Concerns About Persistent Lump After Wisdom Tooth Extraction: What to Do?

Q: Concerns About Persistent Lump After Wisdom Tooth Extraction: What to Do?

Hello： Regarding your questions, here are my suggestions. <br><br>Q： 1) What should I do next? Should I return to the medical center for drainage? Can medication speed up the disappearance of the lump? <br>A： (1) You need to return to the oral surgery (dentistry) department to mo

I'm concerned about a hard lump that hasn't gone away for a long time after having my wisdom teeth removed?

Hello Dr.
Chiu, I had my lower right wisdom tooth extracted at the clinic on February 22.
After the extraction, my cheek was very swollen.
By March 18, the swelling had decreased, but it was still quite noticeable (the pain only occurs when I open my mouth wide).
During this period, I did not experience any fever, headache, or other symptoms.
On the same day, I received a referral to a medical center for drainage (but no drainage tube was placed; the doctor said the extraction was done beautifully based on the X-ray, and I wondered why it was so swollen).
By March 31, the swelling had significantly reduced to a hard lump about the size of a one-dollar coin (it is very hard, and the skin still shows a faint red mark).
It does not hurt when I open my mouth wide or press on it.
Although it is not painful and does not interfere with my daily life (I just pretend it doesn't exist), I am still a bit worried because it has been 23 days since March 31, and it feels like it is neither disappearing nor getting smaller—just a slight feeling that it might be smaller, but not noticeably so (it even seems like it might just be a psychological effect).
Therefore, I would like to ask Dr.
Chiu: 1) What should I do next? Should I return to the medical center for drainage again? Can medication help speed up the disappearance of the lump? 2) Are there any methods I can try at home (such as warm compresses or massage) to help the lump dissolve faster? 3) Can you tell me what the lump might be? (pus, blood, or something similar) 4) My biggest concern is whether the lump will ever go away completely.
Thank you, doctor.

Mingming, 20~29 year old female. Ask Date: 2024/04/23

Dr. Qiu Qiongyao reply Dentistry

Hello: Regarding your questions, here are my suggestions.

Q: 1) What should I do next? Should I return to the medical center for drainage? Can medication speed up the disappearance of the lump?
A: (1) You need to return to the oral surgery (dentistry) department to monitor the healing of the wound.
(2) Drainage is performed only if there is an abscess; if you do not have an abscess, drainage is not necessary.
(3) Based on your description, there seems to be inflammation of the wound, so medication typically needs to be taken for about a month, along with regular follow-up visits for wound cleaning and monitoring of the healing process.
Q: 2) Are there any methods I can use at home (such as warm compresses or massage) to help the lump disappear faster?
A: It is recommended to apply warm compresses.
Q: 3) Dr.
Qiu, can you tell me what the lump might be? (pus, blood, etc.)
Q: 4) My biggest concern is whether the lump will never go away.

A: For questions three and four, it is advisable to continue follow-up visits to the dental oral surgery department for monitoring and examination.
The Hualien Hospital of the Ministry of Health and Welfare cares about your health.

Reply Date: 2024/04/23

More Info

After wisdom tooth extraction, it is not uncommon for patients to experience swelling and the formation of lumps in the area where the tooth was removed. Your concerns about the persistent lump following your extraction on February 22 are valid, and it’s important to address them with a comprehensive understanding of the healing process and potential complications.

1. What to Do Next: Given that the lump has persisted for over three weeks and has not significantly changed in size, it would be prudent to return to the medical center for a follow-up evaluation. The healthcare provider can assess the lump through physical examination and possibly imaging studies, such as X-rays, to determine its nature. If there is any suspicion of an abscess or other complications, they may recommend drainage or further treatment. Medications such as anti-inflammatories or antibiotics may be prescribed if an infection is suspected.

2. Home Remedies: While waiting for your follow-up appointment, there are some home remedies you can try to alleviate discomfort and possibly promote healing. Warm compresses applied to the area can help reduce swelling and improve blood circulation, which may aid in the healing process. However, be cautious not to apply excessive heat or pressure. Gentle massage around the area, if comfortable, may also promote circulation, but avoid direct pressure on the lump itself.

3. Nature of the Lump: The lump you are experiencing could be a few different things. It might be a hematoma, which is a localized collection of blood outside of blood vessels, or it could be a seroma, which is a collection of fluid that can occur after surgery. In some cases, it could also be a residual piece of tissue or bone that has not fully healed. If the lump is hard and not painful, it is less likely to be an infection, but it is essential to have it evaluated by a professional to rule out any complications.

4. Will the Lump Ever Go Away?: It is understandable to worry about the lump becoming a permanent fixture. In many cases, lumps that form after dental procedures do resolve over time as the body heals. However, the duration of healing can vary significantly from person to person. Factors such as your overall health, the complexity of the extraction, and adherence to post-operative care instructions can all influence healing time. If the lump does not resolve or continues to cause concern, further intervention may be necessary.

In summary, while it is common to have some swelling and lumps after wisdom tooth extraction, persistent lumps warrant further investigation. It is advisable to consult with your dentist or oral surgeon to ensure proper healing and to address any concerns you may have. They can provide tailored advice and treatment options based on your specific situation. Remember to maintain good oral hygiene and follow any post-operative care instructions provided by your healthcare provider to facilitate healing.

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