Dry Socket Definition
Patient with a dry socket
Dry socket (alveolar osteitis) is a temporary dental condition that sometimes occurs after extraction of a permanent adult tooth. A dry socket occurs when the blood clot at the site of the tooth extraction is dislodged, exposing underlying bone and nerves and causing increasing pain.
Dry socket is the most common complication following tooth extractions, such as the removal of impacted wisdom teeth. When it occurs, dry socket usually strikes about three days after a tooth extraction.
Section One Symptoms of Dry Socket
The most significant symptom of a dry socked is steady pain
Signs and symptoms of dry socket can include:
- Severe steady pain within a few days after a tooth extraction is the hallmark of dry socket
- Partial or total loss of the blood clot at the tooth extraction site, which you may notice as an empty-looking (dry) socket
- Visible bone in the socket
- Pain that radiates from the socket to your ear or eye on the same side of your face
- Bad breath or a foul odor coming from your mouth
- Unpleasant taste in your mouth
- Swollen lymph nodes around your jaw or neck
Section Two When to see a doctor for a Dry Socket
Initially when you've had a tooth extracted, any discomfort you experience normally gets better with each passing day. If you develop new or worsening pain in the days after your tooth extraction, don't try to tough it out. Contact your dentist or oral surgeon right away so that you can get properly evaluated and treated.
Section Three Causes of a Dry Socket
Normally, a blood clot forms at the site of a tooth extraction. This blood clot serves as a protective layer over the underlying bone and nerve endings in the empty tooth socket. The clot provides the foundation for the growth of new tissue and bone.
In some cases, though, the clot doesn't form properly or is physically dislodged before complete healing. With the clot gone, bone and nerves in the socket are exposed to air, fluids and food. This can cause intense pain, not only in the socket but also along the nerves radiating to the ear and eye on the same side of your face.
But the precise cause of dry socket remains the subject of study. Some researchers suspect that several issues may be at play, including:
- Bacterial contamination of the socket
- Difficult or traumatic tooth extraction surgery
- Roots or bone fragments remaining in the wound after surgery
- Age of the patient
- Health of the patient
- Smoking and tobacco use
- Excessive alcohol use
- High Bone density and poor blood supply of the extraction site
- Poor patient compliance after extraction
Section Four Prevalence of Dry Socket after Tooth Extraction
Dry socket occurs in about 3 to 5 percent of all tooth extractions. It's much more common after extraction of wisdom teeth and impacted wisdom teeth in particular.
Section Five Risk factors for Dry Socket
Factors that can increase your risk of developing Dry Socket include:
- Smoking and tobacco use. Chemicals in cigarettes or other forms of tobacco may contaminate the wound site. The act of sucking on a cigarette may physically dislodge the blood clot prematurely.
- Taking oral contraceptives. High levels of estrogen can greatly increase the risk of dry socket by dissolving the blood clot.
- Not following post-extraction guidelines. If after oral surgery you don't follow instructions, such as avoiding certain foods or caring for your wound properly, your risk of dry socket increases.
- Having dry socket in the past. Having dry socket once means you're more likely to develop it again.
- Tooth or gum infection. Current or previous infections around the tooth to be extracted increase the risk of dry socket.
- Less experience. Although dry socket can occur with even the most experienced dentists and oral surgeons, having a less experienced dentist or oral surgeon may increase your risk.
- The more of these risk factors you have, the grater the chance of developing a dry socket.
Section Six Complications of Dry Socket
- Absence from work or school
- Delayed healing after tooth extraction
- Interference with other needed dental procedures
Section Seven Preparing to see the Doctor for a Dry Socket
Make an appointment with your dentist or oral surgeon as soon as possible when you develop new or worsening pain after a tooth extraction. Here's some information to help you get ready for your appointment, and what to expect from your dentist or oral surgeon.
Consider preparing a list of questions to ask your dentist or oral surgeon. Some questions you may want to discuss include:
- What is likely causing my symptoms or condition?
- What kinds of tests, if any, do I need?
- What is the best course of action?
- What are the alternatives to the approach you're suggesting?
- Are there any restrictions that I need to follow?
- Should I see a specialist? What will that cost, and will my insurance cover seeing a specialist?
- Is there a generic alternative to the medicine you're prescribing me?
- Are there any brochures or other printed material that I can take home with me?
- What Web sites do you recommend visiting?
- Don't hesitate to ask other questions during your appointment at any time if you don't understand something.
What to expect from your Dentist or Oral Surgeon treating your Dry Socket. Your dentist or oral surgeon is likely to ask you questions about your symptoms. He or she may ask:
- When did you first begin experiencing symptoms?
- Have your symptoms been continuous or occasional?
- How severe are your symptoms?
- What, if anything, seems to improve your symptoms?
- What, if anything, seems to worsen your symptoms?
Section Eight Diagnosis of Dry Socket
Severe pain following a tooth extraction is often enough for your dentist or oral surgeon to suspect dry socket. Your dentist or oral surgeon also will ask about your other symptoms and examine your mouth. He or she checks to see if you have a blood clot in your tooth socket and whether you have exposed bone. You may also need to have X-rays taken of your mouth and teeth to rule out other conditions.
Section Nine Treatments and drugs for Dry Socket
Treatment of dry socket is mainly geared toward reducing its symptoms, particularly pain. Dry socket treatment includes:
- Medicated dressings and pastes. This is the main way to treat dry socket. Your dentist or oral surgeon generally packs the socket with medicated dressings. You may need to have the dressings changed several times in the days after treatment starts. The severity of your pain and other symptoms determines how often you need to change the dressing or other treatment.
- Flushing out the socket. Your dentist or oral surgeon flushes the socket to remove any food particles or other debris that has collected in the socket and that contributes to pain or infection.
- Pain medication. Talk to your doctor about which pain medications are best for your situation. If over-the-counter pain relievers aren't effective, you may need a stronger prescription pain medication.
- Self-care. You may be instructed how to flush your socket at home and to place dry socket medication daily to promote healing and eliminate debris. To do this, you'll be given a plastic syringe with a curved tip to squirt dry socket paste, water, salt water, mouthwash or a prescription rinse into the socket. You may need to continue to do this daily for three or four weeks.
Once treatment is started, you may begin to feel some relief in just 5 minutes. Pain and other symptoms should continue to improve over the next few days. Complete healing typically goes smoothly and generally takes about 10 to 14 days.
Section Ten Homecare after a dry socket has been diagnosed
Dry socket rarely results in infection or serious complications. But getting the pain under control is a top priority. You can help promote healing and reduce symptoms during treatment of dry socket by:
- Holding cold packs to the outside of your face to help decrease pain and swelling
- Taking pain medications as prescribed
- Not smoking or using tobacco products
- Drinking plenty of clear liquids to remain hydrated and to prevent nausea that may be associated with some pain medications
- Rinsing your mouth gently with warm salt water several times a day when advised to do so and not before
- Brushing your teeth gently around the dry socket area
- Keeping scheduled appointments with your dentist or oral surgeon for dressing changes and other care
- Calling for a sooner appointment if your pain returns or worsens before your next scheduled appointment
Section Eleven Prevention of Dry Socket
Steps that both you and your dentist or oral surgeon take may go a long way in helping prevent dry socket or helping reduce your risk.
Although dry socket has been recognized since the late 1800s, medical science has yet to develop a surefire way to prevent it. Some research suggests that treatment with certain medications such as antibiotics before or after oral surgery may reduce your risk of dry socket. However, this practice remains controversial, and some say that preventive treatment with antibiotics isn't appropriate because it may contribute to problems such as antibiotic-resistant bacteria.
Talk to your dentist and oral surgeon about using these medications or precautions when you have tooth extraction surgery:
- Antibacterial mouthwashes or gels immediately before and after surgery
- Oral antibiotics
- Antiseptic solutions applied to the wound
- Medicated dressings applied after surgery
What can you before tooth extraction surgery
- Seek out a dentist or oral surgeon with experience in tooth extractions.
- If you take oral contraceptives, try to time your extraction to days 23 to 28 of your menstrual cycle, when estrogen levels are lower.
- Stop smoking and the use of other tobacco products at least 24 hours before tooth extraction surgery.
- Talk to your dentist or oral surgeon about any prescription or over-the-counter medications or supplements you're taking, as they may interfere with blood clotting.
What can you do after tooth extraction surgery
- Avoid spitting for the first few days.
- Don't drink with a straw for the first few days.
- Take the advised medication as recommended
- Bite on gauze as prescribed and change it only as prescribed
- Don't drink carbonated beverages for two to three days after your tooth extraction.
- Gently brush teeth adjacent to the extraction site.
- Don't rinse your mouth vigorously or excessively especially in the first 24 hours.
- Resist the urge to touch the extraction site with your fingers or tongue.
- Eat soft foods and foods that don't have residuals, which are particles that may lodge in your socket. Avoid pasta, popcorn and peanuts, for example. Instead, eat mashed potatoes, pudding, or clear or cream soups.
Dr. Neal and the team ay Crystal Lake Dental Associates has extensive training in oral surgery including removal of wisdom teeth. Dr. Neal also has also developed a great protocol to prevent and treat dry sockets.
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Crystal Lake Dental Associates
Located at 280 B Memorial Court Crystal Lake Illinois 60014
You deserve a healthy, gorgeous smile. Call Crystal Lake Dental Associates today and schedule an appointment with Dr. Neal, a skilled cosmetic and general dentist. We welcome patients from Lake in the Hills, Woodstock, McHenry, Algonquin, Cary, Huntley, McHenry County and surrounding areas.