Wisdom Teeth - 9 days later, gums inflamed?

Question

Is this normal?

I had 3 wisdom teeth extracted about 9 days ago, and my bottom right last molar has the gums around it sort of sore and inflamed. I saw the surgeon two days ago for my follow-up checkup, and he said I was healing well, and didn't mention that it was a problem or anything, but I didn't specifically ask about it.

Is it normal for my gums to still be inflamed? I don't have a fever or terrible or pain or anything. I haven't noticed any blood or pus, which I understand would be common for an abscess. Should I try and see him tomorrow for an emergency?

I will see him tomorrow

As far as the first answer, I have been very anal about dental hygiene over the past 9 days. I have rinsed with salt water every 4 hours, i've been avoiding chewing in the area, and I have been using the syringe and cleaning after every time I eat something. The gums have been inflamed a couple of days, and was just wondering if it was normal after 9 days.

I will still go see him tomorrow, just to be safe

although, admittedly, i did not use ice, as the swelling was very minor and I didn't feel I needed it...

I had 3 pulled, on one day, which was 9 days ago.. sorry for any ambiguity..

I did indeed rinse with salt and water as directed (every 4 hours, especially after meals)

I am still rinsing with salt water and using the syringe, just my gums are sore and a little inflamed around one of the holes where one of the teeth were removed. Thats why I'm wondering if this is normal after 9 days.

Answer 1

You know your body. Call his office now if you feel that something isn't right.

Answer 2

Overcome Fear Of Dentist - http://DentalBook.uzaev.com/?yrLi

Answer 3

dont worry this is very normal to have your gums or cheeks inflamed after you get those removed

Answer 4

Why did you pull 3 teeth in 9 days thats insane. I had one pulled two weeks ago now I'm going for the next. next week. Did you rinse with salt and water, or iodine, best thing. Dont swallow iodine!

Answer 5

Go see him and ask about it...just to be on the safe side...cause you don't want a small problem to lead to a bigger problem.

Answer 6

you did not listen to your doctor and gargle with salt water, brush your teeth gently, use ice

Answer 7

Call him and tell him what you are feeling and that you are worried. Don't say its an emergency sence your mouth has scabs and its going to hurt thats why they gave those pills to kill the infection and an emergency vist costs a fortune below is some info.

What to expect afterwards
It will be necessary to rest for a while after general anaesthesia or sedation. The jaw may feel stiff and sore, but painkillers will help to relieve discomfort.

Most people can go home as soon as they have recovered from the anaesthesia. However, if you have had general anaesthesia or sedation, you will need to arrange for someone to drive you home and stay with you for at least 24 hours.

General anaesthesia can temporarily affect co-ordination and reasoning skills, so you should not drive, drink alcohol, operate machinery or sign legal documents for 48 hours afterwards.

You may be given painkillers, antibiotics and mouthwash solutions to take home. Once home, the painkillers should be taken as advised by the surgeon and nurses. Any pain, swelling or stiffness is usually at its worst two or three days after the operation and then gradually improves.

Do not vigorously rinse your mouth out during the first 24 hours because this disturbs the blood clots that are part of the healing process. After meals, rinse gently with warm salt water (one teaspoon of table salt to a glass).

At first, it may be possible to feel small fragments of bone with your tongue. These are the edges of the tooth socket and will soon disappear as the gum heals.

Depending on the type of stitches used, they may need to be removed (arrangements will be made for this to be done). If dissolvable stitches have been used, they will disappear 7 to 10 days after the operation.

To begin with, you should eat soft foods, gradually returning to a normal diet once any jaw stiffness has settled. Very hot drinks and spicy food can increase pain and bleeding and should be avoided until the gum has healed.

Drinking alcohol and smoking should also be avoided as they can increase bleeding and delay healing.

Anyone who experiences increased bleeding should fold a clean handkerchief or piece of gauze, place it on the bleeding gum and - in a sitting position - bite on it for at least 20 minutes. It is important not to rinse your mouth out or lie down.

Most people experience no problems following an operation to remove wisdom teeth. However, contact your dentist or the hospital immediately if you develop any of the following:

bleeding that doesn't stop after applying pressure, or that lasts for more than half an hour
difficulty breathing or swallowing
a face that continues to swell more than three days after the operation
a fever or high temperature
severe pain that is not relieved by painkillers
These symptoms may indicate that you have an infection or another problem.

Side-effects and complications
The extraction of wisdom teeth is a commonly performed and generally safe procedure. For most people, the benefits - treatment of pain, decay and infection - are greater than any disadvantages. However, in order to make an informed decision, anyone deciding whether or not to have this procedure needs to be aware of the possible side-effects and the risk of complications.

Side-effects
These are the unwanted but usually mild and temporary effects of a successful procedure. Examples of side-effects include feeling sick as a result of the anaesthetic and occasional bleeding from the gums, which can last 12 hours or more. There may also be some facial swelling, pain and jaw stiffness, which can last for several days.

Complications
Complications are problems that can occur during or after the operation. Most people are not affected. The main possible complications of any surgery include excessive bleeding during or soon after the operation, infection, and an unexpected reaction to the anaesthetic. Complications may require further treatment such as having another operation to stop bleeding, or antibiotics to treat an infection.

Specific complications of having wisdom teeth extracted are uncommon but may include accidental damage to other teeth.

Occasionally nerves in the jaw can be damaged, either by the surgery or by swelling afterwards. This can cause temporary numbness or "pins and needles" in the lower lip or tongue after lower wisdom teeth have been removed. In a small number of cases this altered sensation is permanent.

The risk of complications depends on the exact position of the wisdom teeth, the type of anaesthetic used and other factors such as the person's general health. Your surgeon will be able to explain how these risks apply to you.

Further information
National Institute for Clinical Excellence (NICE) Guidance on the Extraction of Wisdom Teeth
www.nice.org.uk
British Dental Association - Smile
www.bda.org/smile
British Dental Health Foundation
0845 063 1188
www.dentalhealth.org.uk

more info
POST OPERATIVE CARE
After surgery, a 48 to 72 hour recovery is expected. Patients are reevaluated after this time to assess healing and to intercept any complications that may occur. This is very advantageous to the patient.

Bleeding is expected post operatively and can continue up to 10 hours after any procedure. Even a little blood seems like a lot in the mouth due to a mixture with saliva. Saliva can increase what appears to be high concentrations of blood by 10 times. Pressure on the surgical site is most important for bleeding control. If sutures were placed at the time of the surgery, pressure will almost always stop bleeding. A tea bag wrapped in a piece of gauze is also helpful. The tannic acid in the tea constricts tiny blood vessels in the wound and helps to form a clot.

Swelling is to be expected post operatively. Swelling can last for several days and can be significant in some patients. Ice is helpful in keeping the swelling to a minimum. Elevating the patient's head the first couple of nights while sleeping may also help. Steroids given at the time of surgery are a most effective weapon in the battle against selling. They are routinely used intravenously unless medically contraindicated. An interesting phenomena can occur when intravenous steroids are used however. Some patients experience what is called rebound swelling from the medications. in this scenario, patients will experience no swelling following the surgery or the following day but wake up two days after surgery with swelling. not to panic, it responds quickly to ice.

Another complication following wisdom tooth removal is pain in the muscles surrounding the jaws which affects the function of the jaw joint. This post operative problem may need treatment similar to treatment for TMJ patients.

Infection following the extraction of wisdom teeth is not a common complication. Natural immune mechanisms help to protect the surgical site. Antibiotics are prescribed by some oral surgeons after surgery although there is no documentation in the literature to support the use of antibiotics prophylatically. Some patients will experience localized inflammation and infection in the tooth socket 48 hours after surgery. This has commonly been called a dry socket. It is not dry, however, and the name is derived from the clinical appearance of the socket which is commonly void of a normal blood clot or granulating (healing) tissue. This post operative complication is best treated with a medicated dressing placed in the extraction site. It typically contains local anesthetic ointment that soothes the surgical site. If this is ineffective, it usually means the pain is originating in another tooth (most commonly the tooth in front of the wisdom tooth site), or from the muscles surrounding the surgical region. These muscles are used during opening and closing of the jaw and can be aggravated post operatively by overeating, grinding, and heavy chewing. Treatment of this type of pain requires not only a dressing in the surgical site but also anti-inflammatory medications, muscle relaxants and in some cases post operative physical therapy for the muscles.

DIET
For the first two days following surgery it is important to eat soft foods, soups, and plenty of fluids. The list of acceptable odds is as long as your gastronomic imagination. Some basic rules are : (figure 7 page 10)



RISKS AND COMPLICATIONS
Removal of wisdom teeth is a common procedure. Complications can occur, however. The following are potential complications that the patient should understand:

Infection - Infection following the surgical removal of wisdom teeth is an uncommon complication. Any infection, however, should be taken seriously and reported to the oral surgeon. Signs of infection include fever above 100 degrees orally, abnormal swelling, pain or a salty or prolonged bad taste, with or without evidence of discharge from the surgical site.
Injury to teeth - Damage to fillings and adjacent teeth, to bridgework or to surrounding bone can occur during the removal of impacted wisdom teeth. Even the best surgeon will occasionally have this type of complication.
Dry Socket - This term is used to describe a condition that can develop in the empty tooth socket. if a blood clot does not form properly in the socket or is lost prematurely, the bone can be exposed. Exposure of the bone to the oral cavity, foods and saliva, can result in a localized inflammation or infection called alveolitis. It is acutely painful but responds immediately to proper care. Dry sockets are easily treated with the placement of a medicated dressing into the surgical site. Smoking and improper diet after surgery increases the odds of a dry socket.
Numbness - In some cases major sensory nerves serving the mouth are in close proximity to the wisdom teeth. It is possible that one or more of these nerves can be bruised or permanently damaged during surgery. if this occurs, numbness to the tongue, lip or chin may occur. This numbness or tingling sensation is usually temporary. Uncommonly, permanent numbness can occur.
Sinus complications - Upper wisdom teeth roots are in very close proximity to the maxillary sinus. in some cases the roots even penetrate into the sinus cavity. An opening into the sinus after the removal of wisdom teeth occurs on occasion. By and large, small perforations into the sinus are uneventful and heal without being noticed. Occasionally, bacteria from either the sinus or the oral cavity can hinder healing and a hole can develop from the sinus into the extraction site. Drainage can ensue along with the passage of food and air from the mouth into the sinus.
Root fragments - Occasionally root tips remain after the removal of wisdom teeth. Usually the fragment is close to a nerve or adjacent sinus. Removal of the root tip could jeopardize adjacent structures. The oral surgeon uses his clinical expertise to determine the benefit to risk ratio of removing a root tip. Since root tips uncommonly cause post operative infections or pain, their removal is not an absolute necessity. The fragments can be monitored using x-rays. Fragments can be removed in the future if they become clinically symptomatic.
Jaw fracture - In very rare cases, the removal of a wisdom tooth will weaken the jaw bone. This is due to the obligatory removal of bone to obtain access to the impacted tooth. It is very rare for the jaw to fracture during the removal of a wisdom tooth. It is very rare of the jaw to fracture after the removal of a wisdom tooth due to weakening and chewing normal foods. Your surgeon, however, may indicate that a large amount of bone was removed to gain access to the wisdom tooth. he may recommend the patient avoid eating hard foods which may place undue stress on a weakened jaw.
TMJ pain - Temporomandibular joint dysfunction following the removal of wisdom teeth is also unusual and universally temporary. If treatment is required, it is usually conservative in nature and includes anti-inflammatory medicines, physical therapy and in some cases short term bite splint therapy.