Alveolitis: inflammation with pain after pulling a tooth

It is normal for you to experience pain or tenderness after pulling a tooth. This pain should subside after a few days. However, when the pain gets worse and you experience complaints as a bad taste and bad breath, this may indicate disturbed wound healing and the wound may be inflamed. With a small percentage of the extractions (pulling a tooth) this inflammation occurs in the cavity (alveole) in which the tooth was, this is called alveolitis.

Why is it necessary to make a tooth?

By tooth decay or gum inflammation of the tissues around the tooth, it can be decided to extract the tooth. Especially wisdom teeth often give complaints. For a large part of the people, mostly due to lack of space in the mouth, the molar does not come through or does not get through properly. With wisdom teeth that are partially under the gums, bacteria can start to settle which can lead to gum disease. If a molar causes problems, or the dentist estimates that it will cause problems in the future, the dentist can decide to remove the molar in consultation with you.

How is the molar pulled?

After x-rays have been taken of your molar, the dentist will decide whether he can remove the molar himself or whether you will be referred to the dental surgeon. Both at the dentist and at the dental surgeon the molar will be pulled under local anesthesia. Sometimes this can be done in one go and sometimes the molar will be removed in two parts. It depends on the size of the wound whether or not it will be adhered with soluble sutures. After pulling the molar the wound will be covered with gauze bandage or a tampon. A piece of jaw bone is also lost by pulling a tooth. This is being rebuilt by your body itself. A blood clot is formed with normal wound healing. From the walls of the cavity the connective tissue makes this blood clot, after a few weeks young bone will form and over time gums will grow over it.

What can cause an inflammation?

If no blood clot is formed by the connective tissue or this blood clot comes off too quickly, an inflammation can form. A blood clot ensures that the wound (bone and nerve endings) is sealed off from bacteria. It is actually a natural patch for the wound. When this is missing, the bone and the ends of the nerve are exposed and bacteria can form an inflammation. This complication, after the selection of a tooth, occurs in a small percentage of patients. It is not exactly clear what the reason is that a good blood clot is not taking place or that it is releasing too quickly.

Which complaints can indicate an inflammation?

After the anesthesia has worked out after about two to four hours, it is normal for the wound to be painful and everything around the wound sensitive. Against this pain the doctor will often prescribe pain killers on prescription. A considerable swelling of your cheek can also occur, you can reduce this swelling by cooling your cheek with an ice. Because the jaw is often set up, your mouth will open a little harder and all this makes it more difficult to eat the first few days. The symptoms differ from person to person, but after a few days the symptoms will decrease. However, if, after three to 5 days, the symptoms increase and the pain gets worse, this may indicate an inflammation. This inflammation is called alveolitis. Signs of alveolitis can be:
  • Severe pain, which can extend to your head and ears, making even sleeping difficult.
  • A bad taste and a bad smell from your mouth.
  • Fever, an increase may occur and your lymph nodes may start to set up
  • The absence of a blood clot, when you look into your mouth you do not see a blood clot, but an open wound. Sometimes it contains food scraps or you see a grayish film.

Which factors increase the risk of inflammation?

It is never entirely clear what is the cause of the inflammation. There are, however, factors that increase the chance of poor wound healing and thus the chance of inflammation.
  • Smoking: it is advisable not to smoke during the first few days after the procedure, as this will prevent wound healing.
  • Use of alcohol: this can cause secondary bleeding, prevent wound healing and, moreover, alcohol does not coincide with the use of medication.
  • Pre-existing inflammation: pre-existing bacteria in the wound can ensure that no blood clot is produced.
  • Difficult extraction: if the molars were difficult to pull, the walls of the wound may be affected, making it difficult to form the blood clot.
  • Age: research has shown that wound healing is faster and easier with young people, under 25 years of age
  • Inadequate wound flushing: it is important to flush the wound, preferably with lukewarm water or saline. You should not rinse immediately on the first day and also not spit too often and too hard after rinsing. However, it is important to keep the wound wet immediately and to drink a lot.
  • Poor oral hygiene: it is important to keep your teeth clean. You can just brush with your normal toothbrush, just not brush your wound, but gently brush around the wound.
  • Hard foods: Only eat soft foods during the first few days, hard foods can cause the wound to bleed or damage the sutures.

How is inflammation treated?

If you think the wound is inflamed, it is important to contact your treating physician. If an alveolitis is detected, it will open the wound and clean it to remove all bacteria and the affected tissue. After treatment, the doctor will cover the wound with a tampon soaked in disinfectant and prescribe painkillers and / or antibiotics. The wound will remain sensitive in the days thereafter, but the severe pains will subside and over time the wound will heal.

Video: Dry Socket Emergency (February 2020).

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