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Old 07-05-2019, 07:12 PM #1
apalooza apalooza is offline
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Confused Swollen gums days after full upper extractions

I had ten upper teeth extracted June 27th. My question is this, I am on day 8 post procedure. My gums both in front of extraction sites and behind are still quite uncomfortably swollen and tight though not really painful. It is giving me major anxiety and panic attacks. Is this swelling normal? I do not know how much longer I can take this perpetual state of anxiety.
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Old 07-05-2019, 10:41 PM #2
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Hi apalooza,

Yes, with some patients it is typical for there to be significant swelling for several days after 10 teeth are extracted in the same arch and on the same day.

Do you have any autoimmune disorders? Diabetes, Celiac, Sjogren Syndrome, Lupus, Crohns, etc?

Did the dentist place any bone grafts? Did he suture the wounds closed?

Do you have any remaining teeth in your upper arch?
Are you wearing a full upper or partial denture? If so, how often are you wearing it? Are you keeping it clean without using chemical cleaners?

Are you eating hard or chewy foods?

Do you smoke? If so, you should know that the chemicals in the tobacco will increase the swelling of the tissue and could prolong the healing.

Do you drink alcohol? If so, you should know that the alcohol is very irritating to the gum tissue and will cause it to dry out and swell.

Are you rinsing with warm salt water 3-4 times a day? This is imperative and should be done until the wounds close completely.

Are you running a fever? Are you on antibiotics?

As I said, significant swelling is typical. However, some of the things I have mentioned can contribute to the swelling and prolong the healing.

When are you due to go back for a post operative check with the dentist?

Bryanna





Quote:
Originally Posted by apalooza View Post
I had ten upper teeth extracted June 27th. My question is this, I am on day 8 post procedure. My gums both in front of extraction sites and behind are still quite uncomfortably swollen and tight though not really painful. It is giving me major anxiety and panic attacks. Is this swelling normal? I do not know how much longer I can take this perpetual state of anxiety.
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***I have been in the dental profession for 4 decades. I am an educator and Certified Dental Assistant extensively experienced in chair side assisting and dental radiography. The information that I provide here is my opinion based on my education and professional experience. It is not meant to be taken as medical advice.***
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Old 07-06-2019, 01:00 PM #3
apalooza apalooza is offline
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Bryanna, To answer your questions, No I do not have any remaining teeth on the same arch. I was a smoker but I have not smoked since the day of my extractions. I do not know if i am diabetic but most likely am. I had a bad soda habit which I also quit the day of my extractions. I do have dry mouth and dry eyes but never dx with anything.My mouth (and eyes) have been so dry at night I wake up with my tongue stuck to my gums I think i may have un-diagnosed Sjogren Syndrome. I dont know what to do. My oral surgeon is no help to me. All he told me is to come back in 2 weeks. I am not wearing any dentures because when the oral surgeon did my extractions there was sinus communication so they said my immediates were a no go. So now i do not know when I will even get teeth state insurance will not pay for another set. They will have to make the immediates work... There were no bone grafts I am not eating hard or chewy food, actually I am hardly eating I do drink ensure and boost. I have been rinsing a lot with salt water but have cut it down ..it was way more than 4 times a day. I thought it may contribute to my slow heal/ dry mouth. I feel like as long as I am laying down, The swelling goes down a little idk cuz im losing it here. I do have panic disorder, I also tend to get a lot of panic attacks when ever I am sick but this teeth thing is the worst. I have dental phobia I went into this with massive anxiety with no help from oral surgeon. he would not even give me meds for anxiety prior to procedure and afterward sent me home on tramadol for pain which sucks. Im lost in this panic idk what to do. My next step will be ER I cant take it anymore.
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Old 07-06-2019, 07:42 PM #4
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Hi Apalooza,

Okay, I understand your heightened anxiety over this dental event. It is common for people to feel anxious and worried about the whole process and to be very concerned about what the future holds after the swelling goes down.

The immediate denture is meant to be worn immediately after the extractions. I am uncertain as to why the oral surgeon suggested that you not wear it. Unless you had infection in your sinuses and he wanted that to drain through the sinus exposures? But not wearing it is likely one reason why you have so much swelling, it's not the only reason, but one of them. Nothing you can do about that now and I would suggest that you not worry about it. Get through the healing phase first. It may be possible to modify the denture so it fits.

The fact that you smoked up until the day you had the extractions is a factor in what is happening post operatively. It is great that you stopped and hopefully you will never smoke again. However, when a person stops smoking their oxygen level increases and the gum tissue can become saturated with oxygen. This can plump up the gums and you may even notice they bleed sometimes, but the inflammation will dissipate. Your body is trying to detox from the chemicals in the cigarettes.

By any chance are you chewing tobacco?
What are you doing to deal with the nicotine withdrawal?

Dry eyes are often allergy related, even to things like dust mites or pet dander. It could also be a sign of dehydration. Get some eye drops for Dry Eyes to help lubricate them. Use them just before you go to sleep at night and again in the morning. See if that helps.

A dry mouth is typical for a smoker, even after they stop smoking. It is also typical for someone who has had a lot of extractions at one time. But this could also be due to dehydration and/or poor diet one that is high in sugar, carbs or starch. Can you eat fruit? Blend or puree it?

Your mouth has gone through a lot with just 10 extractions. Add to that the recent smoking habit which you stopped just prior to the surgery. So you have a lot of healing that needs to happen, more so than someone who didn't smoke.

Use the salt water rinses no more than 3-4 times a day. Put a dash of salt in a 3-5 oz cup of warm water and rinse until the cup is empty.

Eating solid foods can be difficult and irritating to the wounds. So drink your food as much as possible. But is it possible for you to puree food in a blender or make home made shakes or smoothies that are healthy? Ensure and boost are loaded with preservatives and sugars... not healthy drinks :-(

It's great that you cut out soda... another habit that hopefully you won't go back to. If you think you are diabetic, it would be wise to have your dr do some blood work for that.

One excellent way to promote healing and eliminate toxins from the body is to drink plain water throughout the day. It is usually ideal to drink enough water that equals half your body weight in ounces. For instance, if you weighed 100 pounds, strive to drink 50 ounces of water per day. Not all at once as that is too rough on the renal system. But spread that 50 ounces out throughout the day with like 6-7 eight ounce glasses of water or 10 five ounce glasses of water. Staying hydrated with water will help with the healing and help you feel better overall.

Are you still taking the Tramadol? If you don't need it, don't take it. It can also cause dry mouth and other unpleasant problems.

Are you taking any other meds? Many of them have side effects like dry mouth, dry eyes, all sorts of things. So if you are taking something, it could be contributing to the problems you are having with your mouth.

If you go to the ER they are likely going to give you more meds, none of which will help heal your inflamed gums.

Things like meditation, yoga, walking, listening to music, expressing your creativity and other things that nurture the mind and body are very helpful with anxiety in general. Perhaps you would consider some of those things and find them to be most helpful.

You will get through this, but it's important and so helpful to take good care of yourself along the way. When do you go back to the oral surgeon?

Bryanna














Quote:
Originally Posted by apalooza View Post
Bryanna, To answer your questions, No I do not have any remaining teeth on the same arch. I was a smoker but I have not smoked since the day of my extractions. I do not know if i am diabetic but most likely am. I had a bad soda habit which I also quit the day of my extractions. I do have dry mouth and dry eyes but never dx with anything.My mouth (and eyes) have been so dry at night I wake up with my tongue stuck to my gums I think i may have un-diagnosed Sjogren Syndrome. I dont know what to do. My oral surgeon is no help to me. All he told me is to come back in 2 weeks. I am not wearing any dentures because when the oral surgeon did my extractions there was sinus communication so they said my immediates were a no go. So now i do not know when I will even get teeth state insurance will not pay for another set. They will have to make the immediates work... There were no bone grafts I am not eating hard or chewy food, actually I am hardly eating I do drink ensure and boost. I have been rinsing a lot with salt water but have cut it down ..it was way more than 4 times a day. I thought it may contribute to my slow heal/ dry mouth. I feel like as long as I am laying down, The swelling goes down a little idk cuz im losing it here. I do have panic disorder, I also tend to get a lot of panic attacks when ever I am sick but this teeth thing is the worst. I have dental phobia I went into this with massive anxiety with no help from oral surgeon. he would not even give me meds for anxiety prior to procedure and afterward sent me home on tramadol for pain which sucks. Im lost in this panic idk what to do. My next step will be ER I cant take it anymore.
__________________
Bryanna

***I have been in the dental profession for 4 decades. I am an educator and Certified Dental Assistant extensively experienced in chair side assisting and dental radiography. The information that I provide here is my opinion based on my education and professional experience. It is not meant to be taken as medical advice.***
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Old 07-07-2019, 09:44 AM #5
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Bryanna
I just want to thank you for all the help you have given through this blog.
I found this forum after I had extractions and was stil suffering pain almost 2 months after. I was frustrated and at a complete loss. I went on line and stumbled across this forum. I’ve never written to you personally, but I have followed your exchanges with others and I found them extremely helpful. Your insight coupled with your compassion has been a tremendous help to me and to many others I’m sure.
Thank you for taking the time out to do this - it is greatly appreciated.
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"Thanks for this!" says:
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Old 07-07-2019, 12:03 PM #6
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Bryanna Hello again and thank you so much for your time and information. You have been very helpful. The oral surgeon said no to my immediates because he had to suture cheek fat or buccal flap..over the extraction site that had the sinus communication. the immediate would not have fit over. Though he never told me a thing. It wasnt until the day after extractions when I went in as an emergency (it was a false alarm)..that I saw his colleague who told me absolutly no denture for at least two weeks.

Im on day 10 post extraction now. I do not think I am healing correctly. My gums are still quite swollen and I still have open holes the front teeth extraction sites seem to be the largest. I saw my oral surgeon on 5 days post extraction he said two more weeks .. Because I am not a spring chicken. But i do not see any real improvement since. Perhaps it happens underneath where I can not see. My next appointment with My OS is July 18th ..11 days from now. I am not able to talk to him about my panic and anxiety..he just does not listen I have tried and tried.

I am not really taking the tramadol it does not help. I can not continue the advil much longer. I have been taking it for 10 days now. Im not doing anything for tobacco withdrawl just one day at time but I am over the hump on that now. I am ten days post extraction, I still have open extraction sites my gums are still swollen the same .. no better no worse They feel large to the point that my mouth feels like I am wearing a hockey puck but I am wearing nothing not even my dentures which at this point I don't know If I will ever get to wear.

I panic all the time I wake up from sleeping in a panic. These attacks have me feeling very disassociated I cant sleep I barley eat I cry all the time. I did see my OS the 2nd at my 5 days post op but like I said I see no improvement. I know my mouth has been through trauma but shouldn't it be somewhat better by now?
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Old 07-07-2019, 04:47 PM #7
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Hi apalooza,

Given all the information that you have shared here, the swelling is normal, the open wounds are normal. It can take months for the swelling to completely subside and the holes to close. It really depends on the patients overall health, their diet and their lifestyle habits both pre and post op extractions.

Even when the swelling finally subsides, your gum tissue is likely going to be lumpy, not smooth. That is due to the likelihood that you had periodontal disease and you were a smoker which deprived the gum tissue of oxygen. Again that lumpy gum would be normal in your case. Once the actual swelling has subsided, then a general dentist or prosthodontist can evaluate you for a proper denture. Sometimes some of the gum tissue has to be trimmed to get a good fit, but not always. You'll cross that bridge when you come to it, if you come to it.

Due to the flap procedure to close off the surgical wound to the exposed sinus, correct, you cannot wear that denture. Don't even try. That area will take some time to heal and may require a bit of touch up surgery. But it's too early to tell. Again, try not to worry about that particular issue. Instead, put your thoughts and your energies into healing. Doing that will have a positive and profound affect on your emotional health.

Do you have pain? If not, stop taking the pain meds. I agree, taking advil long term is not good.

I am going to suggest 2 things, that you can try, to help reduce the swelling:

#1: Warm moist heat compresses. Moist Heat applied to the outside of the face at this stage of healing can encourage blood flow and decrease the swelling. If you have a microwave, perhaps you can purchase a heat pack from the drugstore, nuke it for a minute or until it is comfortably warm... not hot... and apply that to the outside of your face for 10 minutes, one side then the other. Do that 2-4 times a day for a few days.

#2: Homeopathic remedies are non toxic and very helpful. You can purchase them at some drug stores or health food stores. I will post a photo of the two containers this particular remedy comes in, in case you are not familiar with it.

ARNICA MONTANA 30C or 30 X: is a homeopathic remedy that can reduce dental swelling and pain. Take it as described on the container and every 4-6 hours as needed. You may see a big improvement with the swelling in a couple of days taking this as directed. At which time you would cut down the frequency to once per day for a week or more. Do not take homeopathic remedies with food, just pop the little pellets under the front of your tongue and let them dissolve. You can eat 30 minutes after you take it.


I know you are not eating much, but your diet plays a huge role in how well you heal. Some foods you can eat are apple sauce, MASHED potatoes and other vegetables as well as fruits like banana/watermelon/peaches, pears, unflavored yogurt, soup, broths, smoothies, milk shakes, scrambled eggs, cottage cheese, hummus, oatmeal, even baked salmon which is soft. Just chew carefully, or gum the food :-), and rinse with warm water after you eat.

I do understand the level of anxiety you are describing. It is normal for many people to feel exactly the way that you do. But with all due respect, you have to take some measures to help yourself because your oral surgeon is not going to offer you much other than a drug, and the ER will only do the same.

Regarding your denture.... I understand that the state insurance paid for the immediate denture and they only allow benefits towards ONE denture. However, if you have not worn it and it turns out that it cannot be modified to fit properly, then you can file a claim with them stating that you were told by the OS not to wear it due to the flap procedure and now it is not able to be modified. You have a legitimate claim and your OS should also write up a letter confirming this to be true. With a bit of persistence, you will likely be entitled to a new denture benefit. However, please don't worry about that right now... focus on your healing first.

I understand, I have worked with countless dental patients over the last 40 years.... this is a tough time for you, and there will be a few hurdles to get over, but you are going to be okay.

Bryanna






Quote:
Originally Posted by apalooza View Post
Bryanna Hello again and thank you so much for your time and information. You have been very helpful. The oral surgeon said no to my immediates because he had to suture cheek fat or buccal flap..over the extraction site that had the sinus communication. the immediate would not have fit over. Though he never told me a thing. It wasnt until the day after extractions when I went in as an emergency (it was a false alarm)..that I saw his colleague who told me absolutly no denture for at least two weeks.

Im on day 10 post extraction now. I do not think I am healing correctly. My gums are still quite swollen and I still have open holes the front teeth extraction sites seem to be the largest. I saw my oral surgeon on 5 days post extraction he said two more weeks .. Because I am not a spring chicken. But i do not see any real improvement since. Perhaps it happens underneath where I can not see. My next appointment with My OS is July 18th ..11 days from now. I am not able to talk to him about my panic and anxiety..he just does not listen I have tried and tried.

I am not really taking the tramadol it does not help. I can not continue the advil much longer. I have been taking it for 10 days now. Im not doing anything for tobacco withdrawl just one day at time but I am over the hump on that now. I am ten days post extraction, I still have open extraction sites my gums are still swollen the same .. no better no worse They feel large to the point that my mouth feels like I am wearing a hockey puck but I am wearing nothing not even my dentures which at this point I don't know If I will ever get to wear.

I panic all the time I wake up from sleeping in a panic. These attacks have me feeling very disassociated I cant sleep I barley eat I cry all the time. I did see my OS the 2nd at my 5 days post op but like I said I see no improvement. I know my mouth has been through trauma but shouldn't it be somewhat better by now?
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Swollen gums  days after full upper extractions-arnica-montana-30c-jpg   Swollen gums  days after full upper extractions-arnica-montana-30x-jpg  
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Bryanna

***I have been in the dental profession for 4 decades. I am an educator and Certified Dental Assistant extensively experienced in chair side assisting and dental radiography. The information that I provide here is my opinion based on my education and professional experience. It is not meant to be taken as medical advice.***
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Old 07-07-2019, 04:48 PM #8
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Hi Jasminedreams,

Thank you for the kinds words, I am glad to have been of help to you!

Bryanna




Quote:
Originally Posted by jasminedreams View Post
Bryanna
I just want to thank you for all the help you have given through this blog.
I found this forum after I had extractions and was stil suffering pain almost 2 months after. I was frustrated and at a complete loss. I went on line and stumbled across this forum. I’ve never written to you personally, but I have followed your exchanges with others and I found them extremely helpful. Your insight coupled with your compassion has been a tremendous help to me and to many others I’m sure.
Thank you for taking the time out to do this - it is greatly appreciated.
__________________
Bryanna

***I have been in the dental profession for 4 decades. I am an educator and Certified Dental Assistant extensively experienced in chair side assisting and dental radiography. The information that I provide here is my opinion based on my education and professional experience. It is not meant to be taken as medical advice.***
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Old 07-07-2019, 05:47 PM #9
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Quote:
Originally Posted by Bryanna View Post
Hi Jasminedreams,

Thank you for the kinds words, I am glad to have been of help to you!

Bryanna
Hi Bryanna,

I opened a thread (it is on top portion of the main page currently), and was hoping you wouldn't mind to give me your advice.

I wasn't sure how to tag you in the new thread, so I thought replying her might alert you. Thanks!
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