What to do if your cheek is swollen after tooth extraction?

Publication date: March 17, 2021

Tooth extraction or extraction is a surgical procedure that inevitably damages the gums. Swelling after surgery is a natural phenomenon, but there are situations when swelling warns of complications.

Gum healing proceeds normally if:

slight swelling and swelling of the cheeks, disappear within 2-3 days;
elevated temperature, passes in the same time frame;

Minor pain is also possible after the anesthesia wears off.

It is clear that discomfort when biting remains for up to 10-12 days, but in general, rehabilitation is characterized by positive dynamics.

What to do if your cheek is swollen after tooth extraction?

Often after a tooth extraction procedure, many people experience swelling that may persist for some time.
Its appearance is natural, since tooth extraction is essentially a surgical operation, after which the wound remaining in the oral cavity remains open. It recovers fairly quickly, but damaged gum tissue will remain swollen for some time. The size of the tumor may depend on several factors, such as the complexity of the removal procedure, the individual characteristics of the person, and the professionalism of the dentist.

Diagnostics

Before proceeding with dental flux treatment, the doctor must conduct an appropriate diagnostic examination. The exact diagnosis is determined based on data obtained during a clinical examination and x-ray diagnosis. Laboratory tests allow you to accurately determine the stage of the inflammatory process. Only after making an accurate diagnosis will a specialist be able to decide what to do with gumboil and which method of treatment in this particular case will be optimal.

Signs of a tumor that is not dangerous to health

swelling of the gums and cheeks does not increase and does not have a pronounced form;
after removing a tooth that caused severe pain, or a wisdom tooth, discomfort and pain should gradually subside;
even if during the removal procedure you had a slight fever, it should no longer be present, and in no case should it rise;
there is no unpleasant odor from the hole, which may occur in case of complications.

The cheek tumor can reach its maximum size the day after tooth extraction. Then the swelling should subside.

In what cases can swelling of the cheek be normal?

Please note that swelling of the cheek may appear not only immediately after tooth extraction (or the next morning), but only a few days later. The last scenario will definitely indicate the development of inflammation. Therefore, the norm may be the occurrence of swelling of the cheek or gums - in the first hours after removal, or the next morning. When it might be normal:

After a complex tooth extraction – in this case, tooth extraction is often accompanied by incisions in the gums, cutting out bone tissue with a drill, and dislocation of tooth roots with special elevators. All this leads to significant trauma to bone tissue, as well as soft gum tissue. And therefore, it is quite natural that after a complex extraction you may experience swelling, and this happens especially often when it comes to the complex removal of wisdom teeth.
What does a complex wisdom tooth extraction look like?
Moreover, if your cheek is swollen after the removal of the 8th tooth, then the appearance of swelling of the surrounding soft tissues can gradually lead not only to facial asymmetry, but also to temporary difficulty opening the mouth, as well as painful swallowing. Therefore, according to the rules, after a complex tooth extraction, the doctor is always obliged to schedule the patient for a second examination (the very next day) so as not to miss the development of inflammatory complications.
After the removal of wisdom teeth , swelling can appear not only after a complex wisdom tooth removal, but also if the removal of the 8th tooth was relatively simple. The fact is that with a small length of the body of the lower jaw, with a small size of the upper jaw, the wisdom teeth may be partially located in the depths of the soft tissues (moving soft tissues of the oral cavity). Such a tooth can be removed easily, but with such localization of 8 teeth, swelling of the soft tissues can easily occur.
When a tooth was removed due to inflammation - if the tooth was removed due to purulent inflammation (i.e. at the time of removal you could have symptoms such as swelling of the gums, pain when biting the tooth, the presence of a fistula on the gum with purulent discharge).
According to the rules, in this case, after removal, the doctor must wash the wound with an antiseptic, put medicine (Alvogel) into the hole of the extracted tooth, and also prescribe antibiotics to prevent suppuration of the blood clot in the hole. The development of soft tissue edema in this case is due to the fact that any surgical operation on inflamed tissues always leads to more pronounced edema. Those. in this case, swelling will not necessarily indicate the development of a complication. But on the other hand (even with prophylactic antibiotics) increasing swelling of the cheek may also indicate a complication that requires a visit to the doctor.
If you have had a gum incision made – if the tooth was removed due to pain and inflammation, then an inflammatory infiltrate (slight swelling) could be present on the gum or in the area of the transitional fold. Making an incision in this case has the purpose of 1) releasing pus if a purulent abscess has already formed, 2) preventing the formation of an abscess after tooth extraction. An incision is made in the center of the infiltrate; usually a thin rubber drainage is inserted inside it.
Making an incision in the area of the transitional fold (i.e., where the gum meets the cheek) can always lead to the appearance or increase of existing swelling of the cheek. According to the rules, if a doctor opens an abscess along a transitional fold, the patient should always be scheduled for a re-examination the next day. If the infiltrate was opened, but no pus was obtained, then in the absence of complaints from the patient, the latter is sometimes recommended to independently remove the drainage from the wound after a few days (24stoma.ru).
Opening an abscess along the transitional fold -
Complaints that the cheek is swollen after tooth extraction occur very often in certain groups of patients. For example, hypertensive patients, as well as people with a significant amount of subcutaneous fat on the face, are predisposed to the appearance of edema after tooth extraction. In these patients, swelling of the cheek may appear after a simple simple removal.

What symptoms in this case will indicate the absence of inflammatory complications -

As we said above: swelling after tooth extraction usually appears either within a few hours after the intervention, or the next morning. Accordingly, only over the next day will it be possible to draw timid conclusions about whether there is a reason to worry or whether you need to urgently run to the doctor for a second examination. Let's look at the signs that indicate that the development of edema does not require urgent intervention -

The swelling that appears is not too pronounced and does not tend to increase. The latter means that the swelling that occurs the next morning after tooth extraction should not increase further in the evening. But if the swelling tends to further increase, this is a bad prognastic sign. Also not a very good sign is hardening of soft tissues, i.e. Normally, edematous tissue should be soft, but if tissue compaction (infiltrate) appears in the center of the edema, then this is a sign of suppuration.

If you do not have a fever, especially an increasing one - if you did not have an elevated temperature at the time of tooth extraction, then normally it should not be elevated the day after the extraction.
At the same time, a slight temperature of up to 37.5 in the evening on the day of removal (after a complex removal or removal due to inflammation) is considered normal. If you had a high temperature before removal, then from the next day it should begin to decrease progressively. If an elevated temperature after tooth extraction appears only the next day or even later, this most likely indicates the development of complications and requires immediate consultation with a doctor.

If you do not have severe pain, especially increasing pain, after a simple removal you may feel pain for only 1 day, after a complex removal it is normal for only a few days. The appearance of severe pain and prolonged pain for 4-7 days only indicate that the removal is excessively traumatic, and this is a question for the doctor’s skills. In any case, normally the pain should progressively decrease every day, but if the pain does not decrease or occurs, this is a symptom of the development of complications.

The hole must be closed with a dense blood clot - after removal, the hole is filled with blood, which immediately coagulates, forming a blood clot in the hole of the extracted tooth. In some cases, the clot may not form, or it may fall out due to the patient rinsing the mouth too much. The absence of a blood clot in the socket will inevitably lead to the development of alveolitis (inflammation of the socket of an extracted tooth).
A fresh clot normally has a dark burgundy color, but after some time a whitish or grayish-yellow fibrinous coating will appear on its surface (this is normal and does not indicate inflammation). The clot should be dense, without an unpleasant odor. Pay attention to how the blood clot should look on the day of removal and a few days after (Fig. 6-7).
What should a blood clot normally look like?

After tooth extraction, the cheek is swollen: what to do in this way, let's summarize... if the resulting swelling of the cheek is 1) soft to the touch and does not tend to increase and harden, 2) if there is no temperature, difficulty opening the mouth and painful swallowing, 3) if the hole is closed by a dense blood clot, 3) if there is no severe or constant aching pain in the area of the socket of the extracted tooth, then, in principle, we do not see any indication for an urgent visit to the dentist for a second examination.

How long does swelling last after tooth extraction?

There is no average answer to this question, because... much depends on the degree of trauma of the removal and the characteristics of the body. In some patients, swelling of the cheek may last only a few days, while in others it can last for a week. The problem here is that after a traumatic extraction (especially with cutting out the roots with a drill), very often a sluggish inflammation can occur in the socket of the extracted tooth for a very long time.

In this case, there may be only slight discomfort or no pain at all, but the swelling in this case can last quite a long time. Therefore, after a complex extraction, it is always worth going to the doctor for a second examination to see if the socket of the extracted tooth and the blood clot in it are normal. By the way, you can also make the swelling go away faster.

How to relieve swelling after tooth extraction -

So, if the appearance of edema is associated with traumatic removal or making an incision along the transitional fold, we can significantly increase the rate of its reduction. This can be done at home using compresses with a dimexide solution (diluted 1:4 or 1:5, i.e. to obtain a 20 or 25% concentration). Dimexide is diluted with lukewarm boiled water.

A gauze bandage is soaked in the diluted solution and applied to the site of swelling for 20 minutes. A layer of cling film is placed over the gauze bandage, and then secured to the head with a bandage. The procedure can be done 1-2 times a day, the duration of the procedure is 20 minutes. An important point - in this case, you cannot place a thick cloth or towel on top of the cling film (this is usually done to make a thermal compress). If there is inflammation, a heat compress can be harmful.

How to remove swelling of the cheeks and gums

If the tumor does not cause particular concern, then it is a natural phenomenon after tooth extraction.

There are ways to relieve pain and reduce swelling, as long as it is not harmful to health.

It is necessary to apply cooling compresses to the inflamed cheek several times during the day, this can be a bottle of cold water, ice in a cloth, a damp towel, which should be kept for twenty minutes, periodically cooling it in cold water. You will immediately feel relief and notice how the tumor decreases in size.
People with high blood pressure are more susceptible to post-operative swelling. They are recommended to take sedatives and blood pressure-normalizing medications after tooth extraction.
Conventional anti-edema products can relieve swelling well - gels, creams, ointments that can be applied to the outside of the cheek.
To relieve pain, which is inevitable after complex removals, you can take a painkiller (except aspirin) or an anti-inflammatory drug and lie down to rest.

Antibiotics for flux

As noted above, flux is a consequence of a bacterial infection, which is often treated by taking antibiotics. Many, at their own peril and risk, try to cope with inflammation by independently taking quite strong medications that can cause serious damage to the health of the entire body. Effective and at the same time safe treatment of flux with antibiotics can only be prescribed by a qualified specialist.

Antibiotics for flux are prescribed by a doctor individually. Self-use of strong medications is fraught with serious consequences for the entire body.

Antibiotics, like anti-inflammatory drugs, are used in dentistry for flux as part of complex maintenance therapy. The only way to stop the inflammatory process and remove the pus is surgery. Antibiotics are usually prescribed at the very beginning of treatment if the disease is in the earliest stages of its development, but identifying such inflammation at the initial stage can be quite difficult. As a rule, the dentist is able to detect the very first signs of periostitis by accident, for example, during a routine examination of the oral cavity. The specialist prescribes antibiotics for flux individually, depending on the characteristics of the patient’s body and the general clinical picture.

Contraindicated actions for swelling:

Under no circumstances should you heat the swollen area, or touch the wound with your hands and tongue;
rinsing on the first day after tooth extraction is not recommended, as it can wash away the blood clot that protects the socket from infections. In the future, you can rinse your mouth with antiseptic solutions - miramistin, furatsilin, or decoctions of chamomile, sage;
the first two to three hours after the removal operation, you should refrain from smoking, drinking and eating;
Until the wound is completely healed, you should not consume solid food, hot and carbonated drinks, or alcohol.

If you follow these simple rules, the swelling will go away quickly enough and there will be no need to visit the dentist.

How to treat flux?

If your tooth hurts and gumboil appears on your cheek, you shouldn’t panic and look for something to rinse your mouth with. “Grandmother’s” treatment methods really help get rid of acute pain and relieve some swelling, but they have not yet helped anyone cope with purulent compaction, which is the main danger. How and with what to treat flux? How to remove gumboil in case of gum inflammation? Only a qualified dentist can give detailed answers to these and other questions.

Self-medication with folk remedies will only help dull the pain and relieve swelling a little. Only a qualified dentist can completely remove pus and eliminate the cause of inflammation.

How is flux treated in dentistry? Currently, there are two main methods of treating gumboil on the cheek:

Opening the pus sac, in which the doctor removes the accumulated pus through a small incision. The procedure is performed under anesthesia. After removing the pus, the specialist installs a drainage at the site of the incision - a special rubber strip that ensures the outflow of pus and prevents the wound from healing ahead of time.
Cleaning an abscess through a root canal is necessary if the inflammation is a consequence of caries or a crack in the tooth.

Often in advanced stages of the disease there is a need for tooth extraction. Typically, this procedure is carried out when there is deep destruction of the causative tooth or if there is a large infected area between the tooth and the gum. Removal is also used if there is a sufficiently large crack in the tooth that cannot be treated.

Typically, the doctor begins by making an incision into the periosteum or lining of the mouth. The causative tooth is usually removed gradually, that is, in parts. For this, a special dental saw or laser is used. Modern equipment has made it possible to make the procedure for tooth extraction quick and completely painless, so there is no need to be afraid of treatment. After the operation, the sharp edges of the incision are smoothed, which is then washed with peroxide or other antiseptic agents and fixed with sutures.

When to see a doctor

If you have followed all the rules, carried out all the procedures aimed at reducing swelling, and your condition continues to worsen, then this is a sure sign that you need to urgently consult a dentist. Immediate medical attention is required if:

the next day the swelling increased, and the pain did not decrease;
the temperature has risen, general health has worsened;
opening the mouth is accompanied by painful sensations, and the smell of rotting from the hole is felt.

All these symptoms should prompt an immediate visit to the dentist to avoid serious consequences.

Swelling after resection of the root apex

What is resection? Postoperative period
Recommendations in the postoperative period

Any competent dentist will try to keep the tooth alive, even if a cyst or other inflammation has formed at the top of the root. Fortunately, today doctors have more and more opportunities for this; for example, they can remove a cyst without depulping the tooth. This operation is called resection of the apex of the tooth root. However, swelling often appears after it. Is this normal and what should I do?

How is the drainage tube installed and what does it look like (photo)?

The drainage in the gum (look at the photo) looks like a small tube. Today, experts prefer drainage made of latex or rubber. Both materials are waterproof, due to which the device is retained in the infected tissue for a long time, is well tolerated by the patient and does not allow the wound to heal.

Before installing a drainage system, the dentist must first determine the location of the lesion and send the patient for an x-ray. During the examination, the depth and size of the abscess will be determined.

The doctor's next steps depend on the results of the x-ray. If the image confirms the destruction of the tooth root, the dentist must remove it, and then install a drainage tube into the open hole without an additional incision in the gum (see also: how to remove a tooth if its root remains in the gum?). In all other cases, the drainage procedure includes the following steps:

administering local anesthesia;
direct dissection of the gum tissue with a scalpel and its treatment with an antiseptic;
fixation of the drainage system.

In case of flux, the doctor will make a releasing incision, that is, opening the abscess, after which he will install a system for the outflow of pus.

Flux - treatment in children

If a child has flux, you should never give him medications on your own, and especially antibiotics. Only a dentist can prescribe a medicinal course of treatment. Antibiotics destroy both pathogenic and beneficial bacteria that help fight infection, so the unauthorized use of such serious drugs can lead to negative consequences for the child’s entire body.

Treatment of gumboil largely depends on the causes of its occurrence. So, this process is not much different from the treatment of periostitis in adult patients. As a rule, to begin with, the specialist makes a small incision in the area of the inflammation and ensures the outflow of pus using a special drainage system. The treatment then continues at home under the supervision of parents. Most often, a complex of medications is prescribed, but in some cases, a specialist may allow you to limit yourself to rinsing with special decoctions and solutions.

Stick to a diet

The diet while wearing drainage is special. Food should be:

mushy or liquid consistency;
room temperature;
do not irritate the mucous membrane.

Possible gum damage also depends on how you eat. It is better to chew in small portions on the opposite side.

Additional Information! You can eat anything that does not injure the wound. Avoid hard, salty, smoked, spicy, sticky foods - they slow down healing and become clogged into the cavity.

Rest after surgery

The first few hours after drainage installation are the most critical. During the procedure, the dental surgeon needs to administer anesthesia, cut the gum, pump out the pus, and perform an antiseptic treatment of the cavity. The patient is weakened by the infectious process and the operation itself. Therefore, upon returning home, it is recommended:

sleep for a couple of hours;
take painkillers and anti-inflammatory drugs after the anesthesia wears off - Nimesil, Nise, Nurofen, Ketanol;
do not drink or eat for several hours.

How to distinguish normality from pathology

On the one hand, tissue swelling is a normal consequence of the body, on the other hand, this symptom can become a manifestation of an inflammatory process that requires surgical therapy.

If the swelling does not have positive dynamics, that is, does not decrease 3-4 days after installation of the implants, if symptoms such as redness of the gums, monotonous or pain when pressing, increased body temperature, pus that is released from the area around the implant are added - all this speaks of a serious inflammatory process, i.e. peri-implant. And, most likely, implant rejection. If such phenomena occur, you should immediately consult a doctor.

You should also be wary of a situation where the swelling has already subsided, but reappears after some time. This situation again requires immediate consultation with a specialist.

Each patient of the Smile-at-Once clinic is assigned an individual manager, whom you can contact for advice in case of doubt. You will be connected with a doctor by telephone or an appointment will be made for an in-person appointment.

Minimizing complications

Gum inflammation after implantation depends on many factors. One of the most important is the poor quality of implants. Therefore, you should be careful about their choice. After your doctor gives you options, make sure the implant meets the following requirements:

the titanium from which it is made has a high degree of purity;
the design has both micro-thread and macro-thread;
the implant and abutment are fixed with a conical connection (this is not necessary, but such a connection is considered the most reliable today);
your future tooth comes with a long, or better yet, lifetime warranty - this is not only a pleasant addition, but also a sign that the manufacturer is confident in its product;
choose products from companies that have been on the market for a long time and are known to specialists; consult an independent dentist about this.

Do not skimp on the system, as in the future, a bad implant can lead to serious complications, which will be much more expensive to eliminate. Of course, even with high-quality products, the body will try to fight, but nothing serious will most likely await you.

Why install drainage?

In dentistry, drainage is used in the following cases:

for tissue healing after removal of a problematic tooth;
with alveolitis;
after opening the flux;
when an abscess or cyst forms;
for administering medications directly into the wound.

The patient should not worry if his gums were cut and a drainage system was installed. Drainage is used to remove purulent exudate and ichor. If drainage is not installed, the opened source of infection will heal quite quickly after cleansing, but if the inflammatory process is not stopped, the formation of purulent masses will begin again. In this case, a new operation will inevitably be required.

Contraindications and complications of the procedure

Dentists exclude the procedure only in the most extreme cases. Contraindications include:

disorders of the lymphatic system and blood clotting;
predisposition to an allergic reaction to anesthetics.

Failure to comply with medical recommendations, the presence of infection or reduced immunity leads to complications. If a patient has a swollen cheek, pain, fever, or bleeding after his gum has been cut and a drainage system has been installed, he should immediately contact his dentist.

When an immediate visit to the doctor is not possible, the patient can use antiseptics that will help temporarily relieve pain and relieve swelling. You can rinse your mouth more often with a warm aqueous solution of soda, salt and iodine, Chlorhexidine, Miramistin, Chlorophyllipt, or lubricate the affected area with anti-inflammatory gels, for example Solcoseryl (we recommend reading: how to rinse the mouth after a tooth has been removed?). It must be remembered that rinsing in the presence of a drainage system in the mouth should not be too intense.

Maintain good oral hygiene

Brushing your teeth after any type of surgery is scary. Therefore, patients completely refuse hygiene or do not clean the operated area.

However, this situation is dangerous. Food debris and plaque accumulate in the oral cavity, are processed by bacteria and microbes, releasing toxins, and provoke inflammation.

It is necessary to maintain the highest quality oral hygiene. First, clean the interdental spaces with floss, then the crowns with a brush and paste, and complete the procedure by rinsing with an antiseptic.

Note! The teeth near the drainage are brushed very carefully so as not to displace the tube or injure the gums. You can use a soft bristle brush in this area.

Take prescribed medications

Postoperative treatment of purulent gum diseases is supplemented with drug therapy. Usually prescribed:

antibiotics to relieve infection – most often “Lincomycin”, or analogue drugs “Tsifran”, “Amoxiclav”;
anti-inflammatory drugs to relieve pain, heat, swelling - “Nimesil”, “Nurofen”, “Nise”, “Ibuprofen”;
wound healing ointments to speed up healing - “Levomekol”, “Levomethyl”, “Metrogil Denta”.

Additional Information! Medications make recovery easier after drainage is installed. If you do not accept them, the process will be delayed. There is also a high chance of relapse of the disease.

Recommendations after gum incision

If you are planning an implantation or removal of a cyst, be prepared for the fact that the dentist will have to cut into the gum. When an unerupted or incompletely erupted wisdom tooth is removed from the gums, an incision is also inevitable.

After surgery, complications such as swelling, bleeding, and aching pain are possible. The reasons include decreased immunity, infection in the mouth, or improper care during the postoperative period. Therefore, the best thing you can do is to remember and follow all the doctor’s recommendations.

Types of complications

The most serious problems can appear during the fusion of the implant surface with the jaw bone: re-implantitis, rejection.

Reimplantitis

This is an inflammation of the tissues that are located next to the artificial tooth. The cause of reimplantitis is the entry of pathogenic bacteria into the cavity between the body of the implant and the gum. This happens if the wall of the paranasal sinus is damaged, there are foci of inflammation in the adjacent tooth, there was an error when closing a postoperative wound, or the crown was made inaccurately. But most often the cause of reimplantitis is poor oral hygiene.

The disease is accompanied by increasing pain, bleeding, and swelling. It is very important to treat it as early as possible, or the disease will become chronic. Gradually, the infection will “eat away” the bone, causing the implant to begin to wobble. In this case, it will have to be removed and then the hole should be treated.

Reimplantitis occurs infrequently - in about 1-2% of cases, but it should be taken seriously.

Rejection of an artificial tooth

Bone tissue may not accept a titanium rod. Most often this occurs due to infectious processes, lack of bone tissue, surgical errors, exacerbation of chronic diseases, and smoking after surgery. Very rarely, rejection may be due to an allergy to titanium.

The beginning of the process is accompanied by increased pain in the surgical area and loosening of the implant. In this case, the tooth is removed and a course of vitamins is prescribed to strengthen the bone tissue. After one to two months, the implant can be re-implanted.

The chance of a new tooth being rejected is 1%.

Avoid gum damage

If you handle cutlery, hygiene products carelessly, or get bumped or dropped, the drainage will not be level, will move, or will fall out prematurely. This is extremely undesirable, since the outflow of pus stops, and the edges of the wound begin to shrink.

The drainage is usually removed after 3 to 5 days by the doctor or patient. If it fell out earlier, you need to go to the clinic. The dentist will assess the patient's condition. In the absence of severe swelling or exudate, the doctor will recommend only drug treatment. When the inflammatory process does not subside, re-installation of the elastic tube will be required.

Improvement after installation of drainage should occur within the first day. If the tumor increases, the pain intensifies, and the temperature does not subside, you must tell your dentist.

Avoid physical activity

The patient is prohibited from doing anything that provokes bleeding:

engage in any sport;
lift weights;
do difficult homework;
to take a bath;
go to the sauna and solarium;
travel for a long time in vehicles or fly on airplanes.

Read also: Closed curettage of periodontal pockets
Important! If you do not follow these recommendations, the wound will bleed, heal for a long time, and pus may spread into nearby tissues.