How long does it take for gums to heal after tooth extraction?
Tooth extraction can be emergency or planned, but in each case healing occurs the same way.
Extraction of the organ is carried out when it is not possible to preserve the crown, in case of severe inflammation, or in advanced periodontal disease. The operation is performed under anesthesia, so there is no pain during removal. Unpleasant symptoms appear after the end of the dentist’s visit. The gums in the area of the removed organ hurt, but normally this goes away after seven days.
When the gums still hurt seven days after the tooth extraction is completed, and the inflammation does not subside for a long time, this indicates a complication. The most common consequences of organ extraction are alveolitis, bleeding, fracture, and injury to the socket.
How many days does it take for the socket and gums to heal?
During a complex operation, the dentist may damage the jaw or push the tooth root into the maxillary sinus. If you do not seek help from a dentist for a long time with such complications, even more terrible conditions appear - gumboil, cyst, osteomyelitis.
Complete healing of the gums after tooth extraction occurs within several weeks. All this time, the mucous membrane hurts a little, but is simply anesthetized with local drugs.
The healing time of the hole is personal for each patient. Recovery takes a long time if care recommendations are not followed. The gums after tooth extraction do not heal even after a couple of weeks, if an infection was introduced during the operation or after the end.
The gum heals in 14 days, and complete restoration of the socket occurs in six months.
Why does the hole take a long time to heal?
Epithelization of the gums after the operation begins after a couple of days, and a white coating appears on it. Now it doesn’t hurt so much anymore, and there are no signs of inflammation. At this time, it is better not to touch the mucous membrane, but just continue to properly take care of the hole. It may not heal for a long time due to the patient’s personal quirks, at a time when there are diseases of the circulatory system or chronic inflammatory processes in the body.
If your gums hurt very badly after seven days, this is possible:
- Dry socket or alveolitis - this complication often appears when the rules for organ removal are not followed, while part of the crown or root remains in the socket. Under such conditions, the blood clot, which should protect against infection, falls out. This complication much more often begins on the 5th day after the end of the operation. Common symptoms are gum discoloration, unpleasant odor, halitosis, soreness, slight bleeding;
- Chronic bleeding - this complication is observed in people with hypertension and in the case of blood diseases. This may result in alveolitis. Before sending the patient home, the dentist stops the bleeding and places a hemostatic sponge on the hole;
- A fracture or dislocation of the lower jaw is a rare complication that occurs more often during the removal of a wisdom tooth; the risk increases if there is a cystic formation or acute inflammatory process in the root area;
- Perforation of the maxillary sinus is possible as a result of complex removal of chewing teeth in the upper jaw.
If the hole hurts for a long time, and it does not go away after seven days, you should immediately consult a doctor. It is forbidden to cope with complications that appeared during the removal on your own. Apart from this, there is no way to prevent them, so first aid is provided immediately after the procedure is completed.
Complications due to improper care, which slow down gum healing, can be prevented on your own.
What therapy is possible for dry socket syndrome?
Before treatment, the doctor must send the patient for an x-ray. It will reveal whether there are tooth fragments left in the hole. Then anesthesia is given, because the pathological process is accompanied by serious pain.
Table. How is dry socket syndrome treated?
Treatment stage | How it goes | Notes |
Cleaning the hole | The fragments and leftover food are removed, the wound is washed with an antiseptic. | Hydrogen peroxide or Furacilin can be used |
Curettage | This is what they call scraping the inner walls of the socket. | The process is unpleasant, but due to anesthesia it does not cause serious pain |
Inspection and reprocessing | And antiseptics are used again | This may be a solution of potassium permanganate |
Drying the hole | Occurs using a special tool | Then anesthesin is poured into the hole |
If it is a serous inflammation, the doctor may apply an iodoform dressing to the wound.
Iodoform dressing for the treatment of post-extraction sockets
In case of a purulent inflammatory process, the bandages need to be changed daily until the patient feels better. In most cases, treatment is accompanied by antibiotics.
What to do after the extraction is complete
It is possible to realize that the hole is healing correctly on the 3rd day. The gums hurt moderately, and a white coating appears on it. It is extremely important not to remove it, since it is new epithelium. After 2 weeks, the onion should be completely covered with granulation tissue. After a month, bone tissue begins to regenerate in the entire socket. After 50 days, bone tissue fills the entire hole. And only after five to six months the hole is completely healed and does not differ from other bone tissue.
The gums will recover faster after tooth extraction is completed if you follow easy recommendations.
In the first days after surgery, minor bleeding may occur. Under such conditions, you need to take a small piece of cotton wool or gauze, soak it in hydrogen peroxide, and apply it to the hole. It is much better to go to the pharmacy immediately after removal and buy a hemostatic sponge. A small piece must be applied to the hole; it will dissolve on its own.
When you urgently need medical help
The reason to visit the dentist again is intense throbbing pain after extraction, swelling of the cheek, and the appearance of a specific (unpleasant) odor from the mouth. All these symptoms indicate the development of inflammation, which requires immediate correction. You should also not postpone your visit to the dental clinic if:
- strong painful pulsation persists for more than two days;
- accumulations of purulent masses appeared;
- pain radiates to the ear, chin, temporal area, bridge of the nose, forehead;
- the cheek is very swollen, it is impossible to touch it, since tactile contact increases the pain;
- body temperature has increased and remains high for more than one day;
- there is no blood clot on the alveolus, which should form in the next few hours after extraction;
- weakness appeared, performance after the operation decreased sharply, and the situation did not improve even a few days after the dental intervention.
You must not allow the infection to spread in your mouth. Attentive attention to your own well-being is the key to successful rehabilitation and rapid healing of the wound surface. By following the doctor’s prescriptions, you can greatly increase the chances of successful rehabilitation after extraction of a molar.
Do not rinse your mouth for the first 24 hours.
It is necessary to avoid warm foods and drinks, and not to take alcohol or blood thinners. It is possible to numb the wound with drugs such as Nimesil, Ibuprofen, Paracetamol. While brushing your teeth, you must avoid moving the bristles near the removed organ. If bleeding starts unexpectedly after a couple of days, you should immediately go to the doctor. This also applies to those cases when the pain is not relieved by simple analgesic and anti-inflammatory drugs.
On the third day, it is already possible to start rinsing the oral cavity with warm antiseptic solutions and herbal decoctions. This will speed up the healing of the hole and prevent inflammation and infection of the wound. For a couple more days you need to refrain from heat, sports, saunas, baths.
Some medications can have the opposite effect, leading to bleeding, so the medication must be coordinated with the dentist. Before removing the doctor, it is imperative to give a warning about concomitant and previous diseases. Tooth extraction has contraindications, and if they are missed, complications cannot be avoided.
Diseases that cause gum pain
Unfortunately, no one is immune from unpleasant consequences after tearing out a root unit. Much depends on metabolism (metabolism), existing chronic pathologies, age, the functioning of the immune system, the tendency to develop allergies - a huge number of factors influence the regeneration processes.
It is necessary to consider whether the person is taking any medications. After all, there are medications that inhibit the formation of a blood clot, prevent blood from clotting quickly, or increase blood pressure. All of these effects are unacceptable during recovery from extraction.
Among the main diseases causing complications after extraction:
- Periostitis. Inflammatory lesion of the periosteum. Most often it occurs due to immunodeficiency or advanced chronic pathologies of the oral cavity. It can also be triggered by hidden infections localized in the maxillofacial area. Periostitis causes inflammation of the soft tissues after the root unit is pulled out. A person’s body temperature rises and their general health worsens. He becomes lethargic and weak. At the same time, the cheek swells. To slow down the inflammatory process and reverse it as soon as possible, combined anti-inflammatory and antimicrobial therapy and oral sanitation are carried out. If the disease has spread to deep-lying tissues, the patient is most often hospitalized in a hospital to avoid abscess and phlegmon of the jaw.
- Alveolitis. Inflammation of the walls of the alveoli after surgery. The disease occurs when tissue healing is slow, there are necrotic areas, or an “empty” socket. First there is pain, then it is accompanied by bad breath. In the area of the torn unit, a light gray coating characteristic of pathology appears. It is difficult to remove. Therapy includes frequent washing of the wound with an antiseptic solution and oral administration of anti-inflammatory drugs selected by a specialist.
Considering the seriousness of these diseases, it is important to treat extraction responsibly. During the preparation period, you should undergo treatment of all existing pathologies of the oral cavity and high-quality sanitation and professional hygiene.
When to see a dentist
A visit to the doctor should not be delayed in the following cases:
- Initially or after a couple of days, a blood clot falls out;
- A purulent lump appears in the area of the hole;
- The pain does not go away for a long time and inflammation appears;
- The entire jaw begins to ache, radiating to the temple and eye areas;
- There is a constant iron taste of blood in the mouth;
- Pain appears in the area of the adjacent tooth;
- Within 5 days the gums are not covered with white plaque.
If you are worried about your teeth, you will be helped at the Doctor-RAF Dental Clinic (Almaty, Muratbayev St., 101). Our highly qualified specialists will help you solve all your dental problems.
During the operation, a neighboring organ may be damaged. This will manifest itself as symptoms of pain, and perhaps the tooth will begin to loosen.
Complex removal will require additional care and the use of bactericidal drugs, but only those prescribed by the dentist. Self-prescribing antibiotics is prohibited. An exception would be local gels and ointments, which are available without a prescription and have an anti-inflammatory effect.
8 reasons why the hole does not heal after tooth extraction, ways to speed it up.
After tooth extraction, it seems that the worst is over. However, this is a surgical operation that does not exclude the possibility of complications, especially if you do not follow the doctor’s recommendations. What to do when the hole does not heal?
Attachment of a secondary infection
The oral cavity is the most microorganism-rich place in the human body. Many pathogenic microbes can penetrate with food. The hole in the hole creates a kind of reservoir of food waste, leading to the accumulation of pathogenic microflora and the development of secondary infection (inflammatory process and suppuration). This interferes with the rapid healing of the holes. Alveolitis begins to develop against the background of infection when it gets into the wound.
Of course, it is unlikely that suppuration will occur after tooth extraction if you provide proper care and oral hygiene, wash your hands before eating, and do not put foreign objects into your mouth in order to pick out stagnant blood clots. In the first 2–3 days after tooth extraction, you should not:
- chew on the sore side;
- thoroughly brush your teeth, rinse your mouth to wash away blood clots;
- Use old toothbrushes that have a lot of bacteria on the bristles.
It is the infected tissue that is difficult to restore, so the healing process is slowed down. The time frame can drag on for many months, until the hole after tooth extraction heals on its own, leading to tissue granulation and the formation of normal young bone.
A fresh wound in the mouth is overly sensitive to various microorganisms and therefore does not heal for a long time. That is why it is so important to follow hygiene and all the doctor’s recommendations after tooth extraction, so that the hole heals faster and the regeneration process is accelerated.
The addition of a secondary infection leads to inflammation and suppuration of the socket and the development of alveolitis. It happens that when brushing your teeth, blood clots literally pop out under the pressure of water and nothing prevents bacteria from penetrating into the wounds again. After an extracted tooth, patients begin to complain of the following conditions:
- excessive bleeding;
- an increase in temperature to +38…+39ºС, as a characteristic sign of the development of inflammation;
- soreness;
- enlarged lymph nodes under the jaw;
- the appearance of flux.
It is normal for bleeding to stop 1 day after surgery. If signs of alveolitis appear, you should contact your dentist again as soon as possible.
Healing process
The stages of wound healing are as follows:
- The first day: the hole fills with blood, which turns into a clot due to coagulation. It becomes the basis for bone formation in place of the void, and also protects against infection.
- 3-4 days: the clot is replaced by granulation tissue. By this time, the severity of pain decreases, and sometimes the area of surgery stops hurting completely.
- Week: a clot remains inside the socket, but most of it has already been replaced by granulation tissue.
- Two weeks: the wound is filled with granulation tissue, turning into bone along the edges and bottom.
- 2-3 months: the hole completely turns into bone.
In order for recovery to occur correctly, you must follow all the doctor’s recommendations.
How is dry socket treated in severe cases of pathology?
If complications arise, the therapy will be slightly different. And complications most often occur when the patient does not immediately contact the dentist.
A severe form of dry socket syndrome is treated as follows.
- Why do my gums hurt after tooth extraction?
- The cavity is treated and a swab moistened with special antibiotics is inserted into it. Usually, drugs that quickly relieve inflammation are added to this remedy.
- Next, an antistatic blockade is carried out.
- To clean the upper part of the wound from dead tissue, proteolytic agents are used.
- This is followed by blocking the nerve with lidocaine.
- Warm rinses are carried out with preparations such as potassium permanganate.
Potassium permanganate solution
To this list are added those procedures that the doctor uses for uncomplicated forms of dry socket syndrome. In general, the healing process will take at least a week. But if a wisdom tooth is pulled out, the recovery period may be delayed. After two, maximum two and a half weeks, the situation should normalize - granulation tissue will begin to form inside the walls of the socket. The pain will decrease, the swelling will subside, and the gums will turn pink. The first epithelial layer will begin to form.
Granulation tissue in the socket
Why doesn't the hole heal?
The timing of wound healing is an individual question. It is determined by several factors - the traumatic nature of the removal, the presence of postoperative sutures, and the age of the patient. It is believed that partial epithelization takes about 2 weeks, complete - up to two months. These deadlines may increase for the following reasons:
- The bone was severely damaged. This happens, for example, during a complex extraction, when the tissue around the tooth has to be cut out with a drill.
- The clot has fallen out, so there is no basis for the formation of granulation tissue.
- Due to the doctor's fault, bone fragments remained in the wound.
- The patient ignores the recommendations received. The most common mistake is rinsing out the clot, after which an infection from the oral cavity gets into the wound.
- The mucous membrane around the wound is mobile, and no stitches were applied.
- Carious remains entered the cavity and inflammation began.
- The surgeon did not take into account individual characteristics. For example, with arterial hypertension, heavy bleeding begins, so drugs that lower blood pressure are additionally prescribed.
- Old age of the patient.
Ways to speed up healing
The best thing a patient can do to speed up epithelialization is to create conditions in the oral cavity that are close to sterile. To do this, you must follow some rules:
- Squeeze the cotton swab applied after surgery tightly with your teeth for 15-20 minutes.
- Do not eat for 3 hours so as not to interfere with the clot formation process.
- In the first days, do not smoke, give up alcohol and solid food.
- Avoid heavy physical activity, temperature effects (hot drinks and dishes, trips to the bathhouse, sauna).
- Do not chew on the injured side for two days.
- Avoid rinsing and use chlorhexidine baths instead.
- Take prescribed medications - for example, antibiotics, which are prescribed after a complex removal, in the presence of purulent processes.
- After consulting with your doctor, use Solcoseryl, a gel that helps accelerate epithelization.
It is important to remember that the area where the deletion took place is a very vulnerable place. The mouth is home to a large number of opportunistic microorganisms, which, in the presence of a source of bleeding, become pathogenic, triggering the inflammatory process. To perform the operation, you should choose an experienced surgeon and strictly follow his recommendations after the procedure.
Healing of the tooth socket after extraction
Tooth extraction is a surgical intervention with the formation of a wound after extraction, therefore, as after any intervention, the wound formed at the site of the tooth must also undergo a healing process, and its tissue must recover and fill the voids. This process lasts for 4 months. The stages of tooth socket healing are as follows:
- a blood clot forms immediately after removal;
- 2-3 days - epithelization of the hole begins;
- 3-4 days - the first signs of granulation tissue formation appear;
- 7-8 days - part of the blood clot is replaced by granulations, gum cells begin to form an epithelial layer; the process of bone tissue formation begins;
- Days 14-18 - granulation tissue completely fills the socket, and the socket itself is completely covered with new epithelium. New bone cells are actively forming on the walls of the socket;
- 1-2 months - active process of bone tissue formation;
- 2-3 — filling the hole with bone tissue; tissue saturation with calcium;
- 4th month - bone formation ends, the structure becomes spongy.
If, when a tooth is removed, a blood clot does not form in the socket, the healing process of the socket occurs thanks to its walls - they are the ones who contribute to the development of granulation tissue. Otherwise, the further stages of healing are the same as those described above.
Healing after removal of an inflamed tooth
We have described a 4-month process of tissue restoration, however, they are restored so quickly only if there is no injury, inflammation or infection in the tooth and surrounding tissues. If the listed processes take place, tissue regeneration does not proceed so quickly. As a rule, it is prevented by the formation and course of the inflammatory process, the time period increases and the stages of healing look like this:
- epithelization and formation of granulation tissue occur in 10-15 days instead of 3-5 days;
- Bone tissue formation begins only on the 15-16th day instead of the 7-8th.
- closure of the hole by the epithelium is 2 times slower and ends only on the 30th or 50th day;
- only at 2 months the hole is completely filled with osteoid cells, which then become full-fledged bone;
The process of epithelium and bone formation can be even longer if the walls of the socket and/or gum tissue were severely damaged during tooth extraction.
Possible complications
Since tooth extraction is a surgical procedure, unpleasant consequences may arise after it is performed—complications of various kinds. In this case, the causes of such complications can be either the patient’s negligence in hygiene after surgery or the incorrect actions of the surgeon. Another category of etiology of adverse consequences is the complex course of the operation (with increased bone strength, non-standard shape or size of the tooth root).
Alveolitis
Alveolitis often forms when, after removal, a blood clot does not form in the socket for some reason. Without a clot, the socket is deprived of a protective barrier from external influences and is therefore susceptible to the appearance of an inflammatory process. The first and main symptom of this disease is pain immediately after removal or after 2 days. There is swelling of the gums, inflammation of the edges of the socket, due to the fact that a blood clot has not formed, the cavity is filled with food, which further contributes to the development of the inflammatory process. Other characteristic signs: temperature, unpleasant odor from the hole, poor health, pain and swelling of the mucous membrane at the extraction site.
The etiology of the development of alveolitis is considered to be an infection caused by oral microbes entering the socket. The body is not able to form a protective barrier in the hole, so inflammation rapidly develops in it.
The following causes of alveolitis are distinguished:
- chronic inflammation in the tissues of the oral cavity, its exacerbation;
- high degree of tissue trauma due to complex tooth extraction;
- a blood clot did not form during or after the operation (for example, due to the patient’s violation of the doctor’s recommendations);
- disorders in the immune system, chronic fatigue, chronic diseases;
- long removal process (longer than 40 minutes).
Treatment of alveolitis
Depending on the severity of alveolitis, both local and general treatment can be prescribed. Local methods are usually used using antiseptic rinsing and treating the socket with an antimicrobial agent. In addition to this treatment, vitamins and antibiotics may be prescribed.
In the case of general treatment, physiotherapy is also added, and the overall period of treatment and healing of the hole is increased.
Socket bleeding
Bleeding can occur both immediately after the operation and some time after the operation: from 1 hour to 24 hours or more. The period of manifestation of alveolar bleeding varies depending on the reasons that cause it. An earlier manifestation may be caused by vasodilation, later - due to injury to the socket by the patient after surgery. However, the etiology of the complication may also include injuries during removal (gums, alveoli, blood vessels) and diseases of the body (sepsis, hypertension, leukemia, the first 2 days of the menstrual cycle in women, taking aspirin and its analogues, diabetes).
The process of preventing bleeding depends on what causes it: local causes are eliminated by applying sutures to the rupture sites or applying cold, using a tampon. If the bleeding is caused by low blood clotting, medications are used to increase clotting.
Paresthesia
Sometimes after tooth extraction, patients complain of numbness in the oral cavity. Symptoms can be expressed over a period of 1 to 30 days or even more. The cause of paresthesia lies in nerve damage. Dentists can speed up the restoration of damaged tissue by prescribing vitamins B and C to the patient in combination with injections of galantamine and dibazole.
Neighboring teeth change position, Popov-Gordon effect
The body does not tolerate emptiness, therefore, after a tooth is removed and there is no analogue in its place for a long time, the neighboring teeth (and the tooth on the opposite jaw) tend to fill the resulting space, leaning towards the socket. Obviously, in such a situation, the dentition changes, which leads to curvature, changes in chewing load and bite.
The problem can be solved by replacing the missing tooth with an analogue after the hole has healed and tissue restoration: an implant, a prosthesis.
Communication of the oral and nasal cavities
When extracting molars and premolars of the upper jaw, the floor of the maxillary sinus may be injured, which will lead to the formation of a connection between the oral cavity and the nasal cavity.
It is noteworthy that this complication occurs even if all actions were performed correctly by the dentist. Its causes are usually:
- absence of a bone septum or close adherence of the roots to the sinus;
- bone destruction due to chronic inflammation in the area of the apex of the tooth root;
The complication requires surgical intervention by a specialist, since the entry of food and drink into the nose through the oral cavity usually leads to inflammation in the sinus (sinusitis), which in itself is a very unfavorable consequence and requires long and complex treatment.
Intervention is not carried out only if acute purulent sinusitis of the upper jaw has developed.
Other complications
Other complications are caused by: incorrect actions of the doctor and the characteristics of the patient’s body.
First category of reasons:
- improper use of forceps and, as a result, damage to the crest of the alveolar tissue;
- erroneous extraction of a tooth germ due to the ignorance of the doctor during milk extraction;
- injuries to adjacent teeth due to careless work of a dental surgeon;
Second category of reasons:
- weak or defective teeth located nearby may break during surgery on the causative tooth;
- low strength of the causative tooth, which causes its fracture and the need to remove parts;
- weak jaw tissue, which increases the risk of fracture and complications;
- individual features of the structure of the roots, jaw and location of nerves.
Rules of care
To prevent complications due to the patient’s fault, it is very important to follow all the dentist’s instructions, namely:
- The first day after surgery: keep the installed tampon in the mouth for 30 minutes, do not eat for 2 hours; do not load food and do not touch the socket area with your tongue or toothbrush;
- 2-3 days after surgery, minimize the load on the teeth located in the extraction area, limit the intake of solid and hot foods, giving preference to soft and liquid foods;
- Refrain from smoking (to prevent a vacuum from occurring in the socket) and try not to drink alcoholic beverages;
- Buy a soft toothbrush to gently clean the area of the extracted tooth a few days after the operation; in the first days it is better not to brush the injured area at all;
- The next day after the operation, make oral baths for the socket (do not rinse under any circumstances) with warm salted water (but not with special rinses).
- Do not exercise for 2-3 days;
- Do not take a hot bath on the first day after removal;
- Do not take aspirin and its analogues.