Complications After Tooth Extraction

Complications may occur after tooth extraction procedure. Some complications after tooth extraction are common and some are not that common. Extraction is painless removal of tooth or tooth roots with minimum trauma to the surrounding tissues so that the extraction socket wound heals uneventfully without any post-operative complications.  Tooth extraction complication symptoms are prolonged pain; swelling, bleeding, bruising, limited mouth opening and many others.  Various Tooth extraction complications are discussed in detail in this article.

Pain as Complication after Tooth Extraction

It is the most common complication which occurs after the tooth extraction procedure. After the tooth removal, there is bound to be some kind of discomfort and pain.  The pain and soreness may last for few days after tooth extraction.  Painkillers are given by the dentist to control the pain. Pain meds such as Ibuprofen, Tylenol, Paracetamol, Solpadeine or Nurofen Plus can be used to control the pain.  The painkillers which are prescribed by the dentist are dependent on the medical history of the patient and the effortlessness with which the tooth was extracted.

Swelling as Complication after Tooth Extraction

Swelling after tooth extraction

Swelling is other common complication after tooth extraction. Swelling after tooth extraction procedure is a normal body reaction and is indicator of normal progress of healing of tooth extraction socket. If swelling persists beyond 1week, then the patient needs to visit the dentist.  After extensive surgical interference, simple inflammatory edema appears in adjacent tissues in most of the cases. This is unavoidable and is generally commensurate with the degree of surgical trauma. Swelling usually occurs after the tooth removal.  The swelling can be there for as long as few weeks.  The swelling can be treated by using an ice-pack or by pressing a bag of frozen peas against the cheek near the tooth which is removed. This will help to lessen the swelling.  Alcohol, hot foods and drinks and work out immediately after the tooth extraction can aggravate the swelling. Warm saline rinses and hot moist compresses 1-2 days after tooth extraction will further help in reducing the swelling.

Bleeding as Complication after Tooth Extraction

Bleeding after Tooth Extraction

Bleeding is other common tooth extraction complication. Slight oozing of blood may occur for up to 24 hours after the tooth extraction. It is considered as normal. If the bleeding is continuing after tooth extraction, then the patient can put a piece of gauze pad on the bleeding socket area with equal pressure without irritating the socket.

 Gauze pack to stop bleeding

Biting on tea bags may also stop the bleeding. If there is prolonged oozing of blood even after 24 hours or incases of heavy bleeding after 1-2 hours after the tooth extraction, dentist should be consulted.

Bruising Complication after Tooth Extraction

There are some people who are more likely to bruise than others after tooth extraction. These are usually older people, people on aspirin or steroids as they tend to bruise much more easily. Intermittent ice packs should be given for the first 24 hours after the tooth extraction procedure followed with intermittent hot moist packs. It is not a gangrenous process and discoloration is due to bleeding into the tissues. Accumulation of red blood cells and subsequent break down of hemoglobin causes discoloration. The bruising can look quite prominent and might take weeks to disappear in some cases.


Limited Mouth Opening which is called as Trismus after Tooth Extraction


 This is the normal mouth opening but in Trismus, there is inability to open mouth normally


Many a time’s the chewing muscles and the jaw joints are so sore after the tooth extraction that it becomes really difficult to open the mouth. This can happen for a few days after the extraction.

In case the patient gets an infection after the tooth extraction in the tooth socket then he will not be able to open his mouth for a much longer period say as much as a week. Although Pain is the most common tooth extraction complication, trismus can become one of the more chronic and complicated problems to manage. 

Post-operative infection Complication after Tooth Extraction

A person might also develop an infection in the socket after the surgical extraction of the tooth. This usually happens about 2 – 4 days afterwards and one knows of it from the deep-seated throbbing pain, the bad breath that the person emits and the perpetual unpleasant taste left behind in the mouth. Dry socket is a painful tooth extraction complication.  This kind of an infection is more bound to happen if a person smokes, use Contraceptive Pills or are on drugs such as steroids or if the bone cutting is done during the tooth extraction.

Secondary infection that is infection several days after tooth extraction may occur. It mostly occurs after surgical removal of wisdom tooth. The patient will have fever, abnormal swelling, pain or a salty or prolonged bad taste with or without discharge from the surgical site as post tooth extraction complication symptoms in case of secondary infection . To avoid this, patient has to maintain good oral hygiene and should avoid smoking and drinking alcohol. To treat infections, antibiotics are given by the patient.

Reaction to medications given after Tooth Extraction Procedure

The pain meds and antibiotics which are given after tooth extraction may have side effects. A patient may experience nausea, vomiting, drowsiness from the medicines which are provided. Patient can consult his dentist in such cases and can tell him to change his medicines.

.Numbness / Tingling /Burning sensation after Tooth Extraction

Numbness and tingling sensation occurs when the nerve is damaged or is injured during the tooth extraction. Nerves are responsible for sensation in the tongue and lips and may get affected while giving the anesthesia.  The nerves may get squashed, bruised or stretched which could result in numbness.

This kind of nerve bruising is usually not permanent but in the rarest of rare cases it might be permanent as well. The temporary phase might go on for a long time and may last from several days to several months. No one can actually say how long the nerve will take to get rid of the nerve bruising and come back to its normal mode of functioning.

Bony Flakes Complication after Tooth Extraction

Sometimes, bony flakes also known as sequestra result from the sockets of the extracted teeth and the patient can feel the roughness with the tongue in the socket area. They may cause soreness and will interfere with the healing after tooth extraction. They need to be smoothened by the dentist. At times, the gums heal on their own whereas some times it becomes imperative to smoothen the underlying bone for healing to take place. 

Bleeding into Cheeks after Tooth Extraction

Bleeding into the cheeks can result in swelling after tooth extraction which may be hard to feel.  This could also go on to result in a difficulty in being able to open the mouth and also result in bruising at that particular spot.  The swelling, bruising and mouth opening will all get better with time and come back to normal.

Periodontal damage Complication after Tooth Extraction

Periodontal damage may occur after tooth extraction. Periodontal pocket may occur after wisdom tooth extraction if the tooth is deeply impacted and there is no bone between second and third molars. To treat periodontal pocket, scaling and root planning is done. Gum surgery may be required to treat it. Gum tissue may be deteriorated after tooth extraction.

Ludwig’s Angina Complication after Tooth Extraction

It is a rapidly spreading infection of floor of mouth and is life threatening. Fascial spaces are affected in this. Difficulty in breathing, difficulty in mouth opening, swelling and severe pain is Ludwig’s angina complication symptoms.  Though it is extremely rare but one still needs to take extreme care if one gets infected by Ludwig’s angina.

Osteonecrosis Complication after Tooth Extraction


 It is a rare dental condition which may occur after tooth extraction or other invasive procedure.  In this condition, there is no sign of healing even after 8weeks of dental extraction. The gums are worn away in this condition and underlying bone is visible. This condition is mostly seen in cancer patients.

Osteomyelitis Complication after Tooth Extraction

It is a rare Tooth extraction complication. Osteomyelitis may occur after tooth extraction. There is inflammation of bone and bone marrow in this condition.  In case of acute osteomyelitis, there is severe throbbing deep seated pain present along with swelling. The teeth may be loose and pus may extrude from the socket.  Fever and enlargement of lymph nodes may be present. In case of chronic osteomyelitis, there may be fistula and sinus tract formation on skin and mucosa.

Post extraction Granuloma Complication after Tooth Extraction

This complication happens four to five days after tooth extraction. The main reason for it to occur is a foreign body in the tooth socket that starts the infection and allows it to set in. This could be the result of e.g. amalgam remnants which is from the tooth filling, bone chips, small tooth pieces, calculus etc. The way this works is that the foreign bodies aggravate the area and this goes on to stop the post-extraction healing and suppuration of the wound happens.

It is treated with debridement of the socket and removal of any and every causative agent of the infection. This is the best and only way to go about it.

Temporomandibular joint (TMJ) dysfunction after Tooth Extraction

It may occur after wisdom tooth extraction. This tooth extraction complication is unusual and is temporary. To treat this condition, anti-inflammatory medicaments, heat therapy, rest and in some cases bite splint therapy is given.

 

 User Comments on -  Complications After Tooth Extraction


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Posted By : Dr.Ritz on 06-May-2012 11:25 PM
Tanya, there are quite a few reasons of joint or muscle pain. If you are having pain on temple region and the extraction socket has completely healed that there are chances that it can be due to clenching of teeth during night. I suggest you to visit your dentist to get in manually checked and s/he will, most probably, put you on medications and mouthguard.
 


Posted By : tanya on 05-May-2012 07:26 PM
I had my back, bottom tooth pulled almost two weeks ago. I had an infection which has been treated and cleared. I have been treated for dry socket also. My dentist told me that I may have muscle/joint damage. What is the treatment?
 


Posted By : Dr.Ritz on 02-May-2012 11:31 PM
Millie, at the age of 69 it usually takes a bit longer to heal and also the pain is comparatively more. I suppose you should visit a dentist to see if it isn't due to dry socket. Common symptoms of dry socket are severe pain starting 4th to 5th day post extraction, empty looking socket, extreme radiating pain to the ear and temple region, exposed bone on visual examination, unpleasant foul smell from the mouth. If the pain is due to dry socket, than your dentist will put a ZOE gauze pack in the socket that will reduce pain. So, visit your dentist ASAP.
 


Posted By : Millie on 02-May-2012 09:10 AM
I had tooth#8 pulled last Friday. I have been on non stopr Torodol and advil since . The whole roof of my mouth and tongue is on fire. I cannot eat anything. I have used parodex and salt rinses and amoxcillan to no avail. The stitch was desolvable. I am 69 years old. Is this pain because I am old. I was not told to return to see the DDS. I cannot talk either. it is much too painful. Thank You. Millie
 


Posted By : Dr. Ritz on 27-Apr-2012 10:17 AM
kailey,If you have pain and swelling after 2 days of extraction then this is normal. You are not able to open the mouth because of the swelling. This pain and swelling will go with in 3 to 4 days of extraction. Keep doing warm saline rinses 2 to 3 times a day and keep taking your meds.maintain very good oral hygiene and follow all the instructions given by your dentist.
 


Posted By : kailey on 27-Apr-2012 01:33 AM
I'm having all of these problems, I have a lot of swelling, more so on one side, I had both of my bottom wisdom teeth removed 2 days ago. I have increasing pain, instead of decreasing pain, the bleeding is minimal, but I can barely open my mouth to put food in, im assuming that's from the swelling, but was wondering when I will be able to open it fully again. I was prescribed ibuprofen, vicodin, and an antibiotic, I've been taking all of them every 8. Hours because I have needed them. Also, the last symptom I've been having is constant hiccups, and I heard this can be a reaction to the drugs. But im not sure, its really uncomfortable, and is causing me alot of chest pain.
 


Posted By : Dr. Ritz on 25-Apr-2012 10:51 AM
Aracely,if it is normal tooth extraction like no bone cutting has to be done then you should not have pain.if pain is there then either you have developed dry socket or infection is there. it is better you visit your dentist as it is difficult to give the treatment options with out seeing the case clinically.till then you can do warm saline rinses 2 to 3 times a day and maintain good oral hygiene.
 


Posted By : Dr. Ritz on 25-Apr-2012 10:32 AM
martina, if the dry socket develops extraction socket takes time to heal . It can take up to 6 weeks to 3 months. You have to go to the dentist and get the dressing done again. For better healing maintain good oral hygiene and do warm saline rinses so that the secondary infection does not set in.
 


Posted By : Martina on 25-Apr-2012 02:53 AM
Hi. I had a front tooth extracted 4 weeks ago after it broke. Unfortuntely I developed a dry socket and infection. I was given antibiotics and a medicated dressing was put in the wound. Two weeks later the dressing came out and the wound was still open and throbbing again. I went back to my dentist who stirred the wound up to make it bleed, put a dressing in again and stitched the wound to help it heal. I also had another course of antibiotics prescribed. I have now finished the antibiotics and this morning the rest of the stitches came out together with the dressing but the wound is still open. What else can be done to get the healing process started? I'm starting to get really frustrated as this is having an affect on my work and of course social life. I'm 29 years old, non-smoker, non-drinker but I do take a contraceptive pill which I know has some kind of effect. I'm due to see my dentist again tomorrow but would appreciate a second opinion. Thank you!
 


Posted By : Aracely on 24-Apr-2012 12:54 PM
Had my lower right wisdom tooth pulled on Friday (4 days ago).Taking Motrin 600mg for pain. Doing fine until late Sunday afternoon when I experienced incredible pain in the area where the tooth was pulled and in my jaw. Have been swishing warm salt/water and hydrogen peroxide. Yesterday afternnoon the pain subsided but it returned again this afternoon. I have had other teeth pulled before, including another wisdom tooth. Usually by now I am fine - no discomfort, not even a need for pain killers. I am wondering why I am having so much pain now AND is it possible to have continued pain from the shot injection site that radiates to the jaw area?
 


Posted By : Jennifer on 17-Apr-2012 03:31 PM
I had 4 teeth removed last Thursday. 2 left wisdom teeth & upper left/right molars. They were all impacted... Infected... And broken. I currently have stitches on the upper left area. I had been given a 5-day Azithromycin antibiotic (which I completed last night), Peridex rinse 3x a day & 5mg Hydrocodone for pain. I was fine until last night. Started having difficulty breathing, it feels like someone is leaning on my chest & neck. And I had slight bleeding from all open areas on the left side of my mouth. Today, I have been experiencing dull numbness all over again, followed by pain throughout the left side of my whole face: temporal lobe and eye socket, included. I haven't been swollen since Saturday. I have a follow-up appointment this coming Friday, but should I wait that long to decipher if there is a bigger issue?
 


Posted By : Dr. Ritz on 29-Mar-2012 10:26 AM
MrsPP,If after healing there is a gap between the gum and the temporary bridge then you should visit your dentist and get the temporary bridge refitted so that the gap is filled. In this gap the food impaction will be there and it can cause complications. Till then keep the area very clean and do warm saline rinses 2 to 3 times a day.
 


Posted By : MrsPP on 28-Mar-2012 02:05 PM
At the end of January I had a front tooth removed and a temporary bridge fitted. After a month the wound was still bleeding and fluid was draining out of it. I returned to the dentist and was advised to continue with salt water washes. After a further month the gum above the tooth split vertically, bled, and a scab formed. After a couple of days this healed but the gum is now indented and higher than the edge of the tooth. Any advice?I am due to go back to the dentist in a month to have the proper bridge fitted.
 


Posted By : Dr Ritz on 06-Mar-2012 10:58 AM
Mrs B, You have to take care. As the bad smell indicates that infectin can be there so do warm saline rinses 2-3 times a day. You can use some good quality antimicrobial mouthwash also. Keep the denture clean and wash it properly. This should take care of your bad smell and white deposits. If the condition goes bad then you have to visit your dentist.
 


Posted By : Mrs. B on 05-Mar-2012 08:30 PM
Last tuesday I had 6 teeth extracted and a denture put in place. I do smoke and didn't have a cigie until 36 hrs after with denture in place. I tried not to make a suction in my mouth. Everything has been healing good, still have stitches and have been doing salt water rinses every 4 hrs. I did start developing a white coating on several of the sockets, but one has an extreme amount on it. Today is my sixth day and I will admit I rinsed and then didn't rinse again for 6hrs. By the time I did go pull the denture out to rinse there was a fowl smell and taste. I don't have any pain, except soreness. I am worried not sure what this is, will call my dentist in the am and continue rinsing. Have any idea?
 


Posted By : Dr Ritz on 24-Feb-2012 10:20 AM
Roxyjo, you have not mentioned whether you had local anesthesia or sedation. If you had opted for sedation then you can wait another couple of hours for this tingling sensation to go. If you got the extraction done under local anesthesia then you should not have this tingling sensation in the arms. You can call your dentist and talk to him as he knows what procedure has been done.
 


Posted By : roxyjo on 23-Feb-2012 09:21 PM
i'm not really sure if this is normal or not but bout 7 mths ago i got my back lower tooth pull'd and was told to go back after i had baby and get my other one's done. so i did today this morn at 9am they pull'd a total of 3~two back ones the top and bottom and my front upper, but its been over 12 hrs now and my arms are really tingley feeling, like i said idk if thats normal because that didnt happen last time. so my q is~how long does it last and should i go see my doctor?~~roxyjo
 


Posted By : Dr. Ritz on 20-Feb-2012 08:43 AM
Eimear, The growth from inside the tooth can be the fibrous growth which has become quite hard due to repeated trauma. Basically it is gum tissue which grows as the tooth is broken but nothing final diagnosis can be given without clinical exam. So it is better to go to dentist and get is examined.
 


Posted By : Eimear on 20-Feb-2012 04:44 AM
hi, I had a root canal on one of my back lower teeth last year. The day after the procedure the tooth fell out in pieces.It has been severely painful for the past year but I didn't go back to the dentist.At this point in time the tooth still looks infected but is not as painful unless provoked. In the last few days I have noticed a thin white growth from the inside of the tooth base protruding upwards and continually growing.The growth is not hard like bone but is solid and when I try to pull it out there is not much pain but I can feel that it is connected pretty far down.I have researched quite a bit and have found very little information.I would be so grateful if you had any information for me?Thank you, Eimear
 


Posted By : Dr Ritz on 07-Feb-2012 08:56 AM
Bernice, If after 5 months of tooth extraction the socket has not healed properly and bony protrusion is then you need to get the bony spicules rounded off from dentist as this is not going to heal itself and denture will be painful till they are rounded off. As such also before going for denture we need well rounded off ridge to support the denture so that denture is not painful. So schedule as visit to your dentist.
 


Posted By : Bernice Hopkins on 06-Feb-2012 05:16 PM
I had all my upper and quite a few of my lower teeth extracted because they were loose. That was in September it is now Feburary and I can feel sharp bone protruding in three sockets, and a long slant of bone is begining to poke out on the inside of the area where my wisdom tteth would be. I can no longer wear my dentures it's too painful. The dentist says they will come out on their own. I feel negilected.
 


Posted By : Sue on 20-Jan-2012 04:37 PM
I always wanted to add the area still bleeds. I was told after the surgery to take 2 Advil every 4 hours and in between those doses take 1500 mg of Tylenol. After 6 weeks of this I am now going for testing to see if I've developed an ulcer from all the Ibuprofen!
 


Posted By : Beth Cullipher on 17-Nov-2011 01:24 PM
Thank you, Dr. Ritz, I went back to my dentist first thing this morning and found out that I had partially lost the blood clot from the extraction and also had an exposed nerve with some infection. They irrigated the site and packed with medicated GelFoam. It feels much better now! Thank you again for your feedback! This site is very helpful!
 


Posted By : Dr Ritz on 16-Nov-2011 10:41 PM
Beth, If it was a difficult tooth extraction, then it may cause severe pain. Fever can occur after tooth extraction. You can take pain meds and antibiotics as prescribed by your dentist. It will provide relief. White film on tooth extraction socket can be because of healing of tooth extraction socket. Don’t irritate tooth extraction socket too much and continue with warm saline rinses for faster healing to take place. If fever and pain doesn’t regress, then you can visit your dentist for evaluation of tooth extraction socket. Avoid eating from the side of tooth extraction socket and keep the area clean to avoid any secondary infections.
 


Posted By : Beth Cullipher on 16-Nov-2011 05:29 PM
Help! I had my #29 tooth extracted this past Monday by a oral surgeon. I was prescribed #8 Vicodin ES for pain and #30 Amoxicillan to prevent infection. I did not slept for a combined two hours Monday night due to pain. Tuesday mid- morning I took my temperature and was running a fever of 102.6. I called the dentist office concerned with the fever and amount of pain and was told "it happens sometimes" and was advised to continue with medicatios as directed. Today (Wednesday), after another night without sleep, I am still running a fever, still in a tremendous amount of pain and out of pain medicine, call the dentist office back and am told to take tylenol for pain (as I am allergic to Aspirin and Ibuprophen) and if no improvement come into the office tom. I have noticed since yesterday there is a whitish film on my gum surrounding the extraction site. I have tried very hard to clean with a q-tip but it will not come off. I have been rinsing with salt water and listerine twice a day. Any input would be greatly appreciated!!!
 

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