Introduction
A swollen cheek is a visible and palpable increase in the size of the cheek region, which can usually be accompanied by the typical additional signs of inflammation such as redness, overheating, pain. The cheek region extends from the zygomatic bone to the lower jaw and is roughly considered to be the area that can be protruded laterally with air in the mouth. The swelling can have any localization in the cheek area and can vary from a flat to punctual swelling. The swelling can be more inward toward the mucous membrane or outward toward the facial skin. What both have in common is that, at least subjectively, the function of the cheek is limited in terms of food intake and speech formation.
What are the possible causes for swelling of the jaw?
The causes for a swollen cheek can be very diverse. The cheek consists of skin, muscles, connective and fatty tissue, nerves, blood vessels and mucous membrane. All structures can act as triggers for swelling.
The most common cause is inflammatory processes that originate from injuries to the mucous membrane. Often it is banal injuries caused by sharp-edged food such as a hard crust of bread or a burn caused by excessively hot liquids that damage the mucosa and thus form an entry portal for bacteria. But an inflamed tooth can also cause discomfort in the cheek, especially if it is an abscess at the root of the tooth.
Traumas, such as a blow to the cheek, are rarely the cause of swelling and have an effusion as their cause. If a lump that can be felt tightly from the outside has developed, it is probably an abscess caused by an inflammation of a skin gland from the outside and is often accompanied by abscesses at other locations. After an anesthetic injection, there is often the subjective feeling of having a thick cheek.
In most cases it is only the feeling caused by the anaesthetized nerves. The anaesthetic blocks the transmission in the nerve fibres, so that the person affected no longer feels any pain in the area. The disturbed self-perception thus causes the transmission of the actual sensory perceptions in the cheek to be blocked for the duration of the effect of the local anaesthetic, which leads to a sensory illusion in the thick cheek.
However, if the anesthetic injection was used to treat the cheek mucosa, it may be a truly swollen cheek. The swelling can then be explained by the amount of fluid stored in the cheek or, if it persists for a long time, by an inflammatory reaction caused by the injury to the mucous membrane. If a swollen cheek is present after a tooth operation or if a tooth has been extracted, the swelling is a completely natural reaction of the body to the previous operation.
Basically, it should be noted that the mucous membrane of the cheek is supplied by the same nerve as the gums and teeth. This means that these three structures often react simultaneously to an external stimulus. This explains the swelling of the cheek as a result of the dental surgery.
The artificially induced injury is answered by the body’s own repair process, which requires increased blood circulation. This enables inflammatory cells to reach their destination quickly. This means that not only the wounded gums swell and hurt, but also the cheek by sensitizing the same nerve.
The swelling should normally subside within a few days and the wound in the gums should close quickly. If this is not the case, it indicates that the wound is infected and needs further treatment. Wisdom teeth can not only cause swelling of the cheek before removal, but also after the operation and removal a “thick cheek” can develop afterwards.
Apart from pain and bruises, the swelling of the cheek that lasts for a few days after the wisdom tooth removal is one of the normal symptoms after such an operation. Only when the swollen cheek is accompanied by fever and a general feeling of sickness or the swelling does not improve even after cooling for several days should a doctor be consulted. In the majority of cases, this possible complication occurs in the lower jaw, since the gums cannot be sealed tightly and bacteria can therefore penetrate into the empty tooth socket.
This way they can multiply and since food remains can constantly get into the threads or into the hole itself, pus can form.Thus, after surgical removal, an abscess may develop, the secretion of which must be drained through a relief incision to prevent further spread, i.e. sepsis. Therefore, if the swelling is noticed, it is not advisable to wait long before visiting the dentist. Every surgical intervention on the teeth, which is connected with surgical incisions, traumatizes tissue.
In order to reach the root tip, the gum has to be detached from the bone, which is equivalent to a wound, as this injures vessels and causes bleeding. As a result, after the local anesthesia has closed and worn off, adrenaline and blood can flow through the tissue again and cause a bruise. The tissue swells and hurts as the wound closure is initiated.
This means that a slight swelling after the apicoectomy is normal and to be expected. The swelling will disappear completely after one to a maximum of two weeks. If this is not the case, the dentist must be consulted.
There is always the risk of an infected wound in the oral cavity, which is why the closure of the wound can be disturbed. After an implantation it is realistic to expect a swollen jaw after the procedure. An implantation is a complex, demanding surgical procedure that places heavy stress on the bone, especially in the upper jaw, for example when an implant has to be “tapped” with a special hammer.
Cutting the gum, drilling the hole in the jaw and inserting the implant is a strong irritation for the tissues. This causes hematomas and swelling of the tissues, which is quite normal. It is important to go to the dentist the day after and the following days for follow-up treatment to control the swelling and to rule out infection.
If the swelling feels hard and rough, you should go to the dentist immediately. Usually the swelling and, if necessary, the bruises will disappear within one to a maximum of two weeks. If the stitches are removed, a clear improvement must be noticeable, otherwise the dentist must be consulted.
A swollen cheek after bone augmentation is caused by the fact that the end branches of the nerves of the cheek and jaw belong to the same original nerve – the trigeminal nerve. If the trigeminal nerve is very strongly irritated, as in bone augmentation, it can react to all its end branches with a pain projection. During bone augmentation, the jawbone is augmented by a piece of the patient’s own jawbone from another site or by an autologous bone donation for an implant, so that the bone is actively injured in a therapeutic sense.
When the bone is injured, even the smallest nerve endings are damaged. This injury causes a central sensitization, which both upregulates the perception of pain and initiates repair processes. The body’s own healing process manifests itself in increased blood flow to the tissue, which is visible in swelling.
The immediate vicinity of the cheek and jaw favors an overlapping of this process and is linked by the common blood supply. The main branches of the blood vessels of the jaw branch out towards the gums into smaller and smaller branches. When the bone is injured, even the smallest nerve endings are damaged.
This injury causes a central sensitization, which both upregulates the perception of pain and initiates repair processes. The body’s own healing process manifests itself in increased blood flow to the tissue, which is visible in swelling. The immediate vicinity of the cheek and jaw favors an overlapping of this process and is linked by the common blood supply.
The main branches of the blood vessels of the jaw branch out towards the gums into smaller and smaller branches. A swelling despite antibiotic intake occurs primarily on the day of the first tablet intake, since the antibiotic needs about twenty-four hours to take effect. Furthermore, one tablet must be taken every eight hours.
According to studies only on the third to fourth day of the income the full effect mirror of the antibiotic is reached, with which all bacteria are killed. Therefore the exact adherence to the taking period of the antibiotic is necessary, so that no bacteria remain, which can still receive the thick cheek. This usually takes 3-5 days or up to 7-10 days.
Please pay attention to the recommendation of the dentist test. As a rule, after the first twenty-four hours, the person affected feels a decrease in parulis.Furthermore, the “thick cheek” can occur if preoperative antibiotic administration has not taken place before an operation, but the antibiotic was prescribed after the operation, so that bacteria can already penetrate the wounded area. If an antibiotic is taken the day before surgery, it will be effective twenty-four hours after surgery, so that parulis does not occur. If the antibiotic is prescribed after the surgery, it will take twenty-four hours to take effect. During this time the bacteria can multiply unhindered and thus cause parulis.
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