Alveolitis: symptoms, causes, treatment
After tooth extraction, a deep cavity (alveolus or hole) forms in this area of the jaw. In certain cases, the patient develops alveolitis of the hole – an inflammatory process that causes pain and carries a potential threat to the health of surrounding tissues (periodontal, jaw bone). If, by all indications, you develop postextraction alveolitis, treatment should be immediate. Timely access to the dental clinic will allow you to diagnose the disease in time, start therapy and avoid dangerous complications.
What is tooth socket alveolitis, types of inflammation
Let’s talk about how the alveolitis of the tooth socket develops. Under favorable circumstances, after extraction, a blood clot forms in the bed where the tooth was located. It is composed of protein cells that are involved in the formation of a blood clot. The clot completely fills the well and covers its walls. Its main task is to protect against damage and penetration of infection to tissues damaged during extraction. As a result, the socket of the extracted tooth heals by primary intention. Loose tissue forms inside the wound, then connective tissue, and then new bone tissue.
But under certain conditions, the natural healing process is disrupted (a blood clot does not form, does not adhere tightly enough to the wound surface, or is mechanically damaged).
Then the patient begins alveolitis after tooth extraction (inflammation of the hole), which has several stages:
- 1Serous alveolitis is the first stage of the inflammatory process. Its signs appear 2-3 days after tooth extraction, accompanied by constant pain and a gradual deterioration in the patient’s well-being.
- 2Purulent alveolitis – develops if the patient did not go to the dentist on time and did not receive the necessary treatment. The purulent form develops approximately 6-7 days after the operation. At this stage, the pain symptoms intensify. Other symptoms are added to them – an increase and soreness of the lymph nodes, the formation of a gray plaque on the surface of the hole, edema of the surrounding tissues, a deterioration in the general condition of the patient.
- 3Hypertrophic alveolitis is the latest stage of the disease, in which there is a weakening of general symptoms, including pain, and an improvement in well-being occurs. This is an insidious condition, since against the background of seeming relief, the disease progresses, against the background of inflammation, there is a violation of the blood supply, strong growth, suppuration, tissue necrosis. In the chronic course of the disease and the presence of granulation, alveolitis can go to the stage of sequestration (rejection of certain areas of infected tissue, bone).
Many patients mistakenly believe that inflammation of the socket of the extracted tooth does not require treatment, that pain and other unpleasant symptoms are the norm after such an operation. The first 3 days really painful sensations (both strong and moderate) are the norm, but at this stage the pain gradually subsides. If this does not happen after 2 to 4 days, and even vice versa, the pain intensifies, you need to urgently make an appointment with a doctor.
In general, it is by the nature and intensity of pain sensations that the alveolitis of the hole can be recognized. Pain is usually:
- spreading to half of the face from the side where the tooth was removed;
- in later stages – intolerable, radiating to the temple, ear.
Other symptoms of alveolitis:
- temperature rise to high values (38 and above);
- swelling and inflammation of the gums in the wound area, periostitis (inflammation of the periosteum);
- absence/damage of a blood clot;
- the formation of gray plaque;
- the appearance of purulent exudate from the hole;
- bad breath;
- an increase in lymph nodes (submandibular, cervical), their pain on palpation;
- sensitivity of inflamed tissues to hot/cold;
- excessive salivation;
- loss of appetite.
Less commonly, with alveolitis, other infections develop in parallel on the oral mucosa (stomatitis), immunity decreases, which can lead to dangerous complications – ostemyelitis, lymphadenitis, osteophlegmon. The patient generally feels unwell (weakness, fatigue).
Alveolitis of the tooth socket: causes
Post-extraction alveolitis usually develops when a blood clot has not formed or has been damaged. Then the wound becomes open for infection, which quickly affects the soft tissues, the jaw bone.
There are also a number of factors that lead to a predisposition to inflammation:
- complex surgical removal, in which the tissues of the alveoli are inevitably damaged, which increases the likelihood of alveolitis;
- removal of third molars – alveolitis develops more often after the removal of a wisdom tooth, since the bone tissue in this segment has a denser structure;
- non-compliance with the norms of tissue processing during the operation: improper antiseptic processing, incomplete removal of tooth fragments, infected tissues (granulomas);
- poor quality of postoperative oral hygiene;
- non-compliance with the prescriptions and recommendations of the dentist during the period of tissue healing;
- eating rough, cold, hot food that could disrupt the integrity of the blood clot;
- smoking – scientists have proven that smokers have a 20-40% higher risk of developing alveolitis;
- rinse 1 day after tooth extraction;
- weakened immunity;
- the patient has internal diseases (for example, diabetes, blood clotting disorders, bacterial infection in the body);
- excess dosage of local anesthetic.
Despite the many predisposing factors in modern dentistry, when removing a tooth by the hands of experienced doctors in compliance with protocols, using high-quality anesthetic and antiseptic materials after tooth extraction, alveolitis develops in rare cases (about 3%). The greatest likelihood of inflammation during the extraction of molars and incisors of the lower row, but especially often, pathology occurs when removing impacted wisdom teeth.
Complications of post-extraction alveolitis
Alveolitis is a dangerous disease that, if treated incorrectly or untimely, can have serious consequences:
- odontogenic sinusitis (infection of the maxillary sinus in case of inflammation of the hole after removal of the molars of the upper jaw);
- phlegmon – an infectious lesion of soft tissues, in which purulent tissue destruction occurs, is aggressive, quickly spreads through the circulatory system, affects the vessels of the pharynx, neck, esophagus, 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 poisoning.
If the pain after tooth extraction does not subside for more than 3 days, and you feel that the inflammation is progressing, immediately contact your dentist.
Alveolitis after tooth extraction: treatment in dentistry
When diagnosing alveolitis of the tooth socket, treatment is aimed at solving the following problems:
- removal of inflammation;
- extraction of infected tissues, tooth fragments, other foreign bodies from the hole;
- complete tissue regeneration;
- prevention of complications.
The first step in treating alveolitis is diagnostics. The doctor examines the site of inflammation visually, if necessary, makes an X-ray to identify the remains of a tooth in the wound.
Alveolitis of the hole: treatment consists in cleansing, disinfecting the infected area and is carried out in several stages:
- 1Anesthesia (all medical procedures are performed under local anesthesia).
- 2Removal of fragments of a blood clot, necrotic masses, food debris from the hole, rinsing with an antiseptic solution.
- 3Extraction of the found fragments of the extracted tooth.
- 4If a necrotic process has begun, the doctor does a wash with trypsin, which contains enzymes that break down dead tissue, helps remove pus, relieve swelling and inflammation.
- 5Disinfection and drying of the well tissue.
- 6The introduction of a tampon soaked in drugs with antiseptic and anesthetic effects.
- 7The doctor prescribes drug therapy to the patient (a course of antibiotics, applications, rinsing), gives recommendations for oral care and sets the time of the next visit, when it is necessary to re-antiseptic sanitation of the hole and replace the turunda.
Baths with 0.01% miramistin solution and 0.05% chlorhexidine solution have an effective anti-inflammatory effect in the treatment of alveolitis. In case of severe pain, the patient can take painkillers recommended by the doctor and in the recommended dosage.
Alveolitis after wisdom tooth extraction: treatment and prevention at home
The result of post-extraction alveolitis treatment largely depends on the patient himself. In order for the wound to heal faster, you must strictly follow the protocol of the prescribed treatment and adhere to the dentist’s recommendations regarding brushing your teeth, diet, and lifestyle.
It is in your power to protect yourself from alveolitis and other unpleasant complications after tooth extraction. To do this, you need to take care of disease prevention.
After tooth extraction, in order to avoid alveolitis, you cannot:
- tongue, brush or fingers to probe the removal site so as not to damage the blood clot;
- rinse your mouth intensively;
- eat solid, tough food;
- actively engage in sports, hard physical labor;
- take a hot bath, visit a sauna;
- drinking alcohol.
How to help tissues recover faster?
- exclude from the diet any foods that can irritate mucous membranes (sour, salty, spicy) as well as hot and cold foods;
- give preference to soft or finely chopped food;
- carefully monitor the cleanliness of the oral cavity, regularly perform hygiene procedures and antiseptic baths recommended by the doctor (to avoid infection of the hole);
- while brushing your teeth, try not to touch a blood clot;
- gently rinse your mouth with water every time after eating, snacking.
How can a dentist prevent the development of alveolitis?
Removing teeth is a complex operation. The doctor’s tasks include:
- maximum control when performing anesthesia;
- accurate atraumatic tooth extraction;
- high-quality cleansing of the hole, especially when extracting a decayed tooth, the presence of a cyst at the apex of the root;
- the appointment of correct postoperative therapy;
- control of results.
Your health depends on the professionalism of the surgeon, accuracy, accuracy of his actions during the operation, therefore, when choosing dentistry, it is very important to take into account the level of equipment of the clinic, the level of training and experience of specialists.