Swelling after Tooth Extraction

Swelling after tooth extraction procedure is normal body reaction. It is a good sign and indicator of normal progress of healing of tooth extraction socket. The degree of swelling and duration of swelling after the tooth extraction procedure varies from person to person. The degree of swelling which occurs after tooth extraction is generally in direct proportion to the degree of surgical trauma to the tissues. If the gums and the surrounding tissues are lacerated and damaged to quite an extent, then the swelling will be more after tooth extraction procedure.

Swelling occurs more commonly in case of wisdom tooth extraction or in case of surgical tooth extraction.  Swelling is comparatively less in case of simple or closed tooth extraction procedures. Laceration of soft tissue, trauma to the bone, careless retraction of the flaps and irritation by fragmented bone are common causes of excessive swelling.  After 2days of tooth extraction procedure, the swelling reaches maximum. The post operative instructions of the dentist explain about the ways to reduce the swelling after tooth extraction.

Swelling occurs more commonly in case of wisdom tooth extraction or in case of surgical tooth extraction.  Swelling is comparatively less in case of simple or closed tooth extraction procedures. Laceration of soft tissue, trauma to the bone, careless retraction of the flaps and irritation by fragmented bone are common causes of excessive swelling.  After 2days of tooth extraction procedure, the swelling reaches maximum. The post operative instructions of the dentist explain about the ways to reduce the swelling after tooth extraction.

After How Long Will Tooth Extraction Swelling Will Subside

Swelling usually lasts for 4-6 days. Normally, the swelling subsides completely in 7days after the tooth extraction procedure.  If it doesn’t happen within this expected time, then one should call the dentist for check up.

In some cases, swelling goes away initially and then sets in again. This occurs if there is infection tooth extraction socket wound.

Persistent post extraction swelling or development of swelling several days after tooth extraction surgery is usually due to infections. Swelling due to infections can be distinguished from post-operative swelling by:

  1. There is increased skin temperature in case of swelling due to infections.
  2. Greater redness of the overlying tissues occurs in them.
  3. Patient may be suffering from fever in case of infections

In case of swelling which occurs due to infections, external hot moist packs are given for 30 minutes every hour. The patient should do warm isotonic saline mouth rinses every 3-4 hours. Antibiotics are given to treat the infection. If pus develops due to infection, then the area is incised and is drained.

Steps to Control the Swelling after Tooth Extraction

1. Application of cold to the operated site decreases the amount of swelling which is present after the tooth extraction procedure. Cold acts by producing vasoconstriction (narrowing of blood vessels) and thereby reduces the exudation (oozing out) of blood and fluid into the tissue spaces. Cold application should be done intermittently as prolonged use of cold after tooth extraction procedure to reduce the swelling can cause compensatory vasodilatation. Cold application is to be done for 20 minutes and then break is taken for other 20mins. It is to be done for one hour within 12 hours of surgery.  During the first 36 hours, heat application should not be done. Ice can be placed in a rubber bag and can be applied.  If a rubber ice bag is not available, then ice can be placed in plastic bag. Cold can be applied intraorally by holding an ice cube in the mouth. Patient should keep the head elevated for first 12-24 hours after the tooth extraction surgery.

2. To limit the swelling after tooth extraction procedure, pressure dressings can also be given.

     a)  If the swelling is present in the front of the mouth, then folded gauze pads are placed on the outside of the lip and the gauze pad is held in position by crossed strips of adhesive tape or Elastoplasts.

     b)  If swelling is present in the back of the mouth after tooth extraction, then fluffed gauze can be placed on the face over the swelling and is held with an elastic bandage.

3. The swelling reaches its maximum in usually 1-2 days after tooth extraction. Cold application at this stage is not effective. Heat in the form of moist compresses should be applied after 1-2 days of tooth extraction. It causes vasodilatation and increases the circulation. More rapid removal of tissue break down products occurs by this. Heat in the form of moist compresses should be used for only 30minutes per hour. To avoid burning of skin, it should be lubricated with petroleum jelly. Intraoral heat is achieved by the use of hot isotonic saline rinses.

4. Many enzymes and hormone preparations are available commercially which have been suggested to treat the post-operative swelling. They should not be used routinely. The enzymes don’t prevent swelling but will redistribute the fluid over a wider area by breaking down the connective tissue and fibrin barriers. They may even allow spread of infection.

5. Corticosteroid hormones can reduce the swelling when they are used in high dosages. But they have many adverse side effects and should not be used after minor or simple tooth extractions.     

What to Avoid So That Swelling is Not Aggravated After Tooth Extraction

1. Do not disturb the extraction socket wound too much.

2. Patient should not smoke minimum for 48 hours after the tooth extraction.

3. Patient should not suck or spit too much or drink cold drinks with straw after tooth extraction procedure as it can dislodge the clot by creating negative pressure. The healing process is delayed which further leads to more swelling. 

4. Patient should take a diet of liquids and soft foods for the first 24 to 48 hours after tooth extraction. Puddings, yogurt, mashed potato, soups; smoothies can be taken by the patient. 

 

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