Dry socket: causes, symptoms, diagnosis and treatment

Dry socket (alveolar osteitis) is a painful dental disease that sometimes appears after the permanent extraction of a permanent tooth. Dry socket occurs when the blood clot at the tooth extraction site fails to grow, dislodge, or dissolve before the wound heals.

Normally, a blood clot forms at the site of the tooth extraction. This blood clot functions as a protective layer over the underlying bone and nerve endings in the empty tooth socket. The clot also forms the basis for the growth of new bone and the development of soft tissue on the clot.

Exposing the hidden bones and nerves causes intense pain, not only in the eye socket, but also along the nerves that run down the face. The cavity becomes inflamed and can fill with food debris, which can contribute to pain. If you begin to have dry socket, the pain usually begins one to three days after the tooth extraction.

Dry socket is the most common complication of dental extractions, such as the extraction of third molars (wisdom teeth). Over-the-counter medications alone are not enough to treat the pain of dry socket. The dentist or dental surgeon can offer painkiller treatments.

Signs and symptoms of dry socket may include:

Severe pain a few days after a tooth extraction Partial or complete loss of a blood clot at the tooth extraction site, which you may notice as a hollow (dry) socket Visible bone in the socket Pain extending from the socket to the ears, eyes, temples or neck, on the same side of the face as the removal Bad breath or unpleasant odor from the mouth Unpleasant taste in the mouth

It is normal to feel some degree of pain and discomfort after tooth extraction. However, you should be able to control normal pain with the painkiller prescribed by your dentist or oral surgeon and it should subside over time.

If you experience other pain or if it gets worse in the days following tooth extraction, contact your dentist or dental surgeon immediately.

Factors that increase the risk of dry socket include:

smoking.

The chemicals in cigarettes or other forms of tobacco can prevent or delay healing and contaminate the wound site. The action of inhaling cigarette smoke can move the blood clot prematurely.

Oral contraceptives.

High levels of estrogen from birth control pills can disrupt normal healing processes and increase the risk of dry socket.

Inadequate home care.

Not following home care guidelines and having poor oral hygiene can increase your risk of dry socket.

Having suffered dry socket.

If you’ve had dry socket, you’re more likely to have it after another extraction.

Infection of teeth or gums.

Current or past infections around the extracted tooth increase the risk of dry socket.

Usually, the intense pain after a tooth extraction is enough for the dentist or oral surgeon to suspect the presence of dry socket. He will also ask you if you have any other symptoms and examine your mouth to see if you have a blood clot in the tooth socket and if you have any exposed bones.

You may need to have an x-ray of the mouth and teeth to rule out other conditions, such as bone infection (osteomyelitis) or small root or bone fragments left in the wound after surgery.

Treatment for dry socket focuses on reducing symptoms, especially reducing pain. Treatment for dry socket may include:

Rinse the cavity.

By flushing the cavity, you can remove food particles or other debris that may be contributing to pain or possible infection.

Bandages with drugs.

The dentist or oral surgeon can fill the cavity with medicated gels or pastes and medicated dressings. This can ease the pain relatively quickly. The severity of pain and other symptoms will determine if and how often you will need a dressing change, or if you need other treatment.

Analgesics.

Ask what would be the best pain reliever for your situation. You may need a prescription pain reliever.

Personal care.

After the dressing is removed, you may need to flush the cavity at home to promote healing and remove debris. You will usually receive instructions and a plastic syringe with a curved tip to spray water, salt water, or a prescription rinse into the cavity. You may need to continue flushing until the cavity no longer collects debris.

Once treatment has started, some of the pain can be relieved quickly. The pain and other symptoms will continue to subside and will likely disappear within a few days. However, make an appointment with your dentist or oral surgeon for dressing changes and other care.