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A dry socket (alveolar osteitis) is a painful inflammation that can develop in the jawbone's open tooth socket after a tooth has been removed.
Dry sockets often develop after extraction and are more common after extraction of the third molars, or wisdom teeth removal.
A socket appears as a hole in the jawbone where a tooth was previously. After a tooth is removed during oral surgery, a blood clot forms in the socket. A blood clot protects the bone and nerves underneath as it heals.
A dry socket occurs when the blood clot is lost or prevented from forming. When the blood clot cannot form properly, the bone and nerves are exposed to the air, which causes severe pain and delays healing.
Dry socket occurs in approximately 1 to 5% of all extractions and up to 38% of wisdom tooth extractions. Dry sockets are more frequent in the lower jaw, in patients older than thirty years, in female patients, and in teeth that were infected before surgery.
Summary
A dry socket is a painful inflammatory condition that can occur after tooth removal (especially wisdom tooth extractions). It is a common but treatable condition.
A dry socket forms when the blood clot at the site of surgery dissolves or is dislodged.
Common factors that cause dry socket include:
Summary
A dry socket can form due to bacteria buildup, food particles, mechanical motions, smoking nicotine, oral contraceptive pills, and alcohol/carbonated drinks.
Symptoms of dry socket are:
Factors that increase the risk for a dry socket include:
Summary
The most common signs of dry socket formation include throbbing pain, bad breath, and an unpleasant taste in the mouth. Fevers can also occur.
A dry socket looks like a hole left after tooth extraction, where exposed bone within the socket or around the perimeter is visible. The opening where the tooth was pulled may appear empty, dry, or have a whitish, bone-like color.
Typically, a blood clot forms over your empty socket. This clot protects the wound while it heals and promotes new tissue growth. Without a blood clot over the socket, raw tissue, nerve endings, and bone are exposed.
The socket bone can be exposed entirely or can be covered by food debris or clumped bacterial material. When surrounded by food debris or bacteria, the socket can appear in various colors, including black, yellow, and green.
On the other hand, some patients sometimes may not be able to visibly notice a dry socket, just a hole after tooth extraction.
A dry socket is treated by a dentist or an oral surgeon, and typically consists of the following steps:
Summary
Dry sockets are relatively easy to treat (but require prompt treatment). The procedure includes flushing the socket and dressing it to prevent another one from developing.
To prevent dry socket, patients should follow their dentist's instructions, which may include:
To care for a dry socket at home, patients should:
Oral antibiotics do not significantly decrease the risk of dry sockets because there are hundreds of bacteria types in the mouth. For that reason, even if patients have good oral hygiene, they may still develop dry sockets.
Summary
If you have a dry socket, do not smoke or rinse the area. Take OTC pain medications and ice your jaw as needed. Visit your dentist ASAP for treatment.
There are a few ways to prevent a dry socket from forming. The most important prevention technique is to rinse your mouth a few times each day. Make sure you gently rinse your mouth because aggressive rinsing/spitting can make the blood clot fall out.
Also, do not brush the extraction site for at least a week post-op. Only eat soft foods like smoothies, eggs, soup, and mashed potatoes. Refrain from drinking hot liquids, carbonated drinks, alcohol, and caffeine until the extraction site heals.
Smoking tobacco products can also increase the risk for infection and dry socket.
Summary
Patients should contact a dental or healthcare professional if they develop severe pain a few days after tooth removal. Dry sockets are easily diagnosable and treatable.
A dry socket may look like an empty hole at the tooth extraction site. It may appear dry or have a whitish, bone-like color.
During the healing process, a red-colored blood clot forms in the socket. The clot is then slowly dissolved away and replaced with fibrin, an insoluble protein formed during blood clotting. Fibrin can appear in a whitish color. Eventually, the gums grow over the fibrin, and the pink color reoccurs until full healing.
In most cases, a dry socket will heal on its own. However, in many cases, as the site heals, patients will likely continue to experience discomfort. Patients should visit a doctor to treat dry sockets to prevent further oral health complications.
Patients who develop dry socket complain of pain 3 to 5 days post-extraction. This pain is usually worse than it was immediately after extraction.
Dry sockets are more common in the lower jaw. The pain often radiates to the ear or neck, or other areas in the jaw. Pain can also be accompanied by bad breath and a bad taste in the mouth. Dry socket is not an infection and is not accompanied by swelling, redness, or fever.
In patients with dry sockets, the pain may keep them up at night and is often not fully treated by over-the-counter pain relievers such as ibuprofen. If things were getting better after surgery and suddenly worsen, it may be a sign of a dry socket.
If you start to feel severe pain 3 to 5 days after the surgery, it may indicate a dry socket.
The pain can last between 10 and 15 days with or without treatment.
If the pain does not improve with medications (and your breath worsens), call your dentist immediately. It could be a sign of a more serious infection.
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