How does a hole heal normally?
Immediately after removal, the hole fills with blood, which coagulates and turns into a dense dark clot. It plays the role of a biological bandage: it protects the bone and nerve endings, stops bleeding and serves as a scaffold on which new tissue grows. In the first two days, aching pain and slight swelling are natural and gradually decrease. By the end of the first week, the hole is covered with soft tissue, and the bone is rebuilt for several more months. Any action that destroys the clot stops this process.
- 1st day - clot formation
- Days 2–3—reduction of pain and swelling
- Days 3–7—formation of granulations
- 7–10 days - closure of the mucosal hole
- Bone reconstruction - several months
Why does alveolitis develop?
The main reason is the loss or destruction of a blood clot, as well as infection in the open socket. Smoking is considered the most significant factor: nicotine impairs blood supply, and the very inhalation of smoke creates a vacuum and literally pulls out the clot. A similar effect is achieved by drinking through a straw and actively rinsing on the first day. The risk is higher with complex removal of wisdom teeth, with inflammation in the tooth area before the intervention, with poor hygiene and in people with poorly controlled diabetes.
- Smoking in the first days after removal
- Active rinsing and drinking through a straw
- Difficult or traumatic removal, wisdom teeth
- Inflammation in the tooth area before removal
- Poor oral hygiene
- Diabetes mellitus and reduced immunity
- Remaining root fragment or bone fragment
Symptoms
A distinctive feature is pain, which after a short improvement returns stronger than before. It is aching or throbbing, radiates to the ear, temple, neck, is difficult to relieve with painkillers and interferes with sleep. Upon examination, the hole looks empty, gray, without a dark clot, sometimes whitish bone or food remains are visible in it. Often there is a putrid odor from the mouth and an unpleasant taste. The temperature in uncomplicated alveolitis is usually normal or slightly elevated.
- Increased pain 2–4 days after removal
- Pain radiates to the ear, temple, neck
- Empty gray hole without clot
- Unpleasant odor and taste in the mouth
- Swelling and tenderness of the gums
- Enlarged lymph nodes under the jaw
What does a doctor do
The dentist numbs the area, rinses the socket with an antiseptic solution, removes food debris, decayed tissue and, if necessary, bone fragments, and then applies a medicinal bandage with an anesthetic and antimicrobial effect. The bandage is changed every one to two days until the pain subsides. Antibiotics are not always prescribed, but in cases of widespread inflammation, fever, and in patients with weakened immune systems. If there is a suspicion of a remaining root fragment or bone inflammation, an x-ray is taken.
- Local anesthesia
- Washing the hole with an antiseptic
- Curettage and removal of necrotic tissue
- Therapeutic bandage changed every 1–2 days
- Painkillers as prescribed by a doctor
- Antibiotics according to indications
- X-ray in case of complicated course
Prevention
Most cases of alveolitis can be prevented by following the recommendations in the first two days. The gauze swab is held for as long as the doctor said, then carefully removed. During the first day, you should not rinse your mouth, drink through a straw, smoke, play sports, go to the bathhouse, or eat hot foods. You need to brush your teeth, but carefully avoiding the hole. Instead of active rinsing, from the second day they use baths: take the solution into the mouth, hold it and calmly release it without creating pressure.
- Do not smoke for at least 3 days after removal
- Do not rinse your mouth on the first day, then only take baths
- Do not drink through a straw or forcefully spit
- Avoid hot, spicy and hard foods
- Do not chew on the removal side
- Continue brushing your teeth, avoiding the hole
- Control sugar levels in diabetes