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Dry socket is also known as fibrinolytic osteitis or alveolar osteitis. It is a common complication of tooth extractions (like wisdom tooth removal) that can occur 2 to 5 days after the extraction procedure.
Dry socket is the delayed healing of the tooth socket. It occurs when a blood clot is dislodged or fails to develop. This exposes the socket and nerve endings to food and bacteria.
People with dry sockets cannot prevent food particles or the tongue from stimulating the exposed bone. This causes frequent, acute pain.
People are more likely to develop this condition if they:
Some common symptoms of dry socket include:
People often describe dry socket pain as throbbing or radiating. It can also extend from the gums to the jaw and ear area. Some people describe the pain as similar to a toothache.
There are some standard practices dentists use to prevent the occurrence of dry socket. They include:
Dentists will often prescribe antibiotics before or after tooth extractions. This is an effective prevention method for postoperative complications like dry socket.
However, some studies suggest the risks of developing complications are too minimal to continue prescribing antibiotics. Researchers are also concerned that taking antibiotics before tooth extractions might cause bacterial resistance.
Using antiseptic mouthwash before a tooth extraction helps prevent dry socket. Betadine or povidone-iodine 1% mouthwash is especially beneficial for older people who are more at risk of developing dry socket.
Betadine is a mixture of povidone and iodine. It contains short-acting but wide-spectrum bactericidal effects. It also helps against sporicidal, fungicidal, and virucidal activity. Its effects also last longer than other antiseptics.
Those who are allergic to povidone-iodine, have thyroid conditions, or are under the age of 12 should not use Betadine.
Chlorhexidine mouth and throat treatments often come as mouthwashes, gels, and sprays. Chlorhexidine is an antiseptic and disinfectant that can help reduce bacteria in the mouth.
It also helps with other conditions, which include:
People who are 12 years or older can use chlorhexidine mouthwashes or gels. Common side effects include staining of the teeth and tongue, taste changes, and tartar formation.
After tooth extraction, dentists sometimes apply platelet-rich fibrin (PRF) and hyaluronic acid (HA) dressings to the socket. These can help promote blood clot formation.
PRF is a biomaterial prepared from a person’s blood. It’s taken before a tooth extraction. Dentists prepare it using a simple processing method.
HA naturally occurs in the body’s tissues. It’s also a critical component in cell migration and proliferation, ideal for wound healing.
The combination of PRF and HA has many advantages, including:
The following are signs of an infection that require a dentist visit:
Touching the exposed bone in dry socket can cause more pain. Treatment is essential to ease symptoms and encourage proper healing.
According to Dr. Nandita Lilly, one of NewMouth’s in-house dentists, “the goal of any treatment for dry socket is to relieve pain. It is important to see your dentist if you have any moderate to severe pain after an extraction.”
Treating dry socket aims to help the tissue form a blood clot to cover the exposed bone inside and around the socket.
A dentist will rinse the area using chlorhexidine gluconate or sterile saline. This flushes out any debris and bacterial material in the area.
After irrigation, a dentist may choose to cover the area with a medicated paste dressing. This needs to remain in the socket for a few days while a blood clot forms. It protects the bone from mechanical stimulation and bacterial infiltration.
The dry socket paste can contain Eugenol and a gel containing 2.5% prilocaine and lidocaine for pain control. Dentists may also use a mixture of Guaiacol, Eugenol, Chlorobutanol, and Balsam of Peru (GECB).
If the blood clot or medicament is consistently dislodged, dentists may choose to suture the tooth socket. This can help retain the medicament and blood clot.
Home Remedies for Dry Socket
To prevent dry socket, follow your dentist's instructions, which may include:
To care for a dry socket at home, you should also:
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Dry socket is also known as fibrinolytic osteitis or alveolar osteitis. It’s a common complication of tooth extractions and can occur 2 to 5 days after the procedure.
Symptoms of the condition include bad breath, bad taste in the mouth, and excessive pain. People are more prone to developing this condition if they:
Dentists often prescribe antibiotics to prevent dry socket from developing. They can also instruct people to use an antiseptic mouthwash or use a PRF and HA dressing after the operation.
Treatments include flushing out debris, applying medicament, and/or suturing.
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