Drainage in the gum after tooth extraction and with flux: what does the incision look like, how much it heals, photo of the operation

Drainage in the gums is a method of treatment or prevention of pyoinflammatory diseases dentoalveolar system.

Its installation is a small, low-traumatic operation and is performed by dental surgeons on an outpatient basis or in a hospital.

Dental drainage characteristics

A drain or desiccant is a device that is placed in your postoperative gum incision. It serves to prevent the accumulation of blood or pus in the wound, to ensure the outflow of these biological fluids outward.

One end of the desiccant system is placed in the deepest area of ​​the incision, the other end extends into the oral cavity. Blood, pus, exudate (fluid formed as a result of inflammation) do not linger in the area of ​​the wound, but flow out of it. This principle allows you to prevent the spread of infection throughout the body and avoid serious complications:

• phlegmon of the maxillofacial region;
• purulent sinusitis;
• meningitis;
• mediastinitis.

What does dental drainage look like?

Most often, the device looks like a rubber strip. It is cut from sterile latex and treated with an alcohol solution, Chlorhexidine or hydrogen peroxide. This procedure allows you to achieve sterility of the rubber desiccant, that is, to completely destroy any kind of microbes on its surface.

Less commonly, a dental inlay is made of a polymer (PVC) tube of small diameter (up to 3-5 mm). This structure allows fluid or pus to actively flow out of the wound without accumulating inside it.

It is extremely rare that small sterile gauze is used for drying. Such drainage requires daily processing of the incision and examination, and is installed in the gum only in a hospital setting during severe operations.

Why and when is it done: in what cases is the gum cut?

Drainage in the gum area is installed in cases where a person has an inflammatory disease of the dentoalveolar system, most often it is flux (or periostitis) - an infectious lesion of the periosteum, covering the upper and lower jaw and located just under the gum.

With the flux, pus accumulates in the bone, severe swelling appears, the body temperature rises, and the state of health worsens. To help the patient, the doctor cuts the gum and places a drain into it, through which the pus will drain outward.

Very often, drainage is used after removing the upper and lower last molars (or wisdom tooth). The operation of their extraction is often traumatic, and the teeth themselves are located near important anatomical structures - maxillary (maxillary) sinus, mandibular canal, periopharyngeal space.

Therefore, after the removal of molars, drainage is put in for a preventive purpose - to prevent the accumulation of blood in the postoperative wound and its subsequent suppuration. The method also allows you to reduce the size of the hematoma in the cheek and avoid swelling of the face on the first and second days after surgery.

Contraindications to installation

Dissection of the gums should not be done if the patient has diseases that cause blood clotting disorders (hemophilia). This method of treatment is used with caution while taking the drugs Trombo-Ass, Aspirin, Warfarin. In all these cases, there is a risk of bleeding from an open wound, and a desiccant can only worsen the condition and increase blood loss.

A relative contraindication is diseases of the cardiovascular system in the acute period - hypertensive crisis, myocardial infarction, stroke, angina pectoris attack. In these cases, the patient is transferred to a physician for treatment, and surgical treatment and installation of the structure are postponed until the general condition is normalized.

Drainage Algorithm

Installation is carried out according to a strict algorithm:

1. Before the operation, the dentist does X-rays the necessary area of ​​the jaw to accurately determine the focus of the problem - purulent inflammation, abscess or the location of the tooth in the jaw.
2. Local anesthesia is performed with an anesthetic solution. The doctor is obliged to select a drug that will not cause allergic reactions in the patient.
3. 10-15 minutes after the injection of the anesthetic, the gum is cut with a scalpel.
4. Pus or inflammatory exudate is released. The wound is thoroughly washed with an antiseptic solution - Chlorhexidine, Furacilin or Iodinol.
5. After the gum has been cut, a strip or drainage tube is inserted into the incision. One end of it is in the wound, and the other goes into the oral cavity. The latex graduate should not rub the cheek, cause discomfort or discomfort.
6. To prevent spontaneous loss, the insert is sewn to the gums with absorbable material - Catgut, Vicril.

On average, the system is installed for 24 hours. Previously, it cannot be removed, since all the exudate will not have time to leave the wound. Leaving the draining graduate in the gum for longer than a day is also not worth it, since it will interfere with normal wound healing.

Possible complications: what to do if the drainage has fallen out

After the drain is installed, complications may develop in some patients. The most common is an allergic reaction to the material from which the desiccant is made - latex, polyvinyl chloride, less often - to the antiseptic with which the drainage was treated - alcohol, Chlorhexidine, Miramistin.

Usually, before using this method of treatment, the doctor asks the patient about the allergy to any drugs.

Sometimes a person does not know about the presence of hypersensitivity to latex or alcohol, then a few hours after installing the device, severe itching and burning in the wound appears. Swelling after gum surgery may increase, and the discharge from the wound becomes more, a person will constantly feel an unpleasant taste in the mouth.

If these symptoms appear, it is necessary to urgently consult a doctor who will remove the desiccant from the gums and replace it with a similar one, but from a different material.

Sometimes, after installation, the drainage falls out of the gums on its own. In such cases, it is recommended to seek the advice of your doctor. Further actions will depend on the initial severity of the disease, as well as on how long after the operation the desiccant fell out:

• if the swelling and inflammation of the gums were not pronounced, and the desiccant separated from the gums after 24 hours and more from the moment of its installation - most likely, nothing needs to be done, the dehumidifier already has its function fulfilled;
• if the disease was serious, the operation was traumatic, and the tube fell out an hour after it, then you will need to come to the dentist's appointment and reinstall the drying element in the gum.

What you can do yourself

If there is no time to come to the doctor a day after the operation and remove the drainage, you can remove it yourself:

1. Wash your hands thoroughly with soap and rinse your mouth with distilled water.
2. Take clean tweezers and rub the tips thoroughly with alcohol. Vodka or cologne can be used as a disinfectant.
3. Grab the edge of the graduate with tweezers, which lies freely in the mouth, and gently and smoothly pull it towards you.
4. The wound must be closed for 20 minutes with a sterile gauze napkin.

Rehabilitation

If pain occurs after the operation, it is allowed to take painkillers (Ketanov, Pentalgin, Nise) for 3 days. A course of antibiotic therapy for 5-7 days is mandatory. Drugs for treatment and their dosage are prescribed strictly by the attending dentist.

After removing the drainage from the gums, the wound will heal in about 7-10 days. To accelerate tissue regeneration, you can rinse your mouth with solutions of herbs (chamomile, oak bark, calendula).