Many patients complain about aching during the first days after tooth extraction. Pain is a natural body reaction to an injury. If not sharp and long-standing, such experience shouldn’t be regarded as an alarming symptom. However, this soreness occurs not only as a result of bone and gum injury, but also because of gums inflammation after tooth extraction.
Note!According to the statistics, only 3-5% of people have to deal with inflammation and healing failure after having their tooth pulled out. The only exception is a wisdom tooth. Its removal can be followed by complications in 25-30% of all medical cases.
The character and duration of pain in gums after extraction depends on two aspects:
- the degree of damage;
- the occurrence or absence of infection.
Normally, a socket must be fully blocked by a blood clot, bright red at first and then going yellowish-grey. Soreness usually lasts for 1–2 days, gradually decreasing by the next evening.
Sharp pain in gum after tooth extraction appears, if the bone tissue of this area is significantly injured. This happens when a surgeon pulls out a difficult tooth with the use of a drill to cut the bone or saw the tooth crown to remove its fragments. In addition to the case difficulty, dentists can sometimes be incompetent or just unwilling to reduce the impact. Thus, they can make the following mistakes:
- Operating without cooling surgical tips. If dental equipment doesn’t have such a detail, the drilling zone gets a thermal burn and superficial necrosis. They cause severe pain after the procedure. If it is the only unpleasant symptom and the blood clot is solid, a patient should take a painkiller and wait for some time.
- Omittance of sharp edges cutting or stitching up the moveable gum area. One can feel exposed bones with the touch of the tongue, or recognize them by the sharp pain occurring after eating and drinking something hot or cold. Sometimes they can be even visible to the naked eye.
- Leaving fragments of the tooth inside the socket. These are the parts which fall off while loosening or twisting. They can cause nerve pain in gum after tooth extraction and inflammation of the socket. With all these signs another visit to the doctor is necessary.
- Wrong strategy of removing. All dentists have different experience and qualification, so they can extract the same tooth in different ways. Thus, a doctor can struggle to pull out a tooth with forceps during some hours, while another one would decide to cut it in two parts and remove each one separately just in 15–25 minutes.
- A dry socket. Sometimes doctors can use too much anesthetic with vasoconstrictor, which stimulates a vessel spasm. Therefore, the hole which is left after removal may not be filled with blood. Doctors who don’t check it just put a cotton pellet and leave the tissue exposed, which results in its sensitivity and acute pain.
- Neglecting stitches. Before removal, the oral mucosa around the tooth is moved aside with a smoother, which makes its edges moveable. In such case, at least one stitch should be put after the extraction of a small single-rooted tooth and even more on a multi-rooted-tooth socket. This helps to reduce painful feelings by 30–50%, prevent complications, fasten healing and keep the clot in the socket.
In some cases, it can be the patient who treats the wound improperly and worsen the situation. They can thoroughly rinse the mouth, thus dislodging the clot and cause profuse bleeding.
Sometimes patients return to their dentists with complaints about constant oozing, mouth odour and gum abscess. The examination reveals remnants of food and necrotic decay of the blood clot in the socket or exposed bone tissue, which hurts after drinking hot or cold water. Such inflammation is called alveolitis of the tooth socket.
It may be the result of an improper extraction or of a wrong patient’s treatment of the wound. In such case, the socket must be cleaned out and anti-inflammatory agents must be put in. Occasionally, the different problem is diagnosed, when the blood clot is solid and doesn’t show any inflammatory signs, but there are some symptoms of hematoma and its sepsis. They include:
- increasing swelling of a gum or a cheek;
- rising temperature and pain;
- pain in gum after tooth extraction;
- tension in soft tissues of the face in the sepsis area;
- skin bluishness followed by appearing of hematoma.
Hematoma can be the result of different factors:
- Damage of the blood vessel. Sometimes it can be done with a syringe while giving anaesthetics, because the doctor can’t see the vessels in the soft tissues. To prevent hematoma, a patient is asked to hold the area of anaesthesia by the hand for 1-2 minutes.
- Arterial hypertension or diabetes. If you have high blood pressure, heavy bleeding can be caused even by minor injury. With diabetes the fragility of capillaries increases, which also contributes to hematomas appearance.
- Aspirin taken before the extraction. This medicine reduces the blood clotting, which leads to profuse bleeding during the removal and hematomas of soft tissues after it.
If the gum is swollen after the tooth extraction, it mustn’t be warmed up or treated by one’s own. The dentist must be visited immediately. He will make a small cut on the gum to remove the blood together with pus, rinse the socket and put in drains. These steps will bring relief and reduce the swelling the following day.