After the tooth is removed, a deep cavity (alveolus or socket) is formed in the area of the jaw. In some cases, the patient develops socket alveolitis – an inflammatory process that causes pain and carries a potential threat to the health of the surrounding tissues (periodontium, jaw bones). A timely visit to the dental clinic will allow timely diagnosis of the disease, start therapy and avoid dangerous complications.
What is tooth socket alveolitis, types of inflammation
Under favorable circumstances, a blood clot forms at the tooth extraction site. It consists of protein cells that participate in the formation of a blood clot. The clot completely fills the hole and covers its walls. Its main task is to protect tissues damaged during extraction from infection. Soon the wound heals, and then new bone tissue is formed.
However, sometimes the natural healing process is disturbed, this happens when a thrombus is not formed or does not adhere tightly enough to the surface of the wound or is mechanically damaged. After the removal operation, the coagulation process is started, as in any wound, with the function of protecting the underlying structures, bones, nerve endings, etc. If something goes wrong in this phase, the tissues are exposed to the accumulation of food residues, oral microorganisms and other materials, become inflamed and the symptoms of alveolitis appear. This condition is the most common complication of tooth extraction.
Alveolitis after tooth extraction (inflammation of the socket), which has several stages:
- Serous alveolitis is the first stage of the inflammatory process. Its symptoms appear 2-3 days after tooth extraction, accompanied by constant pain and gradual deterioration of the patient’s well-being.
- Purulent alveolitis – develops if the patient did not consult a dentist in time and did not receive the necessary treatment. The purulent form develops approximately 6-7 days after the operation. At this stage, pain symptoms intensify. Other symptoms are added to them – the increase and tenderness of the lymph nodes, the formation of gray plaque on the surface of the hole, swelling of the surrounding tissues, deterioration of the patient’s general condition.
- Hypertrophic alveolitis is the last stage of the disease, in which there is a weakening of general symptoms, in particular pain sensations, and an improvement in well-being. This is a dangerous condition, because against the background of feigned relief, the disease progresses, during inflammation there is a violation of blood supply, suppuration and tissue necrosis.
With a chronic course of the disease and the presence of granulations, alveolitis can enter the stage of sequestration (rejection of individual areas of infected tissue, bone).
Symptoms
Many patients mistakenly believe that an inflamed hole after tooth extraction does not need treatment, that pain and other unpleasant symptoms are the norm after such an operation.
The first 3 days really painful sensations (both severe and moderate) are normal, but then the pain should gradually subside. If this does not happen after 2-4 days, or even on the contrary, the pain intensifies, you need to urgently make an appointment with a doctor.
Basically, it is by the nature and intensity of the pain that you can recognize alveolitis of the hole.
Pain usually:
- growing;
- pulsating;
- extends to half of the face on the side of the tooth extraction;
- in the later stages – unbearable, gives in the temple, ear.
Other symptoms of alveolitis:
- temperature rise to 38 and above;
- swelling and inflammation of the gums in the wound area,
- periostitis (inflammation of the periosteum);
- absence/damage of thrombus;
- the formation of a gray coating;
- the appearance of purulent exudate from the hole;
- bad breath;
- an increase in lymph nodes (submandibular, cervical), their tenderness upon palpation;
- sensitivity of inflamed tissues to hot and cold;
- excessive salivation;
- loss of appetite
Rarely, with alveolitis, other infections on the mucous membrane of the oral cavity (stomatitis) develop in parallel and immunity decreases, which can lead to dangerous complications – ostemyelitis, lymphadenitis, osteophlegmon.
The patient feels a general deterioration of well-being (weakness, fatigue).
Reasons
Post-extraction alveolitis usually develops when a thrombus has not formed or has been damaged. The wound then becomes open to infection, which quickly affects the soft tissues and jawbone. There are also a number of factors that lead to inflammation:
- complex surgical removal, during which alveolar tissues are inevitably damaged;
- removal of third molars – alveolitis develops more often after the removal of a wisdom tooth, because
- the bone tissue in this segment has a denser structure;
- non-compliance with the norms of tissue processing during surgery: incorrect antiseptic processing, incomplete removal of tooth fragments, infected tissues (granulomas);
- poor postoperative hygiene of the oral cavity;
- non-compliance with the prescriptions and recommendations of the dentist during the tissue healing period;
- eating rough, cold, hot food that can disrupt the integrity of the blood clot;
- smoking – scientists have proven that smokers have a 20-40% higher risk of developing alveolitis;
- weakened immunity;
- the presence of diseases of internal organs in the patient (for example, diabetes, blood coagulation disorders, bacterial infection in the body);
- overdose of local anesthetic.
Despite the many favorable factors in modern dentistry, when a tooth is removed by an experienced doctor following protocols and using high-quality anesthetic and antiseptic materials, alveolitis develops in rare cases (about 3%).
The highest probability of inflammation occurs when the corner teeth and incisors of the lower row are removed, but pathology occurs especially often when wisdom teeth are removed.
Complication of post-extraction alveolitis
Alveolitis is a dangerous disease that, with improper or untimely treatment, can have serious consequences:
- odontogenic sinusitis (infection of the maxillary sinus during inflammation of the cavity after removal of the molars of the upper jaw);
- phlegmon – an infectious lesion of soft tissues, in which purulent destruction of tissues occurs, has an aggressive nature, spreads quickly through the blood system, affects the vessels of the throat, neck, esophagus, and mediastinum, can have serious health consequences and even lead to death;
- periostitis – purulent inflammation of the periosteum;
- odontogenic osteomyelitis – the development of a purulent-necrotic process in bone tissue;
- sepsis – blood infection.
Treatment
When diagnosing alveolitis of the tooth socket, the treatment is aimed at solving the following problems:
- removal of inflammation;
- removal of infected tissues, tooth fragments, and other foreign bodies from the hole;
- complete tissue regeneration;
- prevention of complications.
The first stage of alveolitis treatment is diagnosis. The doctor examines the site of inflammation visually, if necessary, takes an X-ray to detect the remnants of the tooth in the wound.
Treatment consists in cleaning and disinfection of the infected area and is carried out in several stages:
- Anesthesia (all medical procedures are performed under local anesthesia).
- Removal of thrombus fragments, necrotic masses, food residues from the hole, washing with an antiseptic solution.
- Removal of found fragments of the extracted tooth.
- If the necrotic process has begun, the doctor washes it with a solution that contains enzymes that break down dead tissues, helps to remove pus, relieve swelling and inflammation.
- Disinfection.
- Insertion of a tampon moistened with antiseptic and anesthetic agents.
- The doctor prescribes drug therapy for the patient (a course of antibiotics, rinsing), gives recommendations on oral cavity care and sets the time of the next visit, when it is necessary to carry out repeated antiseptic sanitation of the cavity.
In rare cases, the doctor can remove a bone fragment involved in the pathological process.
In case of severe pain, the patient can take painkillers recommended by the doctor. The result of treatment of post-extraction alveolitis largely depends on the patient himself. In order for the wound to heal faster, it is necessary to strictly follow the prescribed treatment protocol and the recommendations of the dentist regarding brushing, nutrition and lifestyle.
It is in your power to protect yourself from alveolitis and other unpleasant complications after tooth extraction. For this, you need to take care of disease prevention.
After tooth extraction, you cannot:
- touch the tooth removal site with your tongue or fingers so as not to damage the blood clot;
- intensively rinse the mouth;
- eat hard, hard food;
- actively engage in sports, heavy physical work;
- take a hot bath, visit a sauna;
- smoke or drink alcohol.
How to help tissues recover faster
First of all, you should exclude from the diet any foods that can irritate the mucous membrane (sour, salty, spicy), as well as hot and cold dishes, give preference to soft or finely chopped food.
Carefully monitor the cleanliness of the oral cavity, regularly perform the hygienic procedures and antiseptic baths recommended by the doctor (to avoid infection of the cavity). When brushing your teeth, try not to touch the blood clot, carefully rinse your mouth with water after every meal or snack.
How a dentist can prevent the development of alveolitis
Tooth extraction is a complex operation. The doctor’s task includes maximum control during anesthesia, accurate atraumatic tooth extraction, high-quality cleaning of the socket, especially when removing a destroyed tooth, prescribing the correct postoperative therapy and monitoring the results.
Your health depends on the professionalism of the surgeon and his accuracy during the operation, therefore, when choosing dentistry, it is very important to take into account the level of equipment of the clinic, training and experience of specialists.