Fear or fear of a tooth extraction operation is normal if they do not go into a panic and do not provoke a person into a dangerous long-term inaction.
When a patient in a dentist’s surgeon’s office finally gets rid of a diseased tooth, at that moment it may seem that all fears and problems are over. However, in practice, this is not always the case, and you need to be prepared for this.
After the removal of the tooth, many people start to worry about another question – how long do the hole and the injured gum heal?
It is because sometimes after the procedure, the gum begins to be very disturbed, often the bleeding of the hole and the pains stretch for several days.
A wound in the mouth at the site of the extracted tooth creates many inconveniences in general:
- sometimes the hole bleeds for a very long time, and a person in such a situation does not understand how to stop the ongoing bleeding;
- habitual food and strives to clog in the hole, further traumatizing it;
- sometimes the wound begins to fester; a putrid odor appears from it.
In order to understand how long the gum heals after tooth extraction, it is useful to first understand what processes occur in the dental hole after the operation, how the process of its “tightening” proceeds, what factors contribute to this, and which seriously interfere, creating the risk of re-infection surrounding tissue wound with the development of complications – alveolitis (inflammation of the hole).
Immediately after the tooth is removed and the hole is filled with a blood clot, the mechanisms for its healing are triggered, however, it is rather problematic to predict exactly how much the gum will heal, since this process is mostly individual and affects some factors.
However, having the necessary information, it is possible not only to speed up the recovery of the gums and bones in the hole of the extracted tooth but also to make the healing stage relatively comfortable and fast.
Why the hole (gum) sometimes heals for a long time, and on what it depends?
After the dentist has removed the tooth from the hole, the process of wound healing begins with a so-called secondary intention. This means that the circular ligament located around the tooth is reduced, and the edges of the gums come together.
The formation of a blood clot in a well has a very beneficial effect on the process of wound healing after tooth extraction – this clot plays a vital role as a kind of protection against possible infection.
Accordingly, in no case should this clot be removed, for example, by intensive rinsing of the mouth or, especially, mechanically – with a finger or a toothpick.
The blood clot is replaced by granulation tissue for several days, and then osteoid tissue is formed. In other words, over time, a new bone with a gingival above it is built at the site of the extracted tooth.
With traumatic tooth extraction, when gum rupture occurs, and a significant portion of the walls of the hole is damaged, the healing process can be very long, and how long it will take to restore tissue will depend on some factors.
The first of these factors is the condition of the wound immediately after the procedure: the more mistakes were made on the part of the doctor, the gum is always worse.
Two weeks ago, I removed the roots of the lower right last tooth; it seems sevens. Initially, the removal went well: they made two injections in the gum: inside and out, then the surgeon began to grab my aching tooth with forceps, but he broke off, and his pieces flew off my tongue.
After I spat, some nonsense started: the doctor took a chisel and a hammer and began to hammer along with the nurse over my tooth, as I understood it – to split the roots in half. It was not painful, but creepy, blows were heard in the head, and the vibration created unpleasant sensations.
As soon as the roots crunched, the surgeon began to extract them with some sharp metal rods. It did not hurt, but blood flowed a lot, as the gum was picked for about 30 minutes.
After extracting the two roots in turn, the doctor put a piece of gauze into my mouth, let it hold for 20 minutes and put it home.
When I came home, I saw in the mirror, on the site of my former tooth, a dangling gum, both inside and outside, and with my tongue touched the edge of the bone, not covered by anything. An hour later, the gum became very sick and began to bleed.
The ragged wound continued to hurt for more than 3 days, and, even when it was over, the sharp edge of the bone still hurt me significantly during chewing. As a result, the hole at the site of the extracted tooth was tightened for a month and a half, so it was necessary to flush out the remnants of food from it constantly. More to this doctor, I foot.
The second factor that determines the time of wound healing is the possible addition of infection.
Infection of the hole often occurs during a complicated removal, when the various residues of the diseased tooth are thrown into the depth of the wound, which causes its suppuration. In most cases, after such a tooth extraction, the gum and the hole heal for a very long time.
However, it is important to note the fact that the purulent process in the well may occur as a result of poor patient care for the wound: in this case, the infection gets not during the removal procedure, but after it.
When food continually gets into the hole and accumulates there for a long time along with bacteria from the oral cavity, wound suppuration may occur, and its healing is significantly delayed.
Secondary infections or What prevents healing?
It is believed that the oral cavity is the dirtiest place in the human body: here, in addition to the actual pathogenic microbes, there is also a vast amount of so-called conditionally pathogenic microorganisms. The word “conditionally” means that such microbes begin to harm only under certain conditions.
When a deep wound appears in the mouth after tooth extraction, which, moreover, is a kind of reservoir for food “waste,” microbes that previously could not harm a person become conditionally pathogenic, causing inflammatory processes with purulent phenomena.
How much time the gum will heal after tooth extraction, in this case, is primarily determined by the level of oral hygiene and proper wound care.
It is essential to understand that a fresh wound in the mouth is generally vulnerable to any infections from the outside: for example, a secondary infection can get along with dirty hands during meals, with an old toothbrush, and in many other circumstances.
The restoration of the infected tissues of the hole after tooth extraction slows down: in almost all cases, the healing time of the gums stretches for months until the wound itself clears of necrotic lesions, and the growth of granulation tissue begins with the further formation of normal young bone.
What is the rate of healing rate, and what deviations may be
Full convergence of the wound edges with a high-quality tooth extraction usually takes 2-2.5 weeks. Simultaneously with epithelialization, the bone beams are formed, and the young bone develops.
When a tooth is traumatic to be torn out (when the surrounding tissues are crushed and ruptured), the healing of the gums stretches for a long time, because after removal there is a ragged wound, the edges of which are often far from each other, and the sections of the alveoli (bones) and the root gap, not covered by the gum edge.
When tissue inflammation occurs in the well and around it, the edges of the wound do not converge for a long time, and epithelialization does not end after 2 weeks but may last for 30-50 days.
Only in 4-5 months, the formation of young bone tissue is completed, and the final version of the gum “cover” is formed over the hole.
What could be dangerous long-term healing of the gums after tooth extraction?
As a result of an infection being added to the wound, alveolitis may occur – inflammation of the hole after tooth extraction, which usually develops already 1-3 days after the procedure. In this case, there is a sharp pain in the area of the extracted tooth, the normal healing of the hole is disturbed (often there is also an unpleasant putrid breath from the mouth).
The result of a purulent inflammatory process is a prolonged gum healing, which, moreover, determines the risk of developing a serious complication – limited jaw osteomyelitis.
Of particular danger is the long-term healing of the gums against the background of infection after the removal of the lower wisdom tooth.
Since the lower wisdom teeth are surrounded by soft tissues that have an abundant blood supply, the ingress of bacteria into the wound after a simple or, especially, difficult removal can lead to serious consequences, up to the spread of infection deep into the tissues.
Infection of the jaw and periomaxillary areas against the background of reduced immunity can lead to abscesses and abscess that are dangerous for the patient’s life.
The extreme expression of these complications is sepsis – infection of the blood by pathogenic microbial flora, which may well be fatal.
Diseases creating risks during and after removal
For normal healing of the gums in the future, an important role is played by illnesses that a person may have at the time of tooth extraction.
For example, with long-term use of drugs that “dilute” the blood, diabetes, blood diseases that are accompanied by poor blood clotting, there may be bleeding from the hole, which does not last long after the procedure. Sometimes the blood can not stop more than a day.
For normal gum healing, it is necessary to stop the blood as early as possible to form its clot, which plays an essential protective role for a fresh wound.
After a tooth has been pulled out, it is the presence of a blood clot in the well that makes it possible to most effectively stimulate the repair of damaged tissues.
From the practice of the dentist
A couple of years ago, I was approached by patient I., 62 years old, regarding the removal of the lower central incisor, which had high mobility. After a simple removal within 1-2 minutes, I spent the classic stop bleeding by pressing the gauze pad to the hole, gave recommendations.
The next day, the patient again turned to me, already about the non-stopping bleeding from the hole. It turned out that he concealed from me the fact that he was taking indirect anticoagulants, that is, drugs that “thinned” the blood, so stopping the bleeding at home did not bring any result.
After filling the hole with hemostatic means and temporary discontinuation of these drugs by a cardiologist, the problem was solved.
How to speed up the healing process of the gums after tooth extraction?
To understand how you can effectively accelerate the healing of the gums after tooth extraction, you should recall the conditions for normal healing of living tissues in general.
The most favorable option for wound healing is to create the most sterile conditions.
Naturally, the concept of “sterile” is only very conditional here, since the destruction of all bacteria (both beneficial and harmful) can lead to negative consequences, such as dysbacteriosis in the oral cavity, which affects the general health of the person. In order not to bring damage to health, but to provide the well with comfortable and not long healing after tooth extraction, both general and local methods can be used to prevent the addition of secondary infection.
There are specific rules, the implementation of which will allow the gum to begin to recover successfully in the coming hours after the tooth extraction procedure:
- Keep your teeth tightly with a gauze pad placed by the doctor on the well after removal. It is the pressure on the wound edges that is important, not time, although the average retention period is regulated and amounts to 15-20 minutes.
- You can not eat for 3 hours, and it is advisable not to drink, so as not to disrupt the formation of a blood clot in the hole.
- You can not smoke and take alcoholic beverages, spicy, hot and solid food in the first days after removal. Fulfilling this simple rule will protect the blood plug from injury, and the well from repeated bleeding and suppurative inflammation.
- You can not engage in heavy physical labor, sports, go to the bath, sauna, sunbathe in the sun and overheat for several days (for the same reasons).
- If possible, do not chew or sleep on the side of the jaw where the tooth was removed for two days.
To speed up the healing process of the gums after tooth extraction, you can use local methods of care for the hole. Rinsing is the most popular among the options used, although some doctors warn about possible harm to the blood clot.
The fact is that some patients begin to rinse, by mistake, what they did: soda, salt, vodka, vinegar, hydrogen peroxide, etc. Who than much more.
Sometimes such methods do not harm only by luck, but most often there is wound irritation and destruction of a blood clot, which not only does not speed up the gum healing process but also significantly lengthens it, bringing additional pain and suffering to the adherent of such folk methods.
It also happens that such a mockery of one’s health leads a person straight to the operating table.
Generally speaking, even rinsing approved by most dentists with infusions, herbal decoctions, and pharmaceutical solutions causes a lot of controversy regarding the start of rinsing, the frequency, and its duration.
Dentists-surgeons have their own opinion on this matter, because if you assign rinsing from the first day of tooth extraction (mainly after eating), this will serve as a prevention of accumulation of food debris in the wound and its rotting, but it can lead to the separation of a blood clot during an intensive ” gurgling “in the mouth of the same broth chamomile or sage.
Based on the position of common sense, you can use decoctions of herbs (chamomile, sage), pharmaceuticals (a weak solution of furatsilina and chlorhexidine), after consulting with a doctor, and apply – only after a meal, very carefully and without fanaticism, especially in the first two day after tooth extraction, so that the healing of the hole is comfortable.
My position on home rinsing with solutions after tooth extraction to speed up gum healing is simple and clear to everyone, since it has a logic and a scientific basis. On the first day after removal, you should not apply rinsing, and restrict mouth baths. That is, it is not recommended to rinse your mouth, but rather to hold the antiseptic in your mouth and spit, and repeat this for 2-3 minutes, at least 6-8 times a day.
In my practice, I do not prescribe furatsilin, because, firstly, it must also be able to be diluted to the desired concentration, so as not to cause irritation in the oral cavity, and, secondly, it dries mucous strongly.
Chamomile and sage decoctions are excellent for mouth baths on the first day of tooth extraction, and later for rinsing after each meal. However, this is an excellent budget option, and modern means for preventing suppuration of the hole are antibacterial drugs, ointments, and gels for local use.
Dentist-surgeon, Oleg, Moscow
For topical use to accelerate the healing of the gums after tooth extraction, the dentist-surgeon may prescribe Solcoseryl dental adhesive paste, Metrogel Dent gel or other drugs.
With complex wisdom tooth extraction, when removing a tooth due to serious purulent odontogenic processes in the surrounding tissues and jaw bones, as well as in debilitated patients, additional antibacterial therapy is prescribed, most often with antibiotic drugs, since they reduce the microbial load in and around the wound, so that the gum heals not so long.