A thick cheek is usually a so-called abscess. This describes an encapsulated collection of pus that arises around an inflammation in a newly created cavity.
A thick cheek in the sense of a swelling without an abscess usually appears after tooth extraction, e.g. in the wisdom tooth operation.
This severe swelling can spread widely if left untreated, but does not migrate, as is often described by the patient. The capsule protects the rest of the body from a systemic inflammatory reaction. However, if the swelling spreads so far that the vessels can be reached, the bacteria from the inflammation can break through the capsule and trigger a systemic immune reaction. The pus is the immune response of the white blood cells against the inflammatory germs.
Generally, an abscess is caused by a causal inflammatory reaction that tends to enlarge. It is noticeable that more and more patients with thick cheeks arrive in the emergency room as soon as the weather warms up. Sudden increases in temperature cause more abscesses, which is why dentists refer to it as “abscess weather”.Inflammation spreads particularly well under heat and develops faster because the bacteria that cause the inflammation multiply faster when the temperature rises.
In the oral cavity, most abscesses occur as a result of localized inflammation below a root tip or gingival pocket. The inflammation is encapsulated from the place of origin, pus collects and the "pus bump" begins to enlarge and the swelling develops.
Furthermore, it can also happen that the inflammation forms a channel through the mucous membrane and the skin through which the pus secretion can drain. The exit point of this fistulous duct manifests itself both inside the mouth or outside as a swelling and forms the exit of the canal through which secretion is constantly secreted. This case is more favorable for the patient, since the swelling does not take on such large proportions and does not increase as quickly as the germs are constantly being released through the canal.
Read more on the topic:
- Abscess on the tooth
- Fistula on the tooth
Thick cheek after root canal treatment
Root canal treatment is an attempt to save a tooth and heal the previous inflammation below the tip of the root.
With today's techniques, the chance of a successful root canal treatment is very high. However, a thick cheek can be the result of a failed therapy. If the dentist does not manage to eliminate all pathogens below the root tip and disinfect everything aseptically, the inflammation can spread again and form an abscess.
The bacteria left behind often multiply quickly and lead to pronounced swelling. It is also possible that during the root canal treatment filling material is pressed beyond the root tip., This cannot be absorbed by the body and is recognized and attacked by the immune system as foreign material. An inflammatory reaction develops, in which an abscess forms. The body tries to encapsulate the substance and transport it away, which can take the form of an abscess or fistulous duct.
Read more on the topic: Root canal treatment
Thick cheek after tooth extraction
If a swelling of the cheek, i.e. a ’thick cheek’, appears a few days after pulling a tooth, you should consult a doctor immediately. It is very likely a bacterial infection. The bacteria in the oral cavity were able to penetrate the wound created by the tooth extraction.
An inflammation has developed which must be fought as quickly as possible. Heat and physical exertion should be avoided at all costs so that the swelling does not increase. Instead, the cheek should be cooled. If necessary, the inflammation must be combated with an antibiotic prescribed by the dentist.
Read more on the topic: Tooth extraction
Thick cheek after removal of a wisdom tooth
The development of a ’thick cheek’ after a wisdom tooth extraction, i.e. the extraction of a wisdom tooth, is not an unusual phenomenon. It occurs in most cases and is not a cause for concern. The swelling can be counteracted by cooling.
It can also be rinsed with chamomile. There are many other ways to reduce the appearance of the thick cheek. In general, the swelling is often associated with painful wound healing. In this case, painkillers prescribed by the doctor, such as ibuprofen, can be used to alleviate the symptoms that are often associated with the fat cheek.
This article might also interest you:
- Swelling after a wisdom tooth operation
- Inflammation after a wisdom tooth operation
Thick jaw after placing an implant
A 'thick cheek' or swelling of the cheek is completely normal in most cases after a dental implant has been inserted. In many cases it is accompanied by a kind of throbbing and tenderness in the affected area. The swelling is often greatest on the second day. The reason is that you went to sleep at night and more blood got into the head region.
The swelling should have subsided after about 4 days. If this is not the case and the swelling is accompanied by other symptoms such as reddening of the affected area, fever or fatigue, a doctor should be consulted for clarification. The wound may have become infected. In general, care should be taken not to drink alcohol, coffee, or black tea and to eat only soft foods for the first week after the implantation.
Also read our article: Risks of a dental implant
The abscess symptomatically follows the five signs of inflammation. First of all, the abscess begins to hurt. It swells up, reddens and those affected feel local warming in the affected area.
Furthermore, there is a loss of function, in which the opening of the mouth or the swallowing process can be severely restricted. The process of swallowing hurts when eating and eating and drinking is difficult. The swelling and redness may be so pronounced that it becomes visible outside the oral cavity. In particularly severe cases, when the dentist palpates the lower jaw, it is no longer palpable, which characterizes the rapid spread of the abscess.
Furthermore, the lymph nodes in the head and neck region can swell strongly as the immune system tries to fight the pathogens. The lymph nodes feel very hard when they are touched externally and mere touching leads to pressure pain. Inside the oral cavity the patient has a very uncomfortable feeling due to the warming and reddening; even touching the affected area with the tongue can lead to unbearable discomfort, as the inflamed area is very sensitive.
If the focus of inflammation forms a fistulous duct and is looking for an exit duct, this can be inside or outside the oral cavity and constantly releases secretion in the form of pus. This creates an unpleasant smell and taste in the mouth. Patients with abscesses often feel tired and exhausted as the immune system focuses on fighting the infection and the entire body is affected by it
You might also be interested in this topic: Lymph node swelling in the neck - how dangerous is that?
Thick cheek with pain
The most common dental emergency in the emergency room is the plump cheek as it can cause excruciating pain. Below the tip of the root are potentially infectious bacteria to which the body reacts with an immune response. The body releases more substances that trigger the typical symptoms of inflammation and are responsible for the severe pain.
The typical inflammatory pain is very diverse. Due to the accumulation of pus, the abscess can lead to severe pressure pain, which restricts the person affected. These complaints can be triggered with every movement and can also radiate into other parts of the body. Within the oral cavity, the affected tissue is very sensitive due to swelling and redness, and touching it with the tongue can be painful. In addition, this hypersensitivity can make food more difficult. On the other hand, it is advisable to chew to relieve the affected person.
Salivary stones in the salivary glands can also cause painful swelling.
Learn more about: A swollen cheek - what does it mean?
Thick cheek without pain
A swollen cheek is not always associated with pain and the problem does not have to have a dental cause.
The disease mumps, for example, can lead to swelling of the cheek without causing severe pain.
The diagnosis of a thick cheek can usually be clearly assigned to a focus of inflammation.
To make the correct diagnosis, it is necessary to see a dentist. This takes an x-ray to clearly identify the affected region as the place of origin and, depending on the severity of the symptoms, can initiate the individually tailored therapy.
With a pronounced thick cheek, the dentist cannot do without surgical intervention.
Local anesthesia is applied to the affected area, which is not easy in inflammatory tissue, as the anesthesia cannot develop its full effect in this tissue. The dentist will make a relief incision in the affected area so that the pus that has formed in the cavity can drain away.
This so-called incision gives the patient the feeling of pressure relief during the treatment. The entire content of the abscess is "expressed" and then disinfected with a rinsing solution. This will flush all of the bacteria out of the wound. To support healing, a tamponade strip is inserted into the cavity, which is soaked in a drug and ensures that the wound does not close immediately and that any remaining secretion is not encapsulated again. The strip is changed daily until the patient is absolutely symptom-free. In addition to this surgical therapy, taking antibiotics can accelerate the healing process.
The arrangement is discussed individually with the dentist and the dose is dosed depending on the patient's case. In addition to antibiotics, pain relievers such as ibuprofen are prescribed, which are anti-inflammatory and relieve pain. The dose prescribed by the dentist should not be exceeded here either. If the cause of the thick cheek can be traced back to a tooth, a subsequent therapy must be initiated by the dentist, who will decide whether it is still worth preserving. In the worst case, the tooth has to be removed, a so-called tooth extraction.
Home remedies are very popular with many patients before they go to the dentist, but are not recommended as the sole self-therapy for an abscess disease.
Soothing agents such as clove oil or rosemary leaves can temporarily relieve the pain caused by inflammation, but cannot reach the focus below the tip of the root. The affected area can be cooled with cold compresses or ice cubes wrapped in a towel.
You can also rinse your mouth with chamomile tea. Chamomile has disinfectant and anti-inflammatory properties and can help prevent infection or provide first relief in the event of an infection. Vigorous physical exertion or sporting activities should initially be avoided. Furthermore, a fundamentally extensive and intensive oral hygiene is very important. In addition to this, you should pay particular attention to a healthy diet during this time in order to strengthen the immune system. In addition to dental therapy, home remedies can certainly be used as a support. Nevertheless, the procedure must be discussed with the dentist in order not to reduce the success of the therapy.
The first self-therapy that the patient can do himself is to cool the swelling, which is reddened and warmed up. This measure makes perfect sense, as inflammation germs prefer heat in order to multiply. The cooling ensures that the pathogens no longer spread as quickly and relieves the pain. Ideally, a cooling compress can be wrapped in a kitchen towel and applied to the affected area without pressure for about 15-20 minutes. This process can be repeated, but the cooling process should not be continuous, otherwise the body will resist the cooling with increased blood flow, which would be counterproductive for the reduction in swelling.
When do antibiotics have to be used?
In general, antibiotics are recommended for thick cheeks, as the boil can spread rapidly and the antibiotic quickly eliminates all bacteria.
Depending on the patient's case, size and severity of the abscess, the dentist decides whether antibiotics are sufficient as the sole therapy, whether they are prescribed to support surgical treatment, or whether a single relief incision is sufficient as a therapeutic measure.
When do I have to go to the dentist?
If the swelling of the cheek has not subsided after several days up to a maximum of a week and is accompanied by pain in the area of the wound, impaired general condition or fever, a dentist should be consulted immediately.
In this case it is not a question of the usual post-operative wound healing. Even if no surgery has taken place, swelling that is accompanied by discomfort is always a sign of inflammation or bacterial infection. In such cases, the dentist can find out the cause of the ’thick cheek’ and treat it.
The time frame for an abscess disease cannot be clearly defined.
Even the formation can be variable. From a rapid development of the swelling to the slow manifestation of the disease, anything is possible. However, it can be said with certainty that abscesses develop more quickly in hot summer weather.