question: Why does anesthesia (dentist) make your cheeck feel swollen?
comment: Because there is no sensation at all. Which makes it hard for you to know where it starts ans stops. That can make it feel thick, and full and swollen even when irs not.
passages: BULLET::::- In patients with special needs or where regular oral hygiene is impaired leading to likely breakdown of regular direct restorations.
  
  BULLET::::- In patients with partially submerged primary molars in order to maintain the mesiodistal space.
  
  Section::::Indications and Contraindications.:Contraindications.
  
  Hall Technique stainless steel crowns are contraindicated in the following instances:
  
  BULLET::::- The patient is known to be sensitive or allergic to nickel unless approval is given from an allergologist or dermatologist first.
  
  BULLET::::- There is any evidence that the carious lesion has irreversibly damaged the pulp:
   BULLET::::- Trismus: Trismus, also known as lockjaw, affects functions of the oral cavity by restricting opening of the mouth. A double blind, clinical study was done to test the effect of two different medications on post-extraction trismus. The patients who received a corticosteroid by IV had a statistically significant lower level of trismus when compared to patients receiving an NSAID by IV or no medication.
   BULLET::::- Swelling: Often dictated by the amount of surgery performed, to extract a tooth ("e.g.", surgical insult to the tissues, both hard and soft, surrounding a tooth). Generally, when a surgical flap must be elevated ("i.e.", the periosteum covering the bone is thus injured), minor to moderate swelling will occur. A poorly cut soft tissue flap, for instance, where the periosteum is torn off rather than cleanly elevated off the underlying bone, will often increase such swelling. Similarly, when bone must be removed using a drill, more swelling is likely to occur.
   During probing, it is important to note that the pocket depth around an implant is typically greater than around natural teeth. Also, the value for the pocket depth around an implant is variable in health, therefore, diagnosis of a pocket is reliant on a change in pocket depth when comparing measurements from different appointments. For this reason, a Basic Periodontal Examination (BPE) is not appropriate, and a 4 or 6 point pocket chart is instead recommended.
  
  Below is a summary table of signs and symptoms associated with peri-implantitis.
  
  Section::::Causes & Pathology.
   Almost all recorded cases of long-term numbness or altered sensation (paresthesia) seem only to be present when this anesthetic is used for dental use (no PubMed references for paresthesia with articaine for other medical specialties), and only affect, in the vast majority of the reports, the lingual nerve.
  
  Nonetheless, direct damage to the nerve caused by 4% drugs has never been scientifically proven.
  
  Some research points to needle trauma as the cause of the paresthesia events.
  
  Section::::External links.
  
  BULLET::::- Carticaine(articaine) PubChem page
  
  BULLET::::- Orabloc
  
  BULLET::::- Septodont
  
  BULLET::::- Structure
   Patients should be routinely warned about lingual nerve injuries prior to wisdom tooth and floor of mouth surgery. The risk associated with wisdom tooth surgery is commonly accepted to be 2% temporary and 0.2% permanent.
   Creep or plastic deformation happens when subjected to intra-oral stresses such as chewing or grinding. Creep causes the amalgam to flow and protrudes from the margin of the cavity forming unsupported edges. ‘Ditch’ is formed around the margins of the amalgam restoration and make it prone to fracture. The γ2 phase of amalgam is primarily responsible for high values of creep.
  
  Section::::Properties of amalgam.:Corrosion.
   Periodontal fremitus occurs in either of the alveolar bones when an individual sustains trauma from occlusion. It is a result of teeth exhibiting at least slight mobility rubbing against the adjacent walls of their sockets, the volume of which has been expanded ever so slightly by inflammatory responses, bone resorption or both. As a test to determine the severity of periodontal disease, a patient is told to close his or her mouth into maximum intercuspation and is asked to grind his or her teeth ever so slightly. Fingers placed in the labial vestibule against the alveolar bone can detect fremitus.
   Then, a Williams probe with 1, 2, 3, 5, 7, 8, 9 and 10mm markings to measure the pocket depths around all the teeth. A six point or a four point pocket depth charting can be done. It should also be noted if any of the pockets bleed on probing. Bleeding will be a measure of inflammation; no bleeding on probing suggests health, except in smokers, who don’t usually bleed on probing. 
   Alveolar osteitis is a complication of tooth extraction (especially lower wisdom teeth) in which the blood clot is not formed or is lost, leaving the socket where the tooth used to be empty, and bare bone is exposed to the mouth. The pain is moderate to severe, and dull, aching, and throbbing in character. The pain is localized to the socket, and may radiate. It normally starts two to four days after the extraction, and may last 10–40 days. Healing is delayed, and it is treated with local anesthetic dressings, which are typically required for five to seven days. There is some evidence that chlorhexidine mouthwash used prior to extractions prevents alveolar osteitis.
   Section::::Symptoms.
  
  Patients who have a periapical granuloma are usually asymptomatic; however, when there is inflammation, patients could experience temperature sensitivity, pain while chewing solid foods, swelling and sensitivity to a dental percussion test.
  
  Generally, periapical granuloma is diagnosed due to acute pain in a tooth, or during a radiographic examination in routine visits to the dentist.
  
  Section::::Radiographic Features.
   BULLET::::- Enucleation following marsupialization—sometimes marsupialization is carried out as a single procedure, but usually it is followed by a second procedure to remove the cyst. This is particularly the case when cysts are very large and their removal would leave a significant surgical defect.
  
  BULLET::::- Enucleation with curettage—this is the removal of the cyst and some of the surrounding bone, which may contain some of the lining of the cyst.
  
  Section::::Prognosis.
   As the dental dam clamp is placed along the gum line, this can cause some discomfort or pain (especially in a patient who does not require local anaesthesia), bleeding from the gums, damage to the periodontal ligament or abrasion of the cementum on the root of the tooth, which may cause an uneven surface on the tooth root that can retain plaque.
   Compared to a typical dental filling, where an injection of local anesthetic and the use of a dental drill may be involved, the application of dental sealants is significantly less invasive and generally considered quick and easy. The procedure is entirely painless, although a minor level of discomfort may be experienced by the patient.
  
  Section::::Prevalence.
  
  According to 2011-2012 figures, 30 to 40% of US children aged six to eleven years have at least one dental sealant.
   BULLET::::- The sphenomandibular ligament may act as a barrier to the agent if the injection is given too shallow and the lingual nerve is only anesthetized.
  
  BULLET::::- This injection can rarely cause needle tract infections of the pterygomandibular space. This is because the mouth contains many types of bacteria which are normally harmless by virtue of the physical barrier that the mucosa presents. However, if they are inoculated into the tissues during an injection, they can become pathogenic (disease causing).
   Additionally, for an implant to look esthetic, a band of full, plump gingiva is needed to fill in the space on either side of implant. The most common soft tissue complication is called a black-triangle, where the papilla (the small triangular piece of tissue between two teeth) shrinks back and leaves a triangular void between the implant and the adjacent teeth. Dentists can only expect 2–4 mm of papilla height over the underlying bone. A black triangle can be expected if the distance between where the teeth touch and bone is any greater.
  
  Section::::Recovery.
   Most commonly the individual complains of food getting lodged beneath the gums and a soreness that is usually confused with throat infections. In slightly milder forms a swelling is visible and mouth opening becomes difficult in severe cases. Pain is invariably present.
  
  Section::::Management.
  
  Impacted teeth might be extracted or left alone, depending on the dentist (and the health authority's guidelines in that country) and the situation. Extraction might be contraindicated and might be simple or surgical, often depending on the location of the teeth.
   BULLET::::- Perform a complete extra- and intra-oral examination using a dental mirror under good lighting, look for granulation tissue in the socket and openings into the antrum.
  
  BULLET::::- Panoramic radiograph or paranasal computed tomography can help to locate the fistula, the size of it and to determine the presence of sinusitis and other foreign bodies. Other methods like radiographs (occipitomental, OPG and periapical views) can also be used to confirm the presence of any oroantral fistulas.
  
  BULLET::::- To test the patency of communication the patient is asked to rinse the mouth or water is flushed in the tooth socket.
   Nevertheless, some complications can arise from infiltrations. Complications can be divided in to two groups:
  
  BULLET::::- Local complications
  
  BULLET::::- Systemic Complications
  
  Section::::Nerves for dental infiltration analgesia.:Local Complication.
  
  Needle Breakage – rare since the introduction of disposable needles. If it happens, remove with tweezers if needle end is visible. If the end is not visible, patient must be referred to the maxillofacial unit immediately, and instructed not to talk in the mean time to avoid needle movement.
  
  Pain during administering – avoid injecting too quickly. If injected in to the nerve, retract needle slightly to prevent nerve damage.
   Warning patients of nerve injury prior to administration of deep dental injections has a risk of injury in approximately 1:14,000 with 25% of these remaining persistent. Preoperative warning about these injuries is routinely undertaken in the US and Germany. This reflects good practice recommended by the Royal College of Anaesthetists (prior warning of potential nerve injury in relation to spinal and epidural blocks 1 on 24-57,000 risk) and NHS patient.uk.com.
  
  Infiltration dentistry is a technique that may reduce the possibility of lingual nerve injuries by avoiding deep injections.
   Dry socket occurs in about 0.5–5% of routine dental extractions, and in about 25–30% of extractions of impacted mandibular third molars (wisdom teeth which are buried in the bone).
  
  Section::::Signs and symptoms.
  
  Since alveolar osteitis is not primarily an infection, there is not usually any pyrexia (fever) and cervical lymphadenitis (swollen glands in the neck), and only minimal edema (swelling) and erythema (redness) is present in the soft tissues surrounding the socket.
  
  Signs may include:
   Measuring disease progression is carried out by measuring probing pocket depth (PPD) and bleeding indices using a periodontal probe. Pockets greater than 3mm in depth are considered to be unhealthy. True pocket formation of 4 mm or more are specifically related to chronic periodontitis. Bleeding on probing is considered to be a sign of active disease. Discharge of pus, involvement of the root furcation area and deeper pocketing may all indicate reduced prognosis for an individual tooth. 
   Filling the root canals of the tooth from the crown (orthograde root canal therapy) should be the first treatment option to resolve inflammation caused by the tooth. Periradicular surgery is only considered if the inflammation persists after conventional root canal treatment. A patient's oral hygiene must be considered; poor oral hygiene increases the risk of infection and impairs healing of the surgical site.
  
  Section::::Contraindications.:Patient factors.:Anatomical factors.
   The periodontal ligament becomes inflamed and there may be pain when biting or tapping on the tooth. On an X-ray, bone resporption appears as a radiolucent area around the end of the root, although this does not manifest immediately. Acute apical periodontitis is characterized by well-localized, spontaneous, persistent, moderate to severe pain. The alveolar process may be tender to palpation over the roots. The tooth may be raised in the socket and feel more prominent than the adjacent teeth.
  
  Section::::Causes.:Dental.:Periodontal.:Food impaction.
   Before treatment the correct diagnosis must be made which is easily done by a radiograph. It can be seen the tooth/teeth concerned will be larger than normal which can be seen clinically in the mouth or whilst they are unerupted.
  