Post-Wisdom Tooth Extraction Healing and Gum Inflammation

It has been almost two months since my wisdom tooth extraction, and the gum has only healed halfway. Additionally, the gums around my premolars frequently become inflamed?

Hello, Doctor! I'm really going crazy with this wisdom tooth cavity and the issues with my molars! It's been over a month since I had my tooth extracted, and every day I feel swollen and numb.
I’ve been to the clinic, and they say everything is fine.
I had a few cavities filled and was told to monitor the situation.
I went back to the hospital twice in between, and the doctors said that some tissue is starting to grow back, and I just need to maintain cleanliness.
The swelling and numbness are due to inflammation from not cleaning the area behind my molars properly.

In mid-January, I returned to the hospital, and the doctor prescribed medication for three days, but the symptoms returned after just a few days.
After the Lunar New Year, I went back to the clinic, and the doctor mentioned that it has been over a month and recovery is quite slow.
Recently, I went back to the hospital for two consecutive days.
The previous doctor noted that half of the tissue has grown back, and the swelling is indeed due to the area behind my molars not being cleaned properly.
Since my upper left wisdom tooth was extracted, I no longer have any nerves there, just some capillaries, so I was sent home after a brief cleaning.
The next day, I still had some swelling (but no numbness), so I returned to see the original doctor who performed the extraction.
His assessment was the same, but this time he cleaned the area more thoroughly… he slightly lifted the gums behind the molar to clean it.
It didn’t take long before I noticed a metallic taste, and the doctor said that was due to the areas I hadn’t cleaned properly (I had just been to the clinic for cleaning over two weeks ago).
After the appointment, I rushed to the pharmacy to buy the necessary tools, and after eating… cleaning was really tough! I used interdental brushes, dental floss, and mouthwash, but I’m not sure if it’s truly clean.
The doctors have advised me to observe for another month to see if the swelling persists.
The cavities have already been filled and are not painful, so there’s no need for root canals for now.
Even if I do get a root canal, if I don’t clean properly, the gums will still swell and feel numb… (I’ve been numb for almost two months, thinking it was due to the cavity, which has made me anxious and caused gastrointestinal discomfort, leading me to see a gastroenterologist!).
I’ve read many experiences, and not everyone heals within one to two months; most take about three to six months.
It’s been two months, and I’ve only grown half of the tissue back, so it will likely take another four to five months or more to fully heal.
If I don’t clean properly and get inflammation again, I’ll need to return to the doctor for cleaning! I really want to ask the doctor about using "collagen," but the doctors say that since the tissue has already grown back, it can't be placed now; it should have been done immediately after extraction.
If I want to use it now, I would have to cut open the newly grown tissue to insert it and then stitch it back, which means I’d have to start all over again.

Three months will pass quickly, and the hospital doctor said that the tissue inside the cavity has leveled out and the bone is healing as well.
Now we just need to wait for the tissue to grow out and integrate with the bone.
I’m really worried this will take a long time (I recently asked my brother about his friend who had a tooth extracted last year, and it took several months to heal).
So, is my recovery speed considered normal or slow? Sometimes when I talk a lot, I feel swelling again, and the doctors say it’s really not a wound issue; it’s still due to not cleaning the front area properly… I’ve been to the pharmacy two or three times, and I’ve done my best with what I can use.
Can I use what the pharmacist suggested, like "oral propolis spray" to kill bacteria and promote wound healing? That stuff is really expensive… For regular skin injuries, there are ointments available, but after tooth extraction, it seems I can only rely on cleanliness? Are there any other methods to enhance the healing of the cavity? I’m afraid I’ll soon need to see the doctor for cleaning again; I can’t see that area and can only rely on touch to clean it, but I always feel like it’s not clean enough and I’m worried about injuring the cavity inside…

ken, 40~49 year old female. Ask Date: 2016/02/17

Dr. Zeng Guanghui reply Dentistry

The situation described may be due to inflammation of the extraction site or inflammation of the molar in front of the wisdom tooth.
The prolonged swelling and numbness could be attributed to a larger extraction wound or a wound that is close to the maxillary sinus, increasing the risk of infection and slowing the healing process.
Generally, it takes about 2-3 months for the extraction site to fully heal after wisdom tooth removal.
Regardless, after tooth extraction, it is essential to maintain good oral hygiene.
Regular use of a toothbrush and dental floss, along with the adjunctive use of mouthwash for oral disinfection, can help ensure that the mouth is kept clean, which in turn facilitates smoother healing of the wound.

Reply Date: 2016/02/17

More Info

After wisdom tooth extraction, it is common to experience a range of symptoms, including swelling, discomfort, and the sensation of a "hole" where the tooth was removed. The healing process can vary significantly from person to person, and it is not unusual for some individuals to feel that their recovery is taking longer than expected. In your case, it seems that you have been experiencing persistent swelling and discomfort for over a month, which can be frustrating and concerning.

Firstly, it is important to understand that the healing of the gum tissue and bone after a tooth extraction, especially for wisdom teeth, can take several weeks to months. The initial healing phase typically involves the formation of a blood clot, which is crucial for the healing process. Over time, this clot is replaced by granulation tissue, which eventually matures into healthy gum tissue. The timeline for this process can vary, but it is generally expected to take anywhere from 4 to 6 weeks for the initial healing, with complete healing potentially taking several months.

The sensation of swelling and discomfort you are experiencing may be attributed to several factors. One common issue is the presence of food particles trapped in the extraction site or around adjacent teeth, which can lead to inflammation and discomfort. Maintaining excellent oral hygiene is critical during this period. Using a soft-bristled toothbrush, gentle flossing, and possibly an interdental brush can help keep the area clean. Additionally, rinsing with warm salt water can aid in reducing inflammation and promoting healing.

You mentioned that your dentist has indicated that the swelling is likely due to the adjacent molar not being cleaned properly. This is a valid concern, as food debris can lead to gum irritation and inflammation. It is essential to follow your dentist's advice regarding cleaning and to return for follow-up visits if you continue to experience discomfort.

Regarding the use of topical agents like propolis spray, while some studies suggest that certain natural products may have antimicrobial properties and could potentially aid in healing, it is essential to consult with your dentist before introducing any new products into your oral care routine. They can provide guidance on whether such products are appropriate for your situation and if they might interact with any ongoing treatments.

As for your concern about the healing speed, it is not uncommon for individuals to experience variations in healing times. Factors such as age, overall health, smoking habits, and adherence to post-operative care instructions can all influence recovery. Smoking, in particular, can impede healing and increase the risk of complications, so reducing or quitting smoking can be beneficial for your oral health.

If you find that the discomfort persists or worsens, or if you notice any signs of infection (such as increased redness, swelling, or discharge), it is crucial to seek further evaluation from your dentist. They may need to clean the area more thoroughly or assess for any underlying issues that could be contributing to your symptoms.

In summary, while your experience of prolonged discomfort and swelling after wisdom tooth extraction is not uncommon, it is essential to maintain good oral hygiene, follow your dentist's recommendations, and seek further evaluation if necessary. Healing takes time, and with proper care, you should see improvement in the coming weeks.

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