Alveolitis Of The Hole After Tooth Extraction

2024 Author: Josephine Shorter | [email protected]. Last modified: 2023-12-16 21:43

Alveolitis of the hole after tooth extraction

After tooth extraction, tissue healing normally lasts 3-4 days. But if the pain increases every day, and the general condition worsens, we can talk about alveolitis. Alveolitis is an inflammatory process that develops after tooth extraction due to tissue infection. According to statistics, a complication occurs in 25-40% of cases, more often - after a complex removal, accompanied by damage to the bone and nearby soft tissues.

Content:

• Symptoms of alveolitis of the hole
• The causes of alveolitis of the hole
• Types of alveolitis
• Diagnostics of the alveolitis
• Treatment of alveolitis of the hole after tooth extraction
• Prevention of alveolitis of the hole

Symptoms of alveolitis of the hole

The first symptoms of alveolitis appear 3-4 days after the procedure. It is noted:

• swelling and redness of the gums in the area of damaged tissues;
• absence of a blood clot in the hole;
• the formation of a grayish plaque on the hole and the absence of a blood clot;
• separation of pus from the hole;
• unpleasant odor from the mouth;
• severe, growing pain that spreads to nearby areas and tissues;
• high temperature (38–39 ° С);
• malaise;
• enlarged lymph nodes;
• swelling of the cheeks (not always).

Some symptoms appear at the initial stages of the development of alveolitis, others - severe pain, high fever, swollen lymph nodes and separation of pus from the hole indicate a severe stage of inflammation. Therefore, any manifestation of alveolitis should be the reason for seeking medical attention.

Inaction and self-treatment with painkillers and rinsing is fraught with the penetration of infection into the deep layers of the bone, tissue necrosis and the development of dangerous complications:

• osteomyelitis of the jaw bone;
• phlegmon;
• periostitis;
• abscess and even blood poisoning.

The causes of alveolitis of the hole

The ingress of infection and the development of inflammation can be due to various reasons, including:

• caries of the surrounding teeth and the penetration of pathogenic bacteria into the hole even before the removal procedure;
• getting a piece of bone, tartar or plaque into the wound;
• tooth extraction with untreated instruments or unscrupulous cleaning of the hole;
• violation by the patient of oral hygiene and recommendations for wound care after surgery;
• low immunity and depletion of the body (after a serious illness);
• destruction / flushing of a blood clot that forms in the hole after surgery (normally, the clot disappears a week after the removal procedure).

A blood clot covers the hole, protecting the wound from mechanical damage and infection. Washing / destruction of the clot from the hole can lead to the penetration of pathogenic flora into the bone, gum and ligament of the tooth, and cause a pathological process.

Alveolitis often occurs after complex operations, accompanied by damage to the hole and the surrounding gums. Removal is considered difficult if:

• impacted or incompletely erupted tooth is removed;
• curved roots of the tooth;
• the dental crown is completely destroyed;
• a fragile tooth crumbles during extraction.

Types of alveolitis

Serous alveolitis

It is characterized by continuous pain, the intensity of which increases during eating. When examining the hole, the absence or partial destruction of the blood clot is noted. Serous alveolitis develops 3-4 days after surgery, and a week later turns into a purulent form.

With a serous form, the general state of health does not deteriorate, the lymph nodes do not increase and the temperature does not rise.

Purulent alveolitis

It is accompanied by continuous severe pain radiating to the ear and temple. When examining the wound, a dirty gray plaque on the hole, redness and swelling of nearby tissues, thickening of the alveolar ridge, and putrid breath are noted. On palpation of the wound, acute pain is felt.

The general condition of the patient worsens: the temperature rises, the lymph nodes increase, the skin turns pale. There is soreness of the lymph nodes on palpation. Difficulty eating due to sharply increasing pain and inability to open the mouth normally.

Hypertrophic alveolitis

Hypertrophic alveolitis develops when purulent passes into a chronic form. At the same time, there is a decrease in pain, normalization of body temperature, a decrease in regional lymph nodes and an improvement in the patient's well-being.

Visual inspection reveals a strong growth of pathological soft tissue (granulations) from the hole. There are empty spaces and small areas of dead tissue between the bone and soft tissue. There is a discharge of pus from the hole, redness and swelling, cyanosis of inflamed tissues.

Very difficult (with more pronounced symptoms) and long-term alveolitis occurs in patients with diabetes mellitus, since the diseases aggravate each other.

Diagnostics of the alveolitis

Diagnosis of alveolitis is carried out by the dentist through a thorough visual examination of the oral cavity and the area of inflammation, studying the patient's complaints and taking X-rays (performed to detect bone fragments and other foreign bodies in the hole).

Alveolitis treatment is required!

Inaction is fraught with penetration of infection into the deep layers of the bone, tissue necrosis and the development of dangerous complications:

• osteomyelitis of the jaw bone;
• phlegmon;
• periostitis;
• abscess and even blood poisoning.

Treatment of alveolitis of the hole after tooth extraction

Alveolitis treatment is carried out by a dentist and includes several stages:

• anesthesia (local or stem);
• washing out the remains of a clot, food, saliva from the hole using a syringe with a blunt needle with antiseptic solutions - hydrogen peroxide, a solution of potassium permanganate, furacilin, chlorhexidine;
• removal of dead tissue and food particles, bone fragments remaining after washing with a sharp surgical spoon (carried out very carefully so as not to damage the walls of the hole);
• repeated washing of the well with an antiseptic;
• drying the well with a sterile cotton swab;
• sprinkling the wound with anesthesin powder;
• the application of a gauze swab soaked in an anesthetic, antiseptic and antibacterial drug.

The bandage protects the wound from mechanical damage and chemical irritants, protects tissues from infection.

In severe forms of the disease, systemic antibacterial drugs (tablets, capsules), daily baths with antiseptic solutions, soda and decoctions of medicinal herbs are prescribed. In addition to drug treatment, physiotherapeutic procedures are prescribed: infrared and ultraviolet irradiation, fluctourization, microwave therapy.

The gradual disappearance of pain, swelling and redness of soft tissues, restoration of the normal appearance of the gums indicate recovery. If the clinical picture does not change, perhaps a more serious complication has arisen, and treatment should be continued.

Prevention of alveolitis of the hole

The main goal of preventive measures is to preserve the blood clot and prevent infection.

Dentists recommend:

• do not rinse the oral cavity intensively (during rinsing, the clot can collapse and bacteria can freely enter the open wound);
• do not consume hot food and drinks (high temperature promotes intensive multiplication of bacteria and increases inflammation);
• do not touch the hole with your hands or foreign objects, so as not to infect.

The author of the article: Makarova Evgenia Vladimirovna, pulmonologist