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

Gingival edema is one of the most common symptoms in the pathology of the oral cavity. It appears with inflammatory diseases of the gums, with traumatic lesions, with dental manipulations - and this is only a small list of conditions in which one of the first symptoms is swelling of the gum. Usually, this symptom appears in combination with other symptoms of inflammation, such as redness, pain, local fever, and impaired function of the affected organ or tissue. Gingival swelling can be a reaction to the effect of any agents, for example, high or low temperatures. In this case, with a shallow burn edema, like other symptoms after a while will go away by themselves and there will be no consequences. However, if the lesion is deep, then it will take the help of a specialist who will draw up a treatment plan. Everyone needs to understand the reasons for the appearance of a particular type of edema for an adequate response to the current situation, therefore this article will consider the main types of edema of the gum, their causes, signs and methods of treating various types of edema of the gum.

Causes of the edema of the gum

With many interventions in the oral cavity, the gum inevitably suffers, which eventually causes her swelling. The fact that the gum surrounds the teeth from all sides and in one way or another can be traumatized as a result of their treatment, not to mention manipulation on the gum itself. If the gum is inflamed or bleeding, the doctor will never be able to make a qualitative restoration without removing the inflammation and stopping the bleeding. Conversely, if the doctor did not remove tartar and did not conduct professional hygiene, in the future poor hygiene can affect the gum and cause serious illness. Due to this close relationship, there are many causes of inflammation and swelling of the gums. All these reasons can be conditionally divided into dental, gingival, traumatic, edema associated with common diseases and those caused by dental interventions.

Dental causes of the gingival edema are the conditions under which gum disease arises against a background of dental pathology. With inflammation of the ligamentous apparatus of the tooth (periodontitis), a purulent exudate accumulates near the tips of the roots of the tooth. With an excessive amount of this exudate, it breaks the bone tissue and comes out, appearing fistula on the gum. Throughout this process, the gum near the aching tooth is red-blue at first, swollen and painful. After the appearance of the fistula, the pain subsides a little, but the redness and swelling of the gum still remains. If in this situation do not go to the doctor, then after a while there will be a complication called periostitis (inflammation of the periosteum). In this complication, the pus from the ligamentous apparatus of the tooth advances to the periosteum and the bone itself, with a strong edema not only of the gums of this zone, but also of the mucous membrane of the cheek, lips, etc. A characteristic feature of the gingival edema of this disease is its localization only from the outer surface of the bone. But if not to eliminate this disease, osteomyelitis develops - a serious complication of periodontitis of the teeth, in which pus spreads into bone tissue and destroys it. In the oral cavity it can look like a bilateral swelling of the gums with the lingual and buccal side on the lower jaw, and with the palatine and buccal side on the upper jaw. Also in this group should be attributed completely physiological process, namely - teething. With this process, the tooth "paves" its way to the surface of the gums, inevitably injuring it, causing swelling, redness, itching of the gums in the region of the erupting tooth.

Another physiological cause of gingival edema is pregnancy. Everyone knows that during a hormonal outbreak, some metabolic processes are violated in the body of a pregnant woman, the defenses of the body are weakened and susceptibility to the action of irritating environmental factors is increased. The gums of the oral cavity react to an increased level of hormones with swelling, redness, and sometimes even an increase in the gingival papillae. This state is completely reversible and there is no reason for excitement. The main thing is to visit the dentist regularly for professional oral hygiene.

Gingival causes of gingival edema are directly related to gum disease, which includes gingivitis and periodontitis. According to statistics, 80% of the world's population suffers from periodontal disease. With gingivitis, the gingival margin becomes bright red and swollen. This situation can be observed both in the area of one tooth, and in the field of all teeth or their groups. With periodontitis, cyanotic shade and suppuration from the inflamed gingiva may be added. One of the first signs of gingivitis and periodontitis, which can be seen accidentally at home during daily hygiene - bleeding and swelling of the gums after brushing your teeth.

With the regular occurrence of such symptoms it is worth immediately contacting your doctor!

The traumatic causes of the gingival edema can be caused by a trauma of the gingival margin with coarse or spicy food, for example, bones. In case of trauma, reddening and swelling of the damaged gum area, where there was a contact with a sharp object. Also, gum trauma can be caused by acid or alkali, high and low temperature. The causes of gingival edema associated with common diseases occur against the background of diseases of the body and are only a symptom of this disease in the oral cavity.

Also, edema can occur with dental manipulation. After the extraction of the teeth around the hole inevitably there is a swelling of the gums, which is part of the reaction of the tissues to the performed intervention. The size of the edema depends on the complexity of the removal and, accordingly, can be either significant or small. A case in point is the swelling of the gums after the removal of wisdom teeth. By placing the eighth teeth closer to the angle of the jaw and palate, the edema after removal will affect several anatomical areas and will be visible from the outside. Another situation in which there is swelling of the gums is implantation. Even if the implant gets accustomed, then initially there will be hyperemia and swelling around the implant. If the implant does not survive, these symptoms will not disappear and pain, implant mobility, and others will add to them. Gingival swelling can accompany any other manipulations that the doctor conducts in the oral cavity. Even removal of the cyst will be accompanied by swelling of the gums, since a cut will be made along the transitional fold, after which a hole will be created in the bone to remove the cyst. All procedures for which a section of the mucous membrane of the gums is performed will be swollen for some time. Especially if it is surgery on the gum itself, which is quite extensive in terms of tissue volume. However, it is worth saying that swelling of the gums can cause even an injection of anesthetic. In any case, if the integrity of the gums is broken in this area of the tissues, there will be swelling, but with the correct technique of anesthesia it will pass very quickly and will not cause any discomfort.

When treating the root canals in both children and adults, there can be swelling of the gums when it gets arsenic anhydride. It is used to kill the neurovascular bundle of the tooth and, with a leaky temporary filling, can reach the surrounding surrounding tissue. In this case, it will burn the gums with a mouse, which will be accompanied by hyperemia, swelling and cyanosis.

[1], [2], [3]

Risk factors

Speaking about all the causes of gingival edema, 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 does not conduct hygiene of his oral cavity, he can not clean the subgingival zone without the help of a dentist. Not to mention the observation of the condition of the teeth, gums and mucous membrane, to prevent many diseases, including those accompanied by swelling of the gums.

Late referral to the doctor and unsatisfactory oral hygiene are the risk factors that everyone should know. If there are unusual feelings in the oral cavity, pain, itching or some external manifestations of the disease, you can not lose a minute! It is necessary as soon as possible to get an appointment with a dentist, in order to avoid the development of the disease or its complications. As for hygiene, the gum is the first organ in the oral cavity that will react to poor hygiene and will cause gingivitis or, worse, periodontitis. Means and objects of hygiene are of great importance. If they are too aggressive for your oral cavity, it will reduce the defenses and cause serious injury. 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 tools are recommended by your dentist.

The next group of factors consists of nutrition, sleep quality, work and rest. Of course, it is impossible to always correspond to all the points of the right way of life. But it is worth remembering that inadequate nutrition, insufficient sleep and disturbed mode significantly affect the reduction of the body's immunity, which inevitably leads to both obscheomatic diseases and diseases in the oral cavity. In addition, the issue of nutrition is also relevant, since the use of too aggressive food (acute, salty, hot, cold) leads to the appearance of traumatic and precancerous diseases.

Injuries are often the cause of gingival edema, and therefore all actions that lead to injuries are risk factors. The habit of biting scotch, tearing the teeth with a teeth, opening bottles with teeth and other occupations of this kind are the direct causes of gingival edema when they are regularly performed. Therefore, in order to avoid serious consequences, it must be remembered that all these actions harm the entire dental system and can be performed with other devices, not the oral cavity.

[4], [5]

Pathogenesis

Mechanisms of gingival edema will be considered depending on their etiology. If we consider the dental causes of gingival edema, namely periodontitis with their complications, the pathogenesis of this condition is the spread of the infection. The accumulation of purulent contents at the tips of the root canals looks for outflow and outlet to the outside, which can be done by creating a fistulous course. At the same time, naturally, the surrounding gingiva tissues are involved in the inflammatory process, become hyperemic, edematous and painful. Once the purulent exudate enters the gum surface through the fistulous course, the pain subsides, the hyperemia is replaced by some cyanotic gum. In this case, such a fistulous course 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 host. When teething, the mechanism of edema formation is a trauma. Due to the movement of the erupting tooth from the hole into the oral cavity, it traumatizes and "cuts" the gum tissue. As a result, there is inflammation of the gums due to a tooth injury, redness, swelling, tenderness of the area. If the tooth is cut in the correct position and place, all of the above signs decrease and disappear on their own. Teething is a physiological process and swelling of the gums in a particular case is a natural reaction of the gum tissue. Another thing, if the tooth is excessively inclined and erupted in its place, then there is a danger for the entire dentition and such situations require the consultation of several specialists - orthodontist, surgeon and periodontist.

Periodontal disease and the resulting swelling of the gums associated primarily with the effect of microbial agents of the dental plaque on the subgingival region. Due to this, redness, soreness, bleeding and swelling of the gingival margin appear. The described signs characterize the inflammation of the gum, or gingivitis. However, if the process spreads deeper into the periodontal ligament and parodontitis occurs, the gingiva becomes red-cyanotic, swollen and bleeding. To distinguish these diseases with the greatest probability it is possible with the help of an overview radiography, where changes in bone tissue will be visible.

Manipulations performed by the dentist in the oral cavity are often accompanied by swelling of the gums, especially during surgical treatment. The mechanism of edema formation in this situation has a traumatic nature, because the dissection of the mucosa and the interference on it are stress for the tissues of the oral cavity. There is posttraumatic inflammation, which includes swelling of the tissues of the entire operating field and the tissues surrounding it. And there is no significance to the type of operation in the oral cavity, because in any case, if the mucosal integrity is violated, such processes will develop. When injuring the gum tissue, local reactions such as a local increase in temperature, increased blood flow of gum tissues, release of biogenic amines, and an increase in the permeability of the capillary wall are observed. As a result of successive reactions through the wall of the capillaries, blood plasma begins to flow, the intercellular substance enters from the tissue spaces, which together create puffiness and swelling of the tissues.

Thus, it can be said that the mechanisms of edema of the gingiva have many similar elements and differ only in the causes of their origin. After all, in the end everything leads to the onset of inflammation, which causes redness and swelling of the gums. However, it is important to understand the causes and mechanisms of development for choosing the next tactic for treating gingival edema.

[6], [7], [8], [9]

Symptoms of the edema of the gum

Swelling of the gums may be localized and generalized. Localized gingival edema is located in the gum area of several teeth and accompanies such diseases as gingivitis, localized periodontitis. Generalized gingival edema is located on the gum in the region of all teeth of the upper or lower jaw and is observed with gingivitis, generalized periodontitis.

Gingival swelling in various types of diseases can be combined with a variety of symptoms. For example, with periostitis, there is hyperemia and swelling of the gums from the vestibular surface of the jaw, and also the cheek or lip is involved in this process, depending on the localization of the process. With this disease, edema of the vestibular gum and cheeks is an important differential feature that visually distinguishes periostitis from osteomyelitis. The latter disease also has an important difference for differential diagnosis - puffiness and redness of the gums both from the vestibular surface of the jaw, and with the oral.

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

The consequences and complications of the gingival edema depend on the disease that caused the edema, respectively. Although complications rarely occur specifically gum edema, there are cases of gum enlargement with hormonal failures or medication, or vice versa, a decrease in the number of gums in the neck of the teeth (gum recession). These complications are not observed often, so you just need to treat the underlying disease and there will be no problems in the oral cavity.

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Diagnostics of the edema of the gum

Diagnosis of the gingival edema does not cause complications, because the necessary signs can be seen with the naked eye - the increase in gingival tissue compared with a number of located tissues. Although, to identify the cause of edema of the gums, it will be necessary to perform a series of studies. In cases of oral tissue diseases, the results of intraoral shots and the state of periapical tissues are important. With periodontal disease, the dentist performs a number of clinical trials, in addition to which there is an overview radiography. In case of trauma, one of the main diagnostic points is the presence of trauma in this area. If the swelling of the gum is caused by dental manipulation, it is necessary to start from the procedure itself. In operations such a situation, a certain time after the intervention is considered the norm, but if there are still reasons for concern, it is worthwhile to see a doctor and share your feelings.

[11], [12], [13]

Differential diagnosis

Differential diagnosis of gingival edema should be carried out with diseases of tumor origin. And also it is necessary to differentiate the gingival edema with diseases of the teeth, periodontal tissues, with injuries and dental interventions.

Treatment of the edema of the gum

To treat such a symptom as swelling of the gums, you need to know the cause of its appearance and the disease in which it is included. When gum edema appears against the background of periodontitis, it is first of all necessary to take an intraoral image to determine the tactics of treatment. With a favorable picture of the X-ray of the image, it is important to carry out endodontic treatment of the root canals of the tooth with subsequent restoration of the crown. If the picture is unfavorable, the tooth will be advised to be removed. In parallel with tooth treatment, it is recommended to rinse with antiseptic and solutions based on herbal components. If there is gingival edema during the treatment of pulpitis, which uses arsenic anhydride, it is possible to get arsenic from the channels to the gum. If this happens it is necessary to clean the gum as soon as possible with an antiseptic solution and treat its surface with unithiol or potassium iodide. These substances will neutralize the action of arsenic on the gum and prevent its further spread. The subsequent treatment consists of rinsing and treating the affected area with keratoplastics.

As a result of orthopedic treatment, setting crowns, veneers, prostheses, gums may be subjected to acute or, most often, chronic trauma. In this case there is swelling and hyperemia of the gingival margin, pain in this area. Edema of the gingiva under the crown may indicate the inflammation of the marginal periodontal, accumulation of dental deposits, gum trauma with an inconsistent crown, etc. In any of these cases, specialist consultation is necessary. In one case, you can do with cleaning the dental deposits, rinsing and preventing periodontitis. For example, if the gingiva is swollen under a crown that was recently placed, but did not perform a preliminary cleaning of the subgingival region or did not check the height of the occlusion, then this situation can be solved without removing the structure. In other situations, if the gingiva is swollen and inflamed, and the periodontitis is on the X-ray, then it is necessary to remove the structure and make a decision about further treatment of this tooth. There are also cases in which the swelling of the gum appears as a result of a poor-quality design. When prosthetics with veneers, it is necessary to remove a very thin layer of hard tissues and create an ideal fit of the veneer to the tooth. Not always it turns out, and in case of the broken contact there is a swelling of a gum or gingiva near pridevnevoj areas of a veneer. In this situation, it is also necessary to remove the structure, treat the periodontal tissue and choose further tactics.

In case of gingival edema in periodontitis and gingivitis, you should urgently consult a doctor to solve this problem. However, if there is no immediate access to a doctor, you can remove the swelling of the gums at home for 1-3 days. Treatment is reduced to taking analgesics (analgin, diclofenac), anti-inflammatory drugs (nimesil, ibuprofen, celecoxib) and rinsing the mouth with antiseptic solutions (hydrogen peroxide, chlorhexidine), as well as herbal treatment. To do this, perfect broths of chamomile, calendula, sage, oak bark, celandine, nettle, and others. When combined with the gingival edema with pain, suppuration and the appearance of temperature, antibiotics of a wide spectrum of action are prescribed inside. These include lincomycin, augmentin, gatifloxacin, taken within 5-7 days of 1 tablet 2 times a day. Also of the drug treatment, anti-inflammatory drugs are used, such as sodium mephenaminate, nimesil, anesthetics - citramone, dexalgin, diclofenac sodium. Do not forget about b fortified therapy in the form of vitamin therapy - complexes aevit, supradin, duovit. To stimulate immunity and increase the resistance of the body use homeopathic remedies, which include limfomiazot, gastritol traumeel-gel, etc. This group of drugs act gently on the body thanks to mini doses. Thus, the effect of these drugs is accumulated and their effectiveness can be estimated after several months. Also, with swelling of the gums, which is part of the inflammatory process, physiotherapy is actively used, namely uv therapy in the period of exacerbation. Fluctuarization, darsonvalization, vacuum-therapy and light therapy are used at the final stages of treatment and during remission to prevent exacerbations.

Presented drug therapy can remove swelling of the gums, redness, stop pain and eliminate pus, but this is not always enough. In such cases, resort to surgical treatment of gingival edema. It can be and pruning the gums (gingivotomy), and removing it (gingivectomy) and of course plastic (gingivoplasty). Methods of treatment of periodontal tissues are very diverse and edema as a component of gum disease will be eliminated by the presented methods of surgical treatment.

Prevention

Prevention of gingival edema depends on the cause and mechanisms of its occurrence. Although for many situations the decisive role is played by sanation of the oral cavity and regular examination by a specialist, each situation should be considered individually.

[14], [15], [16], [17]

Forecast

The prognosis of the gingival edema depends on the disease in which it is included. With periodontitis and gingivitis prognosis favorable due to the treatment of the underlying disease after which the swelling will go away by itself. But with parodontitis the prognosis is relatively favorable, since this is a chronic relapsing disease and if there is an exacerbation, there will also be an edema again. In the case of surgical procedures, in the absence of complications, the swelling of the gum is resolved 5-7 days after the operation. If it is a question of orthopedic treatment, then when the structure is removed, the gums and teeth are treated, edema will be eliminated. Due to the fact that the swelling of the gums symbolizes the inflammatory process, it is much easier to cope with it, when the treatment begins immediately. Therefore, access to the dentist and the implementation of all the recommendations often ensures a successful recovery.

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