What to do if the gum is swollen after tooth extraction, implantation, inflammation

Gum swelling is one of the most common symptoms of oral pathology. It appears with inflammatory gum diseases, traumatic lesions, dental procedures - and this is only a small list of conditions in which one of the first symptoms is gum swelling. Usually, this sign appears in combination with other symptoms of inflammation, such as redness, pain, local increase in temperature and dysfunction of the affected organ or tissue. Gum swelling can be a reaction to the effects of certain agents, such as high or low temperatures. In this case, with a shallow burn, the swelling, like other symptoms, will go away on their own after a while and there will be no consequences. However, if the lesion is deep, then you will need the help of a specialist who will draw up a treatment plan. Each person needs to understand the reasons for the appearance of a particular type of swelling for an adequate response to the current situation, so this article will discuss the main types of gum swelling, their causes, signs and methods of treating different types of gum swelling.

Causes gingival swelling

With many interventions in the oral cavity, the gums inevitably suffer, which ultimately causes their swelling. The fact is that the gums surround the teeth from all sides and can be injured in one way or another as a result of their treatment, not to mention manipulations on the gums themselves. If the gums are inflamed or bleeding, the doctor will never be able to make a high-quality restoration without removing the inflammation and stopping the bleeding. And vice versa, if the doctor did not remove tartar and did not perform professional hygiene, then in the future, poor hygiene can affect the gums and cause serious diseases. Due to such a close relationship, there are many causes of inflammation and swelling of the gums. All these causes can be conditionally divided into dental, gingival, traumatic, swelling associated with general diseases and those caused by dental interventions.

Dental causes of gum swelling are conditions in which gum inflammation occurs against the background of dental pathology. Inflammation of the ligamentous apparatus of the tooth (periodontitis) causes accumulation of purulent exudate near the apices of the tooth roots. If there is an excessive amount of this exudate, it breaks through the bone tissue and comes out, appearing as a fistula on the gum. Throughout this process, the gum near the diseased tooth is initially red-blue, swollen and painful. After the fistula appears, the pain subsides a little, but the redness and swelling of the gum still remains. If you do not consult a doctor in this situation, then after some time a complication called periostitis (inflammation of the periosteum) will occur. With this complication, pus from the ligamentous apparatus of the tooth moves to the periosteum and the bone itself, causing severe swelling not only of the gum in this area, but also of the mucous membrane of the cheek, lip, etc. A characteristic feature of gum swelling of this disease is its localization only on the outer surface of the bone. But if this disease is not eliminated, osteomyelitis develops - a severe complication of periodontitis of the teeth, in which pus spreads into the bone tissue and destroys it. In the oral cavity, this may look like bilateral gum swelling on the lingual and buccal side of the lower jaw, and on the palatine and buccal side of the upper jaw. Also, this group should include a completely physiological process, namely, teething. In this process, the tooth "makes" its way to the surface of the gum, inevitably injuring it, causing swelling, redness, itching of the gum in the area of the erupting tooth.

Another physiological cause of gum swelling is pregnancy. Everyone knows that during a hormonal surge, some metabolic processes in a pregnant woman's body are disrupted, the body's defenses are weakened, and susceptibility to environmental irritants increases. The gums of the oral cavity react to the increased level of hormones with swelling, redness, and sometimes even an increase in the gingival papillae. This condition is completely reversible and there is no reason to worry. The main thing is to regularly visit a dentist for professional oral hygiene.

Gingival causes of gum swelling are directly related to gum diseases, which include gingivitis and periodontitis. According to statistics, 80% of the world's population suffers from periodontal diseases. With gingivitis, the gum edge becomes bright red and swollen. This situation can be observed both in the area of one tooth and in the area of all teeth or a group of them. With periodontitis, a bluish tint and purulent discharge from the inflamed gums can be added. One of the first signs of gingivitis and periodontitis, which can be noticed by chance at home during daily hygiene is bleeding and swelling of the gums after brushing your teeth.

If such symptoms appear regularly, you should immediately consult a doctor!

Traumatic causes of gum swelling can be caused by trauma to the gum edge with rough or sharp food, such as bones. When trauma occurs, redness and swelling of the damaged area of the gum occurs where contact with a sharp object occurred. Gum trauma can also be caused by acid or alkali, high and low temperatures. Causes of gum swelling associated with general diseases occur against the background of diseases of the body and are only a symptom of this disease in the oral cavity.

Swelling can also occur during dental procedures. After tooth extraction, gum swelling inevitably appears around the socket, which is part of the tissue reaction to the intervention. The size of the swelling depends on the complexity of the extraction and, accordingly, can be either significant or small. A good example is gum swelling after wisdom teeth extraction. Due to the location of the eighth teeth closer to the angle of the jaw and the palate, the swelling after their extraction will affect several anatomical areas and will be noticeable from the outside. Another situation in which gum swelling occurs is implantation. Even if the implant takes root, hyperemia and swelling around the implant will still be observed at first. If the implant does not take root, these symptoms will not disappear and will be accompanied by pain, implant mobility, and others. Gum swelling can also accompany any other manipulations that the doctor performs in the oral cavity. Even cyst removal will be accompanied by gum swelling, since an incision will be made along the transitional fold, after which a hole will be created in the bone with a bur to remove the cyst. All procedures that involve cutting the mucous membrane of the gum will be swollen for a while. Especially if these are surgical operations on the gum itself, which are quite extensive in terms of tissue volume. However, it is worth saying that gum swelling can even be caused by an injection of anesthetic. In any case, if the integrity of the gum is compromised, there will be swelling in this area of tissue, but with the correct technique of anesthesia, it will pass very quickly and will not cause any discomfort.

When treating root canals, both children and adults may experience gum swelling when arsenic anhydride comes into contact with it. It is used to kill the vascular-nerve bundle of the tooth and, if the temporary filling is not hermetically sealed, it may also come into contact with the surrounding tissues of the tooth. In this case, there will be an arsenic burn of the gum, which will be accompanied by hyperemia, swelling and cyanosis.

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Risk factors

Speaking about all the causes of gum swelling, it is important to say that one of the main risk factors is the lack of regular visits to the dentist. After all, no matter how well a person performs oral hygiene, he cannot clean the subgingival area without the help of a dentist. Not to mention monitoring the condition of the teeth, gums and mucous membrane, to prevent many diseases, including those accompanied by gum swelling.

Late visits to the dentist and poor oral hygiene are risk factors that everyone should know. If you experience unusual sensations in the mouth, pain, itching or any external manifestations of the disease, do not waste a minute! It is necessary to see a dentist as soon as possible to avoid the development of the disease or its complications. As for hygiene, the gums are the first organ in the oral cavity that will react to poor hygiene and make itself known with gingivitis or, even worse, periodontitis. Hygiene products and items are important. If they are too aggressive for your oral cavity, this will reduce the defenses and cause serious injury to it. Coarse abrasive pastes, alcohol-containing rinses and hard brushes are typical representatives of undesirable components of your oral care. Or, their use is possible if these products are recommended by your dentist.

The next group of factors consists of nutrition, quality of sleep, work and rest schedule. Of course, it is impossible to always comply with all the points of a healthy lifestyle. But it is worth remembering that irrational nutrition, insufficient sleep and a disturbed schedule significantly affect the decrease in the body's immunity, which will inevitably lead to both general somatic diseases and diseases in the oral cavity. In addition, the issue of nutrition is also relevant, since the use of too aggressive food (spicy, salty, hot, cold) leads to the appearance of traumatic and precancerous diseases.

Trauma is often the cause of gum swelling, and therefore all actions that lead to trauma are risk factors. The habit of biting off tape, tearing floss with teeth, opening bottles with teeth and other similar activities are direct causes of gum swelling when performed regularly. Therefore, in order to avoid serious consequences, it is necessary to remember that all these actions harm the entire dental system and can be performed with the help of other devices, not the oral cavity.

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Pathogenesis

The mechanisms of gum swelling will be considered depending on their etiology. If we consider the dental causes of gum swelling, namely periodontitis with its complications, then the pathogenesis of this condition lies in the spread of infection. The accumulation of purulent contents at the tips of the root canals seeks an outflow and exit to the outside, which can be done by creating a fistula. In this case, naturally, the gum tissues surrounding the fistula are involved in the inflammatory process, become hyperemic, edematous and painful. As soon as the purulent exudate gets to the surface of the gum through the fistula, the pain subsides, hyperemia is replaced by some cyanosis of the gum. At the same time, such a fistula can exist for a long time, creating an outflow of pus, in the case of its formation in the periodontal system and without disturbing its owner. During teething, the mechanism of swelling is trauma. Due to the movement of the erupting tooth from the socket into the oral cavity, it injures and "cuts" the gum tissue. As a result, inflammation of the gum occurs due to the tooth injury, redness, swelling, and soreness of this area. If the tooth has erupted in the correct position and place, all of the above signs are reduced and disappear on their own. Tooth eruption is a physiological process and gum swelling in this particular case is a natural reaction of the gum tissue. Another matter is if the tooth is excessively tilted and erupts in the wrong place, then there is already a danger for the entire dentition and such situations require consultation with several specialists - an orthodontist, a surgeon and a periodontist.

Periodontal diseases and the resulting gum swelling are primarily associated with the impact of microbial agents of dental plaque on the subgingival area. This causes redness, soreness, bleeding and swelling of the gingival margin. The described signs characterize gum inflammation, or gingivitis. However, if the process spreads deeper into the periodontal ligament and periodontitis occurs, the gum becomes red-blue, swollen and bleeding. These diseases can be distinguished with the greatest probability using plain radiography, where changes in bone tissue will be visible.

Manipulations performed by a dentist in the oral cavity are often accompanied by gum swelling, especially during surgical treatment. The mechanism of swelling in this situation is traumatic in nature, because the dissection of the mucous membrane and interventions on it are stress for the tissues of the oral cavity. Post-traumatic inflammation occurs, which includes swelling of the tissues of the entire surgical field and the tissues surrounding it. And the type of surgery in the oral cavity does not matter at all, because in any case, if the integrity of the mucous membrane is violated, such processes will develop. When gum tissue is injured, local reactions are observed such as a local increase in temperature, increased blood flow in the gum tissue, the release of biogenic amines, and increased permeability of the capillary wall. As a result of successive reactions, blood plasma begins to flow through the capillary wall, intercellular substance from the tissue spaces enters, which together create swelling and tissue puffiness.

Thus, it can be said that the mechanisms of gum swelling formation have many similar elements and differ only in the causes of occurrence. After all, in the end, everything leads to inflammation, which results in redness and swelling of the gum. However, it remains important to understand the causes and mechanisms of development for choosing subsequent tactics for treating gum swelling.

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Symptoms gingival swelling

Gum swelling can be localized and generalized. Localized gum swelling is located in the gum area of several teeth and accompanies such diseases as gingivitis, localized periodontitis. Generalized gum swelling is located on the gum in the area of all teeth of the upper or lower jaw and is observed with gingivitis, generalized periodontitis.

Swelling of the gums in different types of diseases can be combined with many symptoms. For example, in periostitis, hyperemia and swelling of the gums from the vestibular surface of the jaw occur, and the cheek or lip is also involved in this process, depending on the localization of the process. In this disease, swelling of the vestibular gum and cheek is an important differential sign that visually allows you to distinguish periostitis from osteomyelitis. The latter disease also has an important difference for differential diagnostics - swelling and redness of the gums from both the vestibular surface of the jaw and the oral surface.

When such a situation is observed in a child, the symptoms of the disease are aggravated by the general condition. When the gums are swollen, the child may have a fever, chills, a sore throat, and even enlarged lymph nodes. Therefore, if the gums are swollen in a child, it is necessary to consult a dentist immediately.

The consequences and complications of gum swelling depend accordingly on the disease that caused this swelling. Although complications are rarely observed specifically gum swelling, there are cases of gum enlargement due to hormonal imbalances or taking medications, or, conversely, a decrease in the amount of gum at the necks of the teeth (gum recession). These complications are not often observed, so it is necessary to simply treat the underlying disease and there will be no problems in the oral cavity.

Diagnostics gingival swelling

Diagnosis of gum swelling is not difficult, because the necessary signs are visible to the naked eye - an increase in gum tissue compared to nearby tissues. Although, to identify the cause of gum swelling, it will be necessary to conduct a series of studies. In diseases of the hard tissues of the oral cavity, the results of intraoral images and the condition of the periapical tissues are important. In periodontal diseases, the dentist conducts a number of clinical tests, in addition to which there is a survey radiography. In case of trauma, one of the main diagnostic points is the presence of trauma to this area. If gum swelling is caused by dental manipulations, it is necessary to start from the procedure itself. In operations, such a situation is considered normal for a certain time after the intervention, but if there are still reasons for concern, you should consult a doctor and share your feelings.

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Differential diagnosis

Differential diagnostics of gum edema should be carried out with diseases of tumor origin. It is also necessary to differentiate gum edema in diseases of teeth, periodontal tissues, in trauma and dental interventions.

Treatment gingival swelling

To treat such a symptom as gum swelling, it is necessary to know the reason for its occurrence and the disease in which it occurs. If gum swelling occurs against the background of periodontitis, it is necessary first of all to take an intraoral X-ray to determine the treatment tactics. If the X-ray picture is favorable, it is important to perform endodontic treatment of the root canals of the tooth with subsequent restoration of the crown. If the picture on the picture is unfavorable, the tooth will be recommended to be removed. In parallel with the treatment of the tooth, rinsing with antiseptic and solutions based on plant components is recommended. If gum swelling occurs during the treatment of pulpitis, in which arsenic anhydride is used, arsenic from the canals may get onto the gum. If this happens, it is necessary to clean the gum as quickly as possible with an antiseptic solution and treat its surface with unithiol or potassium iodide. These substances will neutralize the effect of arsenic on the gum and prevent its further spread. Subsequent treatment consists of rinsing and treating the affected area with keratoplasty.

As a result of orthopedic treatment, installation of crowns, veneers, dentures, the gum may be subject to acute or, more often, chronic trauma. In this case, swelling and hyperemia of the gingival margin, pain in this area appear. Swelling of the gum under the crown may indicate inflammation of the marginal periodontium, accumulation of dental plaque, trauma to the gum by an insolvent crown, etc. In any of these cases, a specialist consultation is necessary. In one case, you can get by with cleaning dental plaque, rinsing and preventing periodontitis. For example, if the gum is swollen under a crown that was recently installed, but preliminary cleaning of the subgingival area was not carried out or the bite height was not checked, then this situation is quite solvable without removing the structure. In other situations, if the gum is swollen and inflamed under the structure, and periodontitis is seen on the X-ray, then it is necessary to remove the structure and make a decision on further treatment of this tooth. There are also cases in which gum swelling occurs as a result of poor-quality construction. When using veneers, it is necessary to remove a very thin layer of hard tissue and create an ideal fit of the veneer to the tooth. This does not always work, and in the case of a broken contact, gum swelling occurs near the gingival area of the veneer. In this situation, it is also necessary to remove the structure, treat the periodontal tissues and choose further tactics.

In case of gum swelling due to periodontitis and gingivitis, it is necessary to urgently consult a doctor to solve this problem. However, if there is no possibility of immediate medical attention, it is possible to relieve gum swelling at home for 1-3 days. Treatment consists of taking painkillers (analgin, diclofenac), anti-inflammatory drugs (nimesil, ibuprofen, celecoxib) and rinsing the mouth with antiseptic solutions (hydrogen peroxide, chlorhexidine), as well as herbal treatment. Decoctions of chamomile, calendula, sage, oak bark, celandine, nettle and others are excellent for this. If gum swelling is combined with pain, suppuration and the appearance of temperature, broad-spectrum antibiotics are prescribed orally. These include lincomycin, augmentin, gatifloxacin, taken for 5-7 days, 1 tablet 2 times a day. Also, anti-inflammatory drugs such as sodium mefenaminate, nimesil, painkillers - citramon, dexalgin, sodium diclofenac are used from drug treatment. Do not forget about general strengthening therapy in the form of vitamin therapy - complexes aevit, supradin, duovit. To stimulate immunity and increase the body's resistance, homeopathic remedies are used, which include lymphomyazot, gastritol traumeel-gel, etc. This group of drugs acts gently on the body due to mini doses. Thus, the accumulation of the effect of these drugs is produced and it is possible to evaluate their effectiveness after several months. Also, with gum swelling, which is part of the inflammatory process, physiotherapy is actively used, namely UHF therapy during an exacerbation. Fluctuation, darsonvalization, vacuum therapy and light therapy are used in the final stages of treatment and during remission to prevent exacerbations.

The presented drug therapy can remove gum swelling, redness, relieve pain and eliminate pus, but this is not always enough. In such cases, surgical treatment of gum swelling is used. This can be gum trimming (gingivotomy), gum removal (gingivectomy) and, of course, plastic surgery (gingivoplasty). The methods of treating periodontal tissues are very diverse and swelling, as a component of gum disease, will be eliminated by the presented surgical treatment methods.

Prevention

Prevention of gum swelling depends on the cause and mechanisms of its occurrence. Although oral hygiene and regular examination by a specialist play a decisive role in many situations, each situation should be considered individually.

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Forecast

The prognosis for gum swelling depends on the disease it is a part of. In case of periodontitis and gingivitis, the prognosis is favorable due to the treatment of the underlying disease, after which the swelling will go away on its own. But in case of periodontitis, the prognosis is relatively favorable, since it is a chronic recurrent disease and if an exacerbation occurs, the swelling will appear again. In the case of surgical manipulations, in the absence of complications, gum swelling resolves 5-7 days after the operation. If we are talking about orthopedic treatment, then when the structure is removed, the gum and tooth are treated, the swelling will be eliminated. Due to the fact that gum swelling symbolizes an inflammatory process, it is much easier to cope with it when treatment begins immediately. Therefore, contacting a dentist and following all recommendations often guarantees a successful recovery.

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