After tooth extraction: lifestyle, nutrition and hygiene rules

How does socket healing occur?

The tissues are restored within approximately 10-15 days. At least by this point, the pain will go away, and external changes will no longer cause you concern. Of course, this is a conditional framework - the healing process for each patient occurs individually. Not only the injured gum is restored, but also the bone tissue inside the hole from which the root was extracted. Below we list approximate deadlines for all stages. If your symptoms are shorter/longer, there is no need to panic - you need to evaluate the remaining symptoms: when there are no additional manifestations of pathology, it means that rehabilitation is going according to plan.

first 3 hours: after tooth extraction, bleeding occurs - this is a common situation, since the tissues have been injured. The hole is completely filled with blood, which normally immediately coagulates - this is how a blood clot or blood clot is formed. It is extremely important for normal rehabilitation! In fact, it is a natural barrier against the penetration of bacteria into the wound. The color of the hole is dark red,
the first 2-3 days: the dark blood clot persists and thickens, its size decreases. Granulation tissue begins to form inside the hole - young connective tissue, which will become the basis for the restoration of the mucous membrane,
3-7 days: the clot brightens and acquires a whitish color. Granulation tissue covers almost the entire socket. Swelling and pain should decrease or even go away completely,
7-10 days: the blood clot dissolves, the remains can be seen only in the center of the hole, which has decreased in size. New bone tissue begins to form under the healing gum, which in 4-6 months will fill the defect from the edges to the center,
after 15 days: young pink mucous membrane covers the entire socket, superficial healing is complete.

Bibliography

Khitrov V. Yu., Zabolotny A. I. Halitosis - a medical and social problem // Practical medicine. - 2009. - No. 1 (33). — P. 12-17
Gorobets S. M. et al. Risk factors for the development of halitosis (review) // Crimean Therapeutic Journal. — 2022. — No. 3. — P. 13-18
Maksimova E.V., Stetsyuk N.S., Shelikhova E.O. Halitosis as a medical and social problem // Crimean Therapeutic Journal. — 2020. — No. 1. — P. 32-37
Temkin E. S., Churikova A. S. Halitosis - modern diagnostic methods and their prospects // Volgograd Medical Scientific Journal. — 2022. — No. 3. — P. 15-18
Vinogradova T. G. Bad breath - halitosis, causes and treatment options // Bulletin of VSMU. - 2014. - T. 13. - No. 2. - P. 129-131
Ushakov R.V. et al. Modern methods of diagnosis, elimination and prevention of halitosis // Textbook: Moscow. - 2016. - 81 p.
Instructions for the medical use of the drug Metrogyl Denta® Dental gel // Registration number P N015982/01 // State Register of the Russian Federation. – URL: https://grls.rosminzdrav.ru/Grls_View_v2.aspx?routingGuid=9bc9a05c-d28b-473d-b8d4-60e8b8323762&t=

Modern aspects of the prevention of diseases of the oral mucosa in patients with xerostomia / L.D. Weisheim, L.M. Gavrikova, T.N. Gomenyuk, T.V. Motorkina, L.N. Shcherbakov, S.M. Dubacheva, G.V. Sorokoumova//Medicinal Bulletin.—2013.—No. 2 (50). -WITH. 32-37.

What to prepare for after removal: what is considered normal, and when to urgently see a doctor

In order to prevent the development of dangerous situations after tooth extraction, you need to notice alarming signs, and even if they are mild, consult a doctor in time - this way you will avoid serious complications. This may be alveolitis, fistula, nerve damage and other pathologies. They cannot be stopped or cured at home.

In the table, we have listed the symptoms and explained in which cases they should alert you, and when the situation remains within the normal range.
What to prepare for after removal

Symptom	Norm	Threat: You need to see a doctor
The gums are painful and swollen, the cheek is swollen and blue	Swelling and hematomas (bruises) are a natural reaction to injury, especially if the removal was difficult. They can intensify for up to 3 days, and then begin to subside	Does not go away for more than 4 days, gets worse or appears after sleeping - a feeling that the cheek is “blowing”
The wound is bleeding	Bleeding stops within the first hour after surgery. Further minor and rare discharge is possible	If the blood flows heavily for several hours or bleeding starts again at home - it is the abundance of discharge that should alert you
Presence of a blood globule in the socket	A dark red clot begins to form immediately after removal, fills the entire hole, and persists for up to 5-7 days	The hole is empty, “dry”, deep, a yellowish-grayish coating has appeared, there is an unpleasant putrefactive smell - this situation is called a “dry hole”
A white coating appeared on the wound	A whitish film appears on days 2-3 - this is the release of fibrin (a protein involved in tissue healing)	Yellow, greenish or dark gray color, as well as bad odor, redness and pain indicate the development of an infection
Discharge from the socket	Ichor is a clear liquid that can ooze from the wound in the first day	Cloudy pus with a putrid odor indicates an infectious process
The temperature has risen	Within two days (usually in the late afternoon) body temperature can rise to 38-39⁰С	The fever is severe, the temperature stays above 38⁰C for more than 2 days in a row or rises again after the condition has returned to normal
It is impossible to open your mouth wide, there is jaw clicking	It mainly happens after the removal of large teeth – molars, wisdom teeth. Symptoms may persist for up to 3 days (for complex operations - up to 7 days), then gradually subside	Difficulty opening the mouth persists for longer than 4 days, there are no positive changes, the pain intensifies
Pain at the site of the extracted tooth	Aching or pulsating - may be on days 1-3, but fades away every day	Lasts longer than 3 days or intensifies every day, spreads across the face, extends to the ear, neck
Part of the gum and cheek are numb	Normal for several hours after surgery - anesthesia continues to work	If the tissues have lost sensitivity for more than a day, the nerves may have been affected. Need to see a doctor
Running nose	Not the norm! Pain when blowing your nose and breathing, liquid discharge and runny nose are a symptom of complications during surgery

Causes of pain after removal

The severity of pain depends on the complexity of the operation performed. Normally, pain may occur immediately after the anesthetic wears off, and discomfort may persist for 2-3 days. Then the symptom should subside. Sometimes dentists allow pain to persist for five days, but in the absence of other complaints.

The main cause of pain in the socket area after wisdom tooth removal is alveolitis. Inflammation of the socket develops for the following reasons:

Highly traumatic surgical procedure.
Incomplete sanitation of the hole, preservation of tooth fragments in it.
Injuries to the mucous membrane during surgery, for example, with a bur when dividing roots or with forceps when applying cheeks to the walls of a tooth.
Refusal to apply sutures if there are direct indications for the procedure.
No course of antibiotics after complex tooth extraction.

Characteristic will be an increase in pain and the addition of other signs of inflammation. The only right decision in this situation is to visit the dentist.

How to ensure that there are no complications after tooth extraction?

At the first stage, you need to choose a doctor who will carry out professional and careful removal without severe tissue injury. It is important that the operation is performed not by a dental therapist, but by a dental surgeon or even a maxillofacial surgeon - an implantologist. It is a highly specialized doctor who knows how important it is to preserve the volume of bone tissue so that after this operation there are as few restrictions as possible for implantation.

The most important thing after the operation itself is to strictly adhere to the instructions and recommendations given by the doctor. If medications are prescribed, they must be taken for a strictly prescribed time. See our short checklist of what you can and cannot do after surgery, as well as detailed recommendations that will help you shorten the rehabilitation period and go through it without pain and complications.

Solution

Such a diagnosis must be treated in time, then after a few days the person feels better. The process includes:

removal of remnants of a blood clot, this is done under local anesthesia;
processing the hole and its walls with a special tool;
treating the hole with an antiseptic solution so that the infection does not go further;
prescription of antibiotics;
the use of drugs that relieve pain;
rinsing the mouth, for this you should take antiseptic solutions;
physiotherapeutic procedures that promote rapid wound healing.

In the absence of timely treatment, osteomyelitis of the jaw bone may occur.

A short checklist: a list of recommendations after tooth extraction

What can and should be done

hold the cotton swab applied by the doctor for 20-30 minutes,
within 2-3 hours after surgery, be sure to apply cold compresses to reduce tissue swelling,
carry out oral baths (not to be confused with rinsing) with antiseptic drugs for 3-5 days: “Miramistin”, “Chlorhexidine 0.5%” or other drugs prescribed by a doctor can be used as medicinal solutions,
after 3-5 days, start using a toothbrush - only a soft one for the operated area, as well as a new one, without bacteria on it. The teeth of the opposite jaw can be brushed immediately, the main thing is to avoid the area of the extracted tooth,
chew food on the side opposite the injured area,
You can drink water immediately, preferably warm water,
You can eat only after the anesthesia wears off, that is, after 2-3 hours,
Lead a quiet lifestyle, try to avoid physical activity and heavy lifting for 5-7 days.

What you should absolutely not do

don't rinse your mouth! Mouth baths in the first 3-5 days are more than enough,
do not use hot compresses! This is fraught with the appearance of edema and the development of inflammation,
do not create a vacuum in your mouth: do not puff out your cheeks, sneeze, blow your nose and spit very carefully,
do not pick the wound, do not touch the clot with your tongue,
do not drink or eat hot or cold food, only warm food,
try to quit smoking for at least 2-3 days after surgery,
Do not drink alcohol for 2-3 days - it does not promote tissue repair. Also exclude it if the doctor has prescribed a course of antibiotics,
Do not overcool or overheat - give up sports exercises, swimming pools, saunas for 5-7 days.

Treatment of alveolitis

When the socket becomes inflamed, the main thing is to eliminate the source of infection, prevent the development of inflammation and preserve the dentition. In order to alleviate the patient’s condition, the dentist uses the following therapy methods:

Mechanical cleansing of the hole, washing out purulent residues with a solution of nitrofural or hydrogen peroxide.
Anesthesia of the hole. The pain syndrome is relieved with the help of local applications with anesthetics and analgesics. To do this, the doctor applies the lotion for half an hour and then removes it to prevent the proliferation of microbes in the area. The dentist will advise the patient to repeat the procedure several times a day. Taking painkillers orally is not recommended.
Taking antibiotics. In the presence of concomitant diseases, alveolitis is treated with antibiotics.

With the right approach, the signs of alveolitis subside 2-3 days after the start of treatment. If therapy was not started on time, residual pain may drag on for 2–3 weeks.

With the permission of the dentist, additional treatment of alveolitis with folk remedies is possible:

Sage rinses. To prepare the solution, brew a large spoonful of dry sage in 250 ml of boiling water, leave the mixture for an hour, wrapping the container in a towel. After this, the liquid should be filtered and used for rinsing.
Gargling with chamomile flowers. To prepare the composition, brew a large spoonful of chamomile flowers in a glass of water for 15 minutes, insulating the container with a towel. The infusion should be strained and rinsed your mouth up to 12 times a day.
Poplar buds. To prepare, take half a glass of buds, pour into a glass container and pour in 500 ml of vodka. The product should be infused for 10 days in the dark and cool, then filtered, soaked in cotton swabs and applied to the inflamed area.
A soda rinse solution can also be an effective addition in the treatment of alveolitis. You should take a large spoonful of powder in a glass of warm water or mix soda with water to obtain a paste-like mass, which then needs to be used to treat the hole.
Burdock leaves. To prepare a medicinal decoction of burdock leaves, you need to pour 20 grams of raw material with 2 glasses of water, and then simmer the mixture over low heat for about 40 minutes. The resulting solution should be cooled and filtered, and then used for rinsing.
Aspen bark. Pour 1 tablespoon of crushed aspen bark into one glass of boiling water. It is important to leave the solution in an airtight container for 3 hours, and then use 100 ml of strained warm liquid at least 3 times a day.
Anise infusion. To prepare the infusion, pour 1 tablespoon of anise into 200 ml of boiling water, and then keep in a thermos for 50 minutes. The liquid should be filtered and used to rinse 3 times a day.

The most complete reminder for patients after tooth extraction

So, you left the doctor's office - the surgeon asked you to tightly squeeze a gauze pad with your teeth, which will help stop the bleeding. You need to hold it for about 20-30 minutes, that is, while you fill out the necessary documents at the clinic or go home. Remove the tampon carefully, moving it slightly to the side, without sudden movements, so as not to damage the fresh blood clot.

Very important! A thrombus (usually called a “blood clot”) protects the wound from microbes and prevents pieces of food and saliva from accumulating in the hole during the first week of rehabilitation. This is a natural sterile dressing that starts the process of new tissue formation. The most important rule that will protect you from complications and severe inflammation of the wound is to never remove the clot, do not touch it with your tongue or fingers, do not touch it with a toothbrush and protect it from other influences. Gradually it will resolve on its own.

Do not keep the tampon in place for more than 30 minutes - gauze soaked in blood and saliva will quickly become a breeding ground for infection. In addition, a blood clot is forming in the hole - the presence of a foreign body and additional injury are of no use to it. You need to give the wound the opportunity to heal naturally.

“If you have a complex tooth extraction, especially if you had surgery to remove wisdom teeth, or if you have an underlying condition, such as diabetes, you may need to observe a doctor for a few more hours. For this purpose, we have our own hospital, where you can sit comfortably and relax while we monitor your condition to see if there are any complications. This will give us confidence that the operation will be successful and will reassure you as the patient.”

Vasiliev Alexander Alexandrovich, implant surgeon, more than 10 years of experience make an appointment

Tooth extraction WITHOUT complications! The modern equipment of our clinic allows us to carry out the most accurate and comprehensive diagnostics. Consultation is free!

Swelling after tooth extraction (especially if it was complicated) can be prevented by applying a cold compress - to do this, wrap an ice pack from the freezer in a towel and apply it to the cheek (that is, from the outside) for no more than 20 minutes. After 15 minutes the procedure can be repeated. If you don't have ice on hand, frozen vegetables or meat will do, but be sure to wrap them in a bag and a towel to avoid cold burns. Cold constricts blood vessels, reduces pain and swelling, although it does not completely remove swelling. Compresses are effective immediately after surgery for approximately 3-4 hours.

Do not warm up the injury site under any circumstances! A hot compress will only make the swelling worse by increasing blood flow to the area of inflammation. This will lead to serious complications after surgery.

Bad breath – is it always a pathology?

We have already found out that only the smell of iodine can be considered normal, provided that the doctor tamponed the hole with the appropriate turunda after the extraction procedure. This smell goes away on its own after a few days.

There is another smell (and taste) that does not indicate the presence of a pathological process for several days after extraction - it is steel, metallic, or even iron. It appears against the background of the fact that the damaged socket and the tissues around it secrete ichor, and it, like blood, has exactly that smell. True, in this case these two concepts should not be confused. Because bleeding for several days is normal, bleeding is abnormal and requires urgent medical attention.

A metallic taste may be present for several days.

People with poor blood clotting, diabetes mellitus and high blood pressure, smokers, and women taking hormonal contraceptives are more at risk of bleeding that does not stop for a long time, accompanied by a characteristic metallic odor. If you have at least one of these factors, then before tooth extraction, be sure to inform your doctor so that he can prescribe you the appropriate medications for maintenance therapy.

If the smell is stale, putrid, rotten, this is a signal of a pathological process and is always a reason to consult a doctor.

When can you eat and drink after surgery?

You should not strictly limit yourself in nutrition, you will need strength to recover - you can eat as soon as the anesthesia wears off, namely after 2-3 hours. You can drink it immediately after you remove the cotton swab. Until this point, it is undesirable for food particles or bacteria to get into the open hole.

In the first 3-5 days, you need to take into account several nuances in nutrition so that further healing of the wound goes well:

food should be warm. Hot or cold food will irritate tissues and cause blood vessels to dilate or constrict, which can cause new bleeding,
It is better to exclude rough food to avoid mechanical damage to the wound. Soups, purees, baked and boiled foods, minced meat dishes,
Do not chew food on the side where the tooth was removed to keep the protective clot intact.

Carefully! Many people mistakenly believe that in the first days it is better to drink and eat liquid foods through a straw. But in fact, suction creates a vacuum in the mouth, which can displace the clot or disrupt its integrity. Should not be doing that. For the same reason, you should not spit or suck in your cheeks.

Metrogyl Denta® for inflammatory diseases of the oral cavity accompanied by halitosis

Since one of the causes of bad breath is inflammatory periodontal diseases2, one of the directions of therapy should be the treatment of inflammatory diseases of the oral cavity.

Dental gel Metrogyl Denta® is a drug that can be used for the treatment and prevention of most infectious and inflammatory diseases of the oral cavity, in particular gingivitis and periodontitis7. It contains two active antimicrobial components - the antibiotic metronidazole and the antiseptic chlorhexidine, which are effective against the main anaerobic bacteria that cause periodontal diseases7.

to come back to the beginning

How to do oral hygiene

The main task is to preserve the blood clot on the wound of the extracted tooth, while maintaining cleanliness and health in the mouth. How to properly care for your teeth during this period:

There is no need to carry out any hygiene procedures immediately after tooth extraction. It is better to postpone the first brushing of your teeth until the next morning. You will need a brush with soft bristles. And it’s better to take a new one so that it is sterile. You need to brush your teeth with a small amount of paste, avoiding the wound area, and clean adjacent teeth with caution.
Do not rinse your mouth (including after brushing your teeth) or use an irrigator in the first three days! The clot may dissolve or be washed away with the flow of fluid, and treatment will have to be restarted. Instead of rinsing, make mouth baths - just take water into your mouth and carefully spit it out. If the doctor prescribes antiseptic drugs, rinse with them,
try not to touch the open wound with your tongue, hands or toothpick - this can damage or dislodge the clot and introduce an infection into the hole.

You can’t neglect hygiene - bacterial plaque will accumulate in your mouth, which can cause inflammation.

Comments

When can you brush your teeth after tooth extraction? And is it possible to immediately use an irrigator if you can’t use a brush?

Vita (01/14/2020 at 00:45) Reply to comment

Editorial staff of the portal UltraSmile.ru (01/18/2020 at 09:22) Reply to comment

My wisdom tooth was removed, the hole was treated and sewn up. after treatment everything heals well, it doesn’t hurt, but the smell is strong, dental, not putrid, some kind of medicinal, it drives me crazy, it seems to me that everyone around me feels it. My job involves close communication with people. What should I do?

Irina (08/27/2021 at 11:04 pm) Reply to comment

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Medicines after tooth extraction: what to take at home

To prevent complications, your doctor will prescribe home remedies for you. Which medications you can take depends on your specific situation, body characteristics, allergic reactions and possible concomitant diseases.

How to reduce pain after tooth extraction

Your doctor will recommend the medications to you. You should take painkillers as needed - at night or when the anesthesia wears off. If the pain becomes severe in the first days, you can take analgesics prescribed by your doctor every 4-6 hours, but no more than 4 days in a row.

Important! Do not take aspirin or other blood thinners.

What antibiotics should you take?

Antibacterial drugs are needed if the immune system itself cannot cope with pathogenic microbes, and infectious inflammation begins. But antibiotics suppress the activity of “good” microorganisms and also have many side effects. Therefore, they are prescribed strictly based on health conditions at the time of tooth extraction and how the operation went. As a rule, they are necessary if there is concomitant inflammation in the oral cavity, an infectious process in the acute stage in the body as a whole, or if a large number of teeth were removed at once.

When receiving a further treatment plan, you need to purchase medications immediately, without delay, so that you can help yourself in case of increased pain and discomfort. The doctor’s recommendations must be strictly followed, avoiding “amateur activities.”

Therapeutic oral baths during tissue restoration

Intense rinsing is prohibited - this way the solution can wash out the blood clot and expose the socket, causing the tissue to become inflamed and difficult to heal. Rinses are replaced with medicinal baths. For this, both plain water and antiseptics prescribed by the attending physician are suitable: a solution of “Chlorhexidine” 0.05% (in this concentration it is sold in a pharmacy) or “Miramistin” you just need to hold it in your mouth for about 30-60 seconds, and then spit it out. You need to repeat the procedure after meals, 3 times a day.

Such baths will become a mandatory component of the prevention of inflammation if you have the following problems in the oral cavity:

other teeth are damaged by caries or have tartar on them. Pathogenic microorganisms in sediments can lead to the development of alveolitis,
cuts were made on the gums to expose the gumboil,
under the extracted tooth or the tissue nearby was inflamed.

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How to get rid of the smell if it does appear

If you have a bad putrid odor from your mouth, you should visit a doctor. There is no need to be afraid; treatment of alveolitis does not involve any complex and painful procedures. On the contrary, it is much more difficult to treat the consequences of complications later - the same abscess, osteomyelitis or phlegmon.

If you notice an unpleasant odor, you should contact your dentist.

The doctor will give you anesthesia, open the wound and clean it of purulent masses, then perform an antiseptic treatment of the tissue. Drainage will also be performed if necessary. The procedure ends with tamponade of the hole with drugs. Next, the patient goes home, where he will have to drink the antibiotics prescribed by the dentist, as well as rinse with antiseptic drugs. To quickly achieve a positive effect, additional physical procedures, for example, electrophoresis, can also be prescribed.

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removal of a tooth

Rodionov N.T., Andreeva E.P., Dobrorodova S.V., Stoletennaya T.P. Prevention and treatment of alveolitis. Bulletin of the Smolensk State Medical Academy, 2010.

Expert “If an unpleasant odor appears after tooth extraction, it is not necessarily associated with the operation. The reasons may lie in the presence of untreated teeth in the mouth with pulpitis or cysts, gingivitis, diseases of the nasopharynx, and gastrointestinal pathologies. This symptom can be caused by general poor oral health, the accumulation of heavy bacterial plaque on the teeth and under the gums. Of course, all of the problems listed can lead to the development of complications and alveolitis, so it is better to eliminate them even before the extraction procedure: you need to carry out professional hygiene and cure diseased teeth. You cannot come for surgery with an untreated acute respiratory viral infection or acute respiratory infection, or with a severely weakened immune system.” Dentist-therapist Elena Vladimirovna Orlova

Consulting specialist

Dzhutova Aida Vladimirovna

Doctor rating: 8.8 out of 10 (5) Specialization: Implant surgeon, periodontist Experience: 10 years

General recommendations after surgery

On the first or second day after tooth extraction, you want to lie down and sleep - this is the body’s natural reaction to the stress experienced. After the release of stress hormones - adrenaline and cortisol - stabilization and rest are needed. Don't deny yourself this.

However, there are recommendations regarding sleep: you should raise the pillow higher and sleep reclining so that your head is elevated. This will prevent unnecessary pressure on the jaw and cause bleeding. To increase the inclination of the bed, place a pillow under the mattress or use two pillows.

Otherwise, maintain a calm regime without physical overload, pressure surges and overheating. That is, for the first time it is better to refuse air travel, hard work, playing sports and lifting weights, visiting the pool, bathhouse or sauna. You should not take a hot bath (a short warm shower would be preferable) and stay in the sun for a long time or sunbathe in a solarium. All this increases blood pressure, which is fraught with new bleeding. It is ideal if you have a couple of days off to recover after your teeth are removed.

Treatment of alveolitis in STOMA clinics

Surgeons at STOMA clinics are required to examine patients and give recommendations on how to care for the hole formed after tooth extraction. If problems arise after extraction, the patient can always call the clinic and clarify whether inflammation has really begun and what to do to reduce pain.

At any time after removal, the patient can contact our clinics. The attending surgeon will examine him and prescribe appropriate therapy.

Feel free to call us at any time and consult about your condition. The sooner we start treating alveolitis, the lower the risk of complications.

Frequently asked questions after tooth extraction

In this section, we answered the most popular questions that arise in the first days after tooth extraction.

How long will the wound bleed after tooth extraction?

The appearance of blood after removing a tooth from the socket is a normal phenomenon, since the periodontal tissues are penetrated by many capillaries and vessels.
When they are injured, even minimally, the hole fills with blood necessary for the formation of a blood clot. Normally, this occurs within 20-30 minutes and depends on the individual characteristics of blood clotting. Minor, very light bleeding may occur for another 2-3 days after surgery. It is important to distinguish blood from ichor - a clear liquid, slightly yellowish in color. Due to the small amount of blood, it can sometimes be pinkish. Ichor can normally be released from the socket within 12-14 hours after tooth extraction.

But if, 3-5 hours after the operation, the bleeding not only does not decrease, but also intensifies, you need to consult a doctor.

I removed the tampon from the wound 20 minutes after the operation, but the wound is still healing. What to do?

If the wound is still bleeding a little after removing the compress, you can apply another swab of sterile gauze (available at the pharmacy). It is lightly moistened with boiled water or chlorhexidine, applied to the wound and the jaws are squeezed tightly. Also, do not keep the new tampon in place for more than 20 minutes, so as not to provoke the development of infection.

Blood flows for more than 3 hours. This is fine?

You should immediately consult a doctor in the following situations:

bleeding does not subside in the first 30 minutes and continues for several hours or even days,
secondary bleeding: in the dentist’s office the hole stabilized, and when you returned home, the bleeding started again, and quite profusely and for a long time.

The reasons are different: taking certain medications (for example, blood thinners or hormonal drugs), menstruation in women, hypertension, diabetes mellitus, abnormalities in blood clotting and other blood diseases, drinking alcohol on the eve of extraction, as well as violating the dentist’s recommendations. Therefore, it is important to inform your doctor in advance about your existing diseases and medications, so that the doctor can prevent an unfavorable outcome.

When will my stitches be removed after surgery?

The wound is stitched for a more reliable connection of the alveolar walls and faster healing. You usually do not need to have your stitches removed by a doctor. We use special surgical threads that dissolve after 7-10 days and eliminate the need to return to this issue. If nothing bothers you and the stitches look healthy, then you don’t need to see a doctor.

Why didn’t the surgeon stitch up my wound after the tooth extraction?

The doctor always evaluates how the situation is developing - how extensive the intervention was, whether the gum had to be cut, how many roots the tooth has, how quickly the blood clots. If the wound is small and the prerequisites for healing are normal, then stitches are not necessary.

Is it possible to drink alcoholic beverages after tooth extraction?

We understand that amid the stress experienced, for some, a natural impulse is to relax with the help of alcohol, especially if the tooth extraction was difficult. But the answer is clear - no. Alcoholic beverages should not be consumed 24-48 hours before removal and for at least 2-3 days after surgery. Due to the dilation of blood vessels under the influence of alcohol, bleeding will open again in the hole, and a hematoma may appear on the mucous membrane. And if you have been prescribed antibiotics, then combining alcohol with them is dangerous, and alcohol is contraindicated until you finish taking the medication.

Is it possible to smoke regular cigarettes? What about electronic cigarettes, hookah and vaping?

Smoking in the first 2-3 days after tooth extraction has an adverse effect on the condition of the wound. Nicotine causes a sharp contraction of blood vessels, and the tars and chemical compounds that make up cigarettes irritate the mucous membrane and slow down healing. If stitches were placed, we do not recommend smoking for 2-10 days after tooth extraction.

Hookah mixtures contain glycerin, which causes tissue dehydration. E-cigarette formulations use propylene glycol, which is converted into toxic compounds that inhibit nerve impulses. Many people believe that vaping is safer than regular cigarettes, but there is still an additional chemical load on the wound. So the restrictions on hookah, vaping and electronic cigarettes are exactly the same as on tobacco - try not to smoke for several days after tooth extraction.

It has been proven that the risk of alveolitis - an infectious inflammation of the tooth socket - increases by 40% if the patient smoked immediately before tooth extraction1.

After a tooth was removed, caries was discovered on the adjacent one. Can it be cured immediately?

It is better to postpone treatment of other teeth or professional hygiene after tooth extraction for two to three weeks, unless otherwise indicated by a doctor. The fact is that when drilling a carious cavity or cleaning deposits, pathogenic microflora can enter the wound and cause its inflammation. But in some cases, when treatment is absolutely necessary, an experienced doctor will take measures to protect the socket using special membranes and protective devices.

I have problems with blood pressure. Is it possible to have surgery?

If you have problems with blood pressure, you need to monitor it regularly. Before tooth extraction and during the recovery period, you will need to take additional medications prescribed by your doctor in order to normalize your condition and indicators.

I have diabetes, but they recommended that I have a tooth removed. Is it dangerous?

If you have been diagnosed with diabetes, you probably have a blood sugar monitor. It is important to maintain normal indicators and take into account additional rules:

Tooth extraction is possible at the stage of disease compensation, when sugar levels are stable for several months. In the decompensated stage, elective operations are not performed due to the risk of bleeding and the body’s reaction to anesthesia,
you should go for an operation to remove teeth in the morning,
Immediately before tooth extraction, it is better to administer an increased dose of insulin to prevent a spike in sugar.

Due to stress before surgery, sugar levels may increase, so it is better to consult with an endocrinologist in advance about which drug to take to avoid a sharp jump in blood sugar. You also need to know that rehabilitation after tooth extraction in patients with diabetes mellitus is slower.

How long should I use a soft brush after surgery?

After the wound has healed, that is, after 2-3 weeks, you need to return to a regular brush of medium hardness - a soft toothbrush copes worse with plaque, and if there are no open wounds in the mouth, there is no need for it.

After the operation, the skin on my lips became dry and cracked, and herpes developed. What's the matter?

Dry lips occur due to a long stay in the dentist's chair (if many teeth were removed or the procedure was complex). Herpes can worsen due to decreased immunity (usually due to an acute stressful situation).

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Causes of inflammation

The disease can develop only after tooth extraction. Most often, the hole formed after removal heals within a day after the operation, and the patient feels better. But if the blood clot that covers the open wound moves or becomes deformed, an infection can penetrate into the hole, in which case alveolitis of the gums develops. As a result, the surface of the wound heals for a long time, and the patient suffers from complex discomfort.

Predisposing factors for the development of inflammation:

Surgical injuries during complex removal. The more complex the operation, the more pronounced the postoperative inflammation of the bone tissue will be, and the more likely the release of direct plasminogen activators.
Complex extractions associated with tooth segmentation, osteotomy, detachment of the mucoperiosteal flap. Complex operations increase the chance of developing alveolitis 10 times.
Removal of wisdom teeth. The denser, less vascularized bone tissue adjacent to the figure eights is prone to the formation of dry sockets.
General diseases of the patient. Alveolitis often occurs against the background of concomitant diseases. For example, patients with diabetes mellitus or immunocompromised patients are more susceptible to alveolitis due to impaired healing processes in the tissues.
Taking oral contraceptives. The estrogen contained in these drugs may indirectly enhance the fibrinolytic process, causing the breakdown of the blood clot.
Smoking. The direct connection between smoking and alveolitis has been repeatedly proven clinically. According to studies, the risk of socket inflammation in smokers increased 4-5 times compared to non-smokers. The incidence increased by more than 20% in patients who smoked 1 pack per day and by 40% in patients who smoked immediately before and after surgery.
Dislocation of a bunch. If the socket is handled carelessly and there is negative pressure (for example, due to drinking through a straw), alveolitis may develop.
Bacterial infections. Dentists agree that bacterial infections are the main risk factor for dry socket.
Poor oral hygiene. The incidence of alveolitis increases significantly with poor oral hygiene.
Excessive use of local anesthetics. According to some studies, excessive use of an anesthetic with a high concentration of a vasoconstrictor can provoke ischemia and make it difficult for the socket to fill with blood. This condition also increases the risk of alveolitis.

In fact, alveolitis is a fairly rare disease. According to statistics, it affects approximately 3% of patients who have undergone tooth extraction surgery. More often than not, the socket is not formed properly when lower incisors and molars are removed.

But alveolitis is especially common when removing lower wisdom teeth: according to experts, in approximately 20% of cases, the removal of “eights” with difficult eruption is complicated by alveolitis. In addition, it is believed that the risk of developing the disease is inextricably linked with age. This is explained by the fact that metabolism slows down, immunity is weakened, and the regenerative abilities of the body deteriorate.

Consequences of tooth loss: what happens to the bone and how to preserve it?

Even if only one tooth is removed, the situation with the jaw in this place immediately begins to deteriorate - the bone no longer receives the chewing load, metabolism stops in it, and the area of bone tissue under the tooth begins to sag, that is, atrophy.

This is a rapid process - bone loss can reach 30% in the first year alone. Subsequently, it will be problematic to place an artificial tooth supported on an implant in this place, both due to the constant subsidence of the bone and gums, and due to the displacement of neighboring teeth. They lose support, so they shift and tilt into the resulting “emptiness” - this is how problems with bite develop.

To prevent bone atrophy, especially during complex extractions of multi-rooted teeth, it is recommended to install a bioframework or replant a biocompatible artificial bone material with the application of a membrane. Thus, the bone volume and height of the alveolar ridge are maintained sufficient for future unhindered dental implantation.

How does halitosis manifest?

Constant bad breath is one of the symptoms of periodontal disease2. With physiological halitosis, when there are no dental or general diseases, the unpleasant odor is a temporary phenomenon. It appears after eating specific foods (onions, garlic) and disappears some time after eating and brushing teeth6. If you notice bad breath in the morning or after intense physical activity, it is likely that you are not producing enough saliva or it is drying up quickly due to breathing through your mouth at night or during exercise6.

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