Dry Socket

By Catherine M. Fascilla, D.D.S.

A dry socket is one of the most common complications of tooth extraction, especially of impacted wisdom teeth. The dental term for it is alveolar osteitis which means inflammation of the jawbone that surrounds teeth.

When a tooth is extracted, a clot begins to form that protects the socket and will create the foundation for healing. If the clot does not form properly or is dislodged, the bone and the nerves in the socket are then exposed to air, fluids and food.

While most people experience some discomfort after having a tooth pulled, the pain diminishes with each passing day. With a dry socket, pain increases one to three days after the extraction becoming severe after a few days. The pain may radiate to the ear, eye, temple or neck on the same side of the face as the extraction. Other symptoms of a dry socket may include visible bone in the extraction site, bad breath, an unpleasant taste in your mouth and swollen lymph nodes around your jaw or neck.

Alveolar osteitis occurs in 1-3% of extractions and its cause is not completely understood. However, there are factors that increase your risk of developing a dry socket. These include smoking and tobacco use, oral contraceptives, improper home care, a previous dry socket and a current or previous infection around the tooth to be extracted.

The first twenty-four hours after surgery are critical for proper wound healing and clot formation. Smoking must be avoided as well as rinsing, spitting , sucking or drinking through a straw.

Care must be taken to avoid traumatizing the area. Vigorous activities and exercise should be avoided.

If a dry socket does develop, the main goal of treatment is pain reduction. Your dentist or oral surgeon will gently flush the socket to remove debris and place a medicated packing in the site. This may need to be replaced periodically and its placement usually provides immediate relief.


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