening the mouth and swallowing), significant swelling of the gums and surrounding soft tissues, and fever.

If after a day or two the edema does not decrease, but, on the contrary, begins to grow, there is a feeling of fullness in the place of the extracted tooth, the cheek swells and the temperature rises, then it is necessary to contact the dentist. Most likely, he diagnoses alveolitis or hematoma after the removal of a wisdom tooth. Treatment of alveolitis is carried out similarly to the therapy for the removal of a conventional molar. And a hematoma - that is, a cavity with liquid or clotted blood - is treated either by oral antibiotics, or (in a more serious patient's condition) by making an incision in the affected area of \u200b\u200bthe gum and setting up drainage, which promotes the outflow of contents. As a rule, when surgical treatment after the removal of the wisdom tooth, antimicrobials are also prescribed.

Treatment of paresthesia after tooth extraction

Paresthesia after tooth extraction is a violation of sensitivity due to mechanical damage to the superficial alveolar nerve or facial nerve(when removing wisdom teeth).

A sign of paresthesia is numbness of the tongue, lips, or chin. According to experts, this complication after tooth extraction occurs with an incorrect operation, that is, through the fault of the doctor. However, within a few weeks (or longer) the damaged nerve is restored.

AT rare cases When the degree of nerve damage is significant, patients experience permanent numbness. Then paresthesia is treated after tooth extraction, which consists in taking combined vitamin preparations containing vitamins of group B (or injections of vitamins of this group), injections of drugs such as dibazol, galantamine and aloe extract. The doctor also prescribes physiotherapeutic procedures (UHF, electrophoresis, diadynamic currents).

Treatment of stomatitis after tooth extraction

This disease is an acute or chronic inflammatory process localized in the oral mucosa. Stomatitis after tooth extraction may occur due to trauma to the oral mucosa during a dental operation. An infection enters the wound that appears on the mucous membrane, which leads to ulceration.

For the treatment of stomatitis after tooth extraction, local antiseptic agents are used in the form of rinses, ointments or aerosols. For example, Hexoral aerosol has antiseptic, antimicrobial and analgesic properties. Its active substance hexetidine effectively fights against various types pathogenic microorganisms. Geksoral spray should be sprayed on the affected areas of the mucosa for 2 seconds (twice a day, after meals). The drug has practically no side effects, but it is contraindicated in case of individual hypersensitivity to the constituent drugs, as well as in children under three years of age. And Hexoral in the form of lozenges is prescribed for adults 8 tablets per day, and for children 4-12 years old - 4 tablets per day. Children under 4 years of age, this medicine is contraindicated.

Has not lost its effectiveness and treatment after tooth extraction with medicinal plants- chamomile, sage, St. John's wort, calendula, oak bark, yarrow, forest geranium, sweet clover. Decoctions and water infusions of these plants are rinsed in the mouth, and this helps with almost all complications after tooth extraction.

From this article you will learn:

why does the hole hurt after tooth extraction,
what is alveolitis: photo and video,
How is alveolitis treated?

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

Alveolitis is a classic complication that occurs after, and consists in the development of inflammation of the socket of the extracted tooth. Often, alveolitis is also called the term "dry socket" (this is due to the fact that the alveolar bone is exposed in the depth of the hole, due to the loss of a blood clot).

On average, alveolitis after tooth extraction develops in 3-5% of cases, but this applies to teeth of any localization, with the exception of wisdom teeth. When the latter are removed, alveolitis occurs already in 25-30% of cases, which is associated with the greater complexity and trauma of the removal process.

Dry socket after tooth extraction: photo

About how normal healing of the hole should look like (on different terms since deletion) - you can see in the photo in the article:
→

Alveolitis after tooth extraction: symptoms

Concerning common symptoms, then since alveolitis is not an acute inflammatory process - it usually does not cause fever or inflammation of the submandibular lymph nodes. However, with its prolonged course, patients often feel weak, fatigued, and the temperature may rise (but not higher than 37.5 degrees).

Patient Complaints –
on aching or throbbing pains in the area of the hole of the extracted tooth (of varying severity - from moderate to severe). Sometimes alveolar pain can also spread to other areas of the head and neck.
With the development of alveolitis, pain usually occurs 2-4 days after removal, and can last from 10 to 40 days - in the absence of qualified treatment. Sometimes the pain is so severe that even very strong analgesics do not save. In addition, almost all patients report bad breath, bad taste in the mouth.

When visually inspecting the hole –
you may see an empty socket without a blood clot (in this case, the alveolar bone in the depth of the socket will be exposed). Or the socket may be completely or partially filled with food debris or necrotic disintegration of the blood clot.
By the way, if the alveolar bone is exposed, then it is usually extremely painful when touched, as well as when in contact with cold or hot water. In some cases, the edges of the mucous membrane converge so closely to each other above the hole that it is completely invisible what is happening in its depth. But when washing such a well from a syringe with an antiseptic, the liquid will be cloudy, with a lot of food residue.

Dry socket after wisdom tooth extraction

Alveolitis after the removal of a wisdom tooth may, in addition, have several more symptoms (in addition to those listed above). It's about difficulty opening the mouth or painful swallowing. Also due to the fact that the hole of the 8th tooth is usually located deep in the soft tissues - suppuration from the hole develops there more often (see video 2).

Alveolitis: video

In video 1 below, you can see that there is no blood clot in the hole, the bone is exposed there, and also in the depth of the hole is filled with food debris. And in video 2 - alveolitis lower teeth wisdom, when the patient presses his finger on the gum in the region of 7-8 teeth, and from hole is coming copious purulent discharge.

Dry socket after tooth extraction: causes

There are many reasons why alveolitis develops. It can occur due to the fault of the doctor, and the fault of the patient, and for reasons beyond anyone's control. If we talk about the responsibility of the patient, then alveolitis can occur when -

Also, alveolitis can occur in women due to the increased content of estrogen in the blood during the period menstrual cycle or as a result of taking oral contraceptives (birth control pills). A high concentration of estrogen leads to fibrinolysis of the blood clot in the hole, i.e. to degradation and destruction of the clot.

It is precisely because of fibrinolysis that the blood clot is destroyed and when poor hygiene oral cavity, and in the presence of carious teeth. The fact is that pathogenic bacteria that live in large numbers in the composition of dental deposits and in carious defects secrete toxins, which, like estrogens, lead to fibrinolysis of the blood clot in the hole.

When alveolitis occurs due to the fault of the doctor –

If the doctor left a tooth fragment in the hole, bone fragments, inactive fragments of bone tissue, which lead to injury to the blood clot and its destruction.

Large dose of vasoconstrictor in anesthetic –
alveolitis can occur if, during anesthesia, the doctor injected a large amount of anesthetic with high content vasoconstrictor (for example, adrenaline). Too much a large number of the latter will lead to the fact that the hole simply will not fill with blood after the extraction of the tooth. If this happens, the surgeon must scrape the bone walls with an instrument and cause alveolar bleeding.

Due to a large bone injury during removal –
as a rule, this happens in two cases: firstly, when the doctor cuts the bone with a drill, without using water cooling of the bone at all (or when it is not sufficiently cooled). Overheating of the bone leads to its necrosis and the start of the process of destruction of the clot.
Secondly, many doctors try to remove a tooth for 1-2 hours (using only forceps and elevators), which cause such bone injury with these tools that alveolitis simply must develop. An experienced doctor, seeing complex tooth, sometimes he will immediately saw the crown into several parts and remove the tooth in fragments (having spent only 15-25 minutes on this), and thereby reduce the injury caused to the bone.

If after complex removal or removal in the background purulent inflammation the doctor did not prescribe antibiotics, which in these cases are considered mandatory.

Conclusions : thus, the main causes of the destruction (fibrinolysis) of the blood clot are pathogenic bacteria, excessive mechanical injury bones, estrogens. Reasons of a different nature: smoking, a clot falling out while rinsing the mouth, and the fact that the hole did not fill with blood after the extraction of the tooth. There are also reasons that do not depend on the patient or the doctor, for example, if a tooth is removed against the background of acute purulent inflammation - in this case it is foolish to blame the doctor for the development of alveolitis.

Treatment of alveolitis -

If alveolitis develops in the hole after tooth extraction, treatment at the first stage should be carried out only by a dental surgeon. This is due to the fact that the hole can be filled with necrotic disintegration of a blood clot, there may be inactive fragments and fragments of a bone or tooth. Therefore, the main task of the doctor at this stage is to scrape it all out of the hole. It is clear that no patient can do it on his own - it will not work.

Antiseptic rinses and antibiotics (without cleaning the socket) - can only temporarily alleviate the symptoms of inflammation, but do not lead to healing of the socket. But at a later stage, when the inflammation in the hole subsides, patients will already be able to independently treat the hole with special epithelial agents to speed up its healing.

Thus, the main method of treatment will be curettage of the hole, but there is also a second technique - by creating a secondary blood clot in the hole of the extracted tooth. Learn more about these methods...

1. Curettage of the tooth socket with alveolitis -

Under anesthesia, a festering blood clot, food residues, and necrotic plaque are removed from the walls of the hole. Without removal of necrotic plaque and disintegration of the blood clot (containing a huge amount of infection) - any treatment will be useless.
The well is washed with antiseptics, dried, after which it is filled antiseptic(iodoform turunda). Usually every 4-5 days the turunda needs to be changed, i.e. you will have to go to the doctor at least 3 times.
The doctor will prescribe you antibiotics, antiseptic baths, and painkillers - if necessary.

Doctor's appointments after curettage of the tooth socket –

(for pain)
for antiseptic rinses (2-3 times a day for 1 minute),
Antibiotics: either Amoxiclav 625 mg tablets (2 times a day for 5-7 days) or Unidox-solutab 100 mg (2 times a day for 5-7 days) are usually prescribed. These antibiotics are better, but not cheap. Of the inexpensive ones - (2 capsules 3 times a day), but keep in mind that after this antibiotic, problems with the stomach and intestines develop more often.

2. Method for creating a secondary blood clot -

However, there are 2 situations in which a different treatment method can be applied. This method involves the creation of a secondary blood clot in the hole and, accordingly, if successful, the hole will heal much sooner than after the constant laying of iodoform turundas in it for 2-3 weeks. It is preferable to use this method only in the following two situations...

Firstly, when you went to the doctor immediately after, for example, you rinsed out the clot from the hole or it fell out by itself (i.e. when the hole is not yet filled with infection and food debris, and there is no necrotic clot decay in it or suppuration). Secondly, when the patient has a sluggish alveolitis for an already long period of time, and the hole is filled with inflammatory granulations.

How this technique is carried out –
if the hole is empty, then under anesthesia, the bone walls of the hole are scraped with a curettage spoon to create bleeding and the hole is filled with blood (video 3). If the hole is filled with granulations, then they are carefully scraped out, i.e. do the same curettage (video 4). Further, in both cases, after the hole is filled with blood, an anti-inflammatory drug (Alvogel) is placed deep into the hole, and several sutures are applied to the mucous membrane to bring the edges of the wound closer together. Antibiotics are prescribed immediately.

Curettage to create a secondary blood clot: video 3-4

Summary : those. both in the first and in the second methods, curettage of the well is carried out in the same way, but in the first case, the well heals slowly under iodoform turundas, and in the second case, a blood clot forms in the well for the second time, and the well heals, as it should do under normal conditions .

What can be done at home -

After the subsidence acute symptoms inflammation, there is no need for antiseptic turundas inside the hole, because they do not help the wound heal faster (epithelialize). At this stage best method treatment will be filling the hole with a special one (Solcoseryl). This drug has just an excellent analgesic effect (after 2-3 hours the pain will practically stop, and after 1-2 days it will disappear completely), and it also accelerates healing many times over.

Scheme of use –
washed with an antiseptic and slightly dried with a dry gauze swab hole - this paste is introduced (completely filling the hole). The paste is perfectly fixed in the hole, does not fall out of it. It is not necessary to remove the paste from the hole, because. it slowly dissolves itself, giving way to growing gum tissue. The only thing that may be required is to periodically report it to the hole.

How to rinse the well from food debris -

In some situations (when the turunda has fallen out of the hole, and there is no way to immediately consult a doctor), it may be necessary to wash the hole. After all, after each meal, the hole will become clogged with food residues that will cause new inflammation. Rinsing will not help here, but you can easily rinse the well with a syringe.

Important: at the syringe from the very beginning it is necessary to bite the sharp edge of the needle! Next, bend the needle a little, and fill a 5.0 ml syringe with a 0.05% Chlorhexidine solution (it is sold ready-made in every pharmacy for 20-30 rubles). Screw the needle tightly so that it does not fly off when you press the syringe plunger! Place the blunt end of the bent needle in upper part wells (do not inject too deeply to avoid tissue injury), and flush the well under pressure. If necessary, do this after every meal.

Dentists do not cease to repeat that it is impossible to delay the treatment of teeth. Banal caries can develop into serious problem. If you do not contact the dentist in a timely manner, in the future you will have to contact the surgeon. But even after the extraction of the tooth, the problems will not decrease. And the point is not only that you will have to put prostheses, which will require considerable financial costs. Let's figure it out in order.

Bleeding at the site of removal

Dental treatment after tooth extraction is a rather lengthy procedure. Usually after surgical intervention the specialist imposes drainage at the site of the operation. This is a pressure bandage that allows you to stop bleeding from the hole. Drainage should never be removed ahead of time. The tampon should stand in the place of removal for at least half an hour. If the drainage accidentally slips, you should immediately contact your dentist. Neglecting this advice can lead to serious blood loss.

Many mistakenly believe that rinsing with antiseptics or a soda solution will lead to the speedy healing of the wound. This is not entirely true. If the dentist has not prescribed such a procedure, you should not resort to self-treatment. Frequent rinsing can also lead to bleeding. You should not rinse the gums, even if there is a flux after tooth extraction. Treatment can only be prescribed by a competent specialist. Pus at the site of surgical intervention is a serious reason to re-see a doctor.

Pain

The extraction procedure itself is painless. Dentistry has come a long way today. The strongest anesthetics are used to alleviate the patient's condition. Along with this, you need to be prepared for the fact that pain will appear a few hours after surgery. Dental treatment after tooth extraction involves the use of special painkillers in the first few days. You should listen to your own feelings. If the pain is tolerable, it is better to refuse tablets. As painkillers, drugs such as Analgin, Ketanov, Dolaren, Solpadein, etc. are used. Before using medications, you must carefully study the instructions. It is worth remembering that any pills have their contraindications.

It is advisable to take painkillers after meals with plenty of water. In this case, they will act much faster. Dental treatment after tooth extraction should be prescribed by a specialist. Only a dentist will be able to choose an analgesic in accordance with the characteristics of the patient's body. With caution, medicines are used by people with pathologies of the gastrointestinal tract.

Cooling at the removal site

In the first minutes after the operation, the doctor may apply an ice pack to the sore spot. This manipulation reduces pain and stop bleeding faster. It is not recommended to use ice at home on your own. Hypothermia can lead to the development of an inflammatory process.

Until the wound has healed, you should dress warmly and be less outside in cool weather. The body has undergone stress and is vulnerable to various infections. People who work should take sick leave or for a few days. Banal hypothermia on the street often leads to the development of flux at the site of tooth extraction.

Dentistry and bad habits

At people who smoke There are many more problems associated with dentistry. Quite often there are Treatment at the same time demands serious financial expenses. Such a phenomenon as “dry sockets” leads to a long healing process of the postoperative wound. In addition, the vacuum that is created when smoke is drawn in can cause dislodgment of blood clots or drainage. As a result, re-bleeding may occur. Experts recommend avoiding bad habits within a few days after tooth extraction.

Alcohol will also have to be temporarily abandoned. Dental treatment after tooth extraction is a serious procedure. Specialists do not prescribe drugs based on alcohol. This is because alcohol thins the blood. Even drinking beer can cause bleeding. AT best case the healing process will be delayed, at worst - it will be needed urgent care dentist.

Alveolitis after tooth extraction

Treatment of gums after surgery is to carry out preventive measures to avoid the development of complications. The most common of these is alveolitis. This is an inflammation of the walls of the hole from which the diseased tooth is removed. Most often, this problem occurs just the same in smokers. The inflammatory process requires integrated approach. In most cases, dentists prescribe from the group of fluoroquinolones. Macrolide antibiotics also have a good effect.

How to proceed so that alveolitis does not develop after tooth extraction? Treatment is not a cheap pleasure and obviously not a pleasant one, so it is better to take, so to speak, preventive measures. For example, resort to the help of antiseptics for prevention. To wash the hole, medicines such as Miramistin, Stomatidine, Hexamidin, etc. can be used. Additionally, a specialist can prescribe anti-inflammatory drugs: Nurofen, Ketorol, Ibuprofen. They not only stop the development of the inflammatory process, but also perfectly relieve pain.

Use of other medicines

Dental problems can rarely be solved without the use of medications. Usage folk remedies often causes complications after tooth extraction. Treatment should be prescribed only by a competent specialist. The dentist, before writing out a prescription, must clarify what chronic ailments the patient suffers from, whether he has a tendency to allergic reactions. Postoperative care is selected in accordance with the individual characteristics of the patient's body.

A special approach requires treatment after the removal of a tooth cyst. Complex therapy will include the use of antibacterial, as well as medicines such as Amoxiclav and Sumamed are widely used in dentistry. When using antibiotics, you must strictly follow the doctor's recommendations. The patient may feel an improvement the very next day after the start of treatment. But in no case should you stop therapy. Bacteria can develop immunity. As a result, the inflammatory process will soon resume. You should stop taking medications only if you have symptoms of an allergy ( pruritus, rash, swelling of the extremities).

Physical exercise

Treatment of the hole after tooth extraction is not only in the correct reception medications. Physical activity control also plays an important role. In the first few days after the operation, you should abandon the load. Overwork can lead to bleeding. In addition, any procedures that may increase blood pressure. These include sauna, hot tub. Overheating is no less dangerous than hypothermia.

Sleep should also be organized correctly. After surgery, you need to rest more. Place another pillow under your head. This will avoid pressure on the sore spot.

Choosing the right food

A proper diet will help you cope with pain after surgery faster. Treatment of gums after tooth extraction consists in the selection of soft foods that do not require much effort when chewing. It is advisable to generally switch to grated food. The diet may include broths, mashed potatoes, compotes. It is necessary to give up coffee and strong tea. These drinks increase blood pressure.

If the removal was simple, you can also include solid foods in the diet. In this case, you need to ensure that food does not fall on the sore spot. Temporarily have to give up too salty, spicy and sour dishes. All of these can irritate tissues. After eating, the oral cavity should definitely be rinsed. Food residues are an excellent environment for the development of pathogens.

Hygiene Matters

In the first few days, teeth that are in close proximity to the extraction site should not be brushed. Hard bristles can injure the wound. Oral hygiene can be organized in a different way. There are many special rinses on sale that are excellent. After each meal, you need to rinse the sore spot with boiled water.

Particular attention should be paid to hygiene if there is pus after tooth extraction. Treatment consists in washing the wound with an antiseptic. Further, it is already possible to carry out the usual cleaning with a rinse aid or a toothbrush if the wound is small.

To clean the oral cavity, you can use various decoctions of herbs. Chamomile, for example, perfectly relieves inflammation after tooth extraction. Treatment with this plant has practically no contraindications. However, it is best to consult with your dentist first.

Suturing

Some dental operations not without sutures. This procedure is often accompanied by treatment after the removal of a wisdom tooth. A large hole is often tightened with special threads that quickly dissolve. In some cases, threads may be used, which must be removed after a few weeks. But you should not be afraid of this procedure. The dentist removes stitches under anesthesia. The patient does not feel any discomfort at all.

Healing time

After tooth extraction, a hole remains, which is tightened for several weeks. The exact timing of wound healing is difficult to specify. They are individual for each patient. If you follow the doctor's recommendations and give up bad habits, discomfort and pain will quickly go away. Wells heal much faster in people under 30 years old. With age, metabolic processes slow down. As a result, the rehabilitation process becomes longer. The healing time also depends on the type of tooth that was removed. Single-root wells are tightened in 7-10 days. Wounds can disturb the patient for about a month.

A few days after surgery, the patient may notice the formation of a white film in the hole. This is a young tissue of the epithelium. It is strictly forbidden to tear or scrape it off. After some time, the hole is completely filled with young epithelium.

Solving aesthetic problems

Removing a tooth solves many problems. First of all, it is possible to prevent the development of infection in the oral cavity. However, missing just one tooth can ruin your smile. Modern prosthetics allows you to solve many aesthetic problems. The doctor will select a crown that looks no different from healthy teeth. Veneers or dentures can be placed on request. Of course, any of these procedures are costly. It is much cheaper to visit a dentist in a timely manner and monitor your oral health.

Alveolitis after tooth extraction is an inflammatory process with the accumulation of pus, which can occur 1-3 days after the procedure. This disease is characterized by dangerous and unpleasant symptoms. Such a pathology interferes with the normal healing of the wound and can lead to more serious consequences.

Risk dangerous complications appears in the case when, after tooth extraction, the hole was not treated properly or the patient did not follow the recommendations of the attending physician. Osteomyelitis can develop from inflammation - this is a complication that leads to jaw abscesses and phlegmon. For the occurrence of sepsis, which often ends in death, it is enough for the infection to enter the bloodstream during the spread of osteomyelitis.

With the correct procedure for removing a tooth, blood immediately begins to flow from the hole. After the formation of a blood clot within 30 minutes, the release of fluid stops. At the same time, the clot protects the wound from environmental influences and various infections.

The clot can change its color from red to yellow within 2-3 days and this will not be a sign of pathology. The change in hue occurs against the background of normal physiological processes, the essence of which is the replacement of erythrocytes with a fibrin skeleton - the basis of the thrombus structure, which prevents bleeding.

This wound healing is almost painless. In this case, the principle of secondary tension operates, the meaning of which is to bring the edges of the wound closer together. Fibroblasts are the main factor in tissue healing. Over time, they are replaced by young osteoblasts.

Normally, the healing process lasts 7 days. During this period, there is a complete replacement of granulocytes with young bone tissue. From type and place surgical intervention time will depend full recovery gums. If the size of the wound is larger than usual or the intervention in the tissues of the oral cavity was too rough, the duration of the wound healing process will increase. In most cases, these types of wounds should heal within the first 2-3 weeks. Complete replacement of alveolar granulocytes with young bone tissue occurs within 2-3 months.

Appearance normal hole a few weeks later

Symptoms and causes of inflammation

If inflammation is present on the roots of the teeth, it is isolated, cyst formation may occur. Inside these membranes contains pus and infection.

Dmitry Sidorov
Dentist-orthopedist
Bacteria accumulate during and after tooth extraction. If bacteria accumulate near or inside the postoperative hole, a primary infection of the wound occurs.
It is impossible to completely kill bacteria. Therefore, the infection can and should be controlled. Particular attention is paid to the patient's immunity.
Dmitry Sidorov
Dentist-orthopedist
Bacteria can enter the body from the external environment. This will be called secondary infection of the wound.
Alveolitis after the removal of a wisdom tooth can occur under the following conditions:
A dry socket after removal can allow bacteria from the oral cavity to enter the wound. Such a pathology develops if the correct blood clot has not formed.
With the penetration of aseptic objects into the hole of the tooth.
If the patient deviates from the direct instructions of the attending physician.

Dentists distinguish the following types of pathology:
Serous alveolitis is manifested by increased pain during meals. With such a pathology, the general condition of the body is normal, no increase in body temperature is observed. When examining the oral cavity, the doctor notices that there is no blood clot in the hole or it is not sufficiently formed. There may be food leftovers at the site of injury. This form of pathology develops on the first day after the procedure. If it is not noticed within a week, it can develop into more serious diseases.
Purulent alveolitis manifests itself putrid smell from the oral cavity, a significant increase in body temperature, general increasing weakness, intense pain in the gum area. The patient cannot eat, he has swelling of the face, lymph nodes are enlarged. During examination, a pink-gray coating is noted in the oral cavity.
Purulent alveolitis of a chronic tooth is manifested by a decrease in intensity clinical picture characteristic of a purulent species. The patient returns to normal. An outgrowth forms around the damaged socket. soft tissue, which can be seen when examining the oral cavity. There may be slit-like wounds. At the same time, pus is released from the hole. The mucosa acquires a blue tint.

In patients who have removed a tooth, suppuration may occur within 2 days after the operation. Gradually increasing pain, swelling of the gums that does not go away - anxiety symptoms which may lead to further deterioration general condition patient.
The video tells about the causes of alveolitis after tooth extraction:
First aid at home
With the manifestation of the above symptoms, but in the absence of the opportunity to consult a dentist, you can alleviate the patient's condition at home. With the help of special compresses and solutions for rinsing the mouth, the intensity of pain decreases, but the disease itself is not treated.
Do not use hydrogen peroxide with baking soda. Rinsing the mouth with this remedy can provoke a general inflammation of the mucous membrane. To effective natural antiseptics include tincture and decoctions of chamomile with sage. There are certain rules for using such tools:
In order not to wash the blood clot, frequent and intensive rinsing of the mouth is prohibited. To provide therapeutic effect it is enough to hold the decoction in the mouth for 2 minutes.
With bad breath, it is forbidden to suck out and pick out a clot with improvised means.
Until the condition improves, it is recommended to do oral baths 10-12 times a day. This schedule should be followed until the affected area is decontaminated.

Before consulting a doctor, it is possible to use strong analgesic. Such medicines only relieve pain, but do not eliminate inflammation. Some drugs in this group are recommended to be taken as prescribed by a doctor (Corsodil, Eludril). On the gum, you can apply Metrogyl Denta gel or a special Solcoseryl paste.
Corsodyl Eludril Metrogil Denta Solcoseryl
microwave treatment;
gel and neon laser therapy;
fluctuorization.

Physiotherapy is widely used in dentistry, including in the treatment of alveolitis.
In advanced cases, surgical treatment is prescribed. If necessary, a jaw examination is performed before the operation in order to find out the extent of the spread of inflammation and the localization of pus. If there is no need for surgical treatment, the dentist recommends other methods of treatment to the patient.
professional treatment
To establish the correct diagnosis, dental surgeons check two factors that indicate the occurrence of alveolitis:
the presence of pus in the hole and its release during palpation;
the presence of residues after the collapse of the blood clot.

Professional treatment of alveolitis after tooth extraction consists of several stages:
administration of anesthesia;
thorough cleaning of the socket of the extracted tooth;
re-opening the hole with a scalpel;
it is possible to establish gauze bandage With active drugs, suturing;
at the end of the appointment, the patient receives recommendations on how to properly treat the wound with antiseptic preparations, ointments and gels.

In the video, the dentist talks about how various complications are treated after tooth extraction:
Dmitry Sidorov
Dentist-orthopedist
An outdated method of treating alveolitis is a room medications into the cavity of the hole. Such therapy is widely used in budgetary institutions.
Alveolitis - serious complication with a bright display unpleasant symptoms. But it can be avoided if you follow the doctor's recommendations. For quick treatment and wound healing, it is necessary to protect it from the influence of the external environment. It is impossible to perform mechanical interventions without the help of a specialist.
The video simulated the process of occurrence of alveolitis and its treatment:
During the first day after the manipulation, it is not recommended to chew food on the side where the tooth was removed. Such measures are taken to preserve the integrity of the blood clot. If there are sutures on the hole, it is forbidden to act on them in any way. A dry socket after the removal of a wisdom tooth needs more careful care, since purulent processes in this area are more dangerous.