What is a dry socket?
When a tooth is extracted (removed by a dentist), one complication that can occur is called a dry socket, also known as alveolar osteitis. After a tooth is removed, a blood clot forms as the gum begins to heal. If that blood clot does not form correctly or is partially or totally lost, the result is a dry socket.
Dry socket is a relatively rare complication, and one recent study determined that it occurs in less than 2% of cases. However, it is the most common complication after certain kinds of tooth extraction. Dry socket is a complication up to 20% of the time after removal of lower wisdom teeth.
Symptoms of a dry socket
Symptoms of a dry socket after a tooth extraction include:
- Severe pain in the extraction site a few days after the procedure
- Loss of blood clot, revealing visible bone or empty socket
- Pain that radiates to your eye, ear, temple, and/or jaw
- Bad breath and an unpleasant taste in your mouth
If you experience these symptoms in the days following a tooth extraction, you should contact your dentist. A dry socket very rarely will go away on its own.
Who can get a dry socket?
It is possible for anyone to get a dry socket after the extraction of a tooth. However, there are a few factors that can make you more prone to this condition. The incidence of dry socket is higher after removal of impacted wisdom teeth than other teeth. Additionally, you may have a higher risk for dry socket if you:
- Have poor overall oral health.
- Take birth control pills.
- Smoke or chew tobacco.
- Have underlying bone issues or clotting problems.
- Have periodontitis.
- Have a difficult or traumatic tooth extraction.
- Do not follow care directions after the procedure.
These factors can interfere with the blood clotting and healing process following a tooth extraction or can cause the blood clot to become dislodged, leaving a dry socket.
Diagnosis of a dry socket
If you experience symptoms of dry socket, it is important to contact your dentist or oral surgeon.
You will likely need to be examined to confirm the dry socket and rule out other underlying causes of your pain. Your dentist will look for indicators at the extraction site like bone exposure and pain when flushed with fluid. An absence of swelling in the face and lymph nodes can also help rule out other causes.
Treatments for a dry socket
Your dentist will clean the dry socket by flushing it thoroughly with saline, and then pack the socket with medicated paste or dressing. You may need to see the dentist frequently during the following days to have the dressings changed. Depending on your pain severity, the dentist may recommend nonsteroidal anti-inflammatory drugs (NSAIDs) or prescribe an analgesic drug.
Your dentist may also recommend that you stop smoking or chewing tobacco for at least six weeks after your dry socket heals. An infected dry socket may require antibiotics.
Your dentist may perform oral x-rays to assess whether there is an infection in your jawbone (osteomyelitis).
A dry socket requires treatment by a dentist or oral surgeon to ensure a full recovery, but there are some ways you can manage the discomfort of the condition at home. Ask your dentist if rinsing with saline and using over-the-counter pain relievers at home can help your dry socket.
However, the best home care for a dry socket is prevention, so make sure you follow all postoperative care instructions. To prevent a dry socket, you should:
Complications and side effects of a dry socket
Dry sockets are painful and are difficult to ignore, but they are generally not dangerous. However, if a dry socket goes untreated it can cause more serious problems.
An untreated dry socket can cause delayed healing or an infection that can spread into your jaw bone.
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Health Solutions From Our Sponsors
Canadian Dental Association: "How Do I Manage a Patient with Dry Socket?"
International Journal of Dentistry: "Dry Socket: Incidence, Clinical Features, and Predisposing Factors."
Merck Manual: "Osteomyelitis."
Merck Manual: "Postextraction Problems."
Journal of the South African Dental Association: "Incidence and predisposing factor for dry socket following extraction of permanent teeth at a regional hospital in Kwa-Zulu Natal."
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