What is a Dry Socket?

A dry socket (alveolar osteitis) is a painful inflammation that can develop after a tooth is extracted in an open tooth socket of the jawbone. Dry sockets are common following extractions, particularly when third molars or wisdom teeth are extracted.

A socket is a hole in the jawbone that once housed a tooth. After a tooth is extracted during oral surgery, a blood clot forms in the socket. A blood clot protects the bone and nerves beneath as they heal.

The socket becomes dry when a blood clot is lost or prevented from forming. When a blood clot fails to form properly, the exposed bone and nerves cause severe pain and delay healing.

Dry socket occurs in 1 to 5 percent of all extractions and up to 38% of wisdom tooth extractions. Dry sockets are more common in the lower jaw, in patients over thirty, in women, and in teeth that were previously infected.

SUMMARY

A dry socket is a painful inflammatory condition that can occur after removing a tooth (especially wisdom tooth extractions). It is a treatable and relatively common condition.

What Is the Cause of a Dry Socket?

A dry socket occurs when the blood clot at the surgical site dissolves or becomes dislodged. Dry sockets are commonly caused by the following factors:

• Bacteria in the area may prematurely dissolve the clot and prevent a dislodged blood clot from reforming.
• Food particles build up within the socket, dislodging a blood clot.
• Mechanical motions such as sucking on a straw or smoking, as well as aggressive rinsing and spitting, can cause a blood clot to dissolve.
• Nicotine consumption slows healing and inhibits the formation of new blood vessels.
• Oral contraceptives and menstrual hormones aggravate dry sockets.
• Alcohol and carbonated beverages can also dissolve a blood clot.

SUMMARY

A dry socket can be caused by bacteria, food particles, mechanical motions, smoking nicotine, oral contraceptive pills, and alcohol/carbonated beverages.

Clinical Picture and Symptoms of a Dry Socket

Three to five days after tooth extraction, the patient complains of:

• Throbbing pain radiating from the socket and reaching the ear, eye, temple, or neck on the same side as the tooth extraction.
• Mouth taste is unpleasant.
• Bad breath or mouth odour
• A mild fever

Factors that increase the likelihood of a dry socket

• Oral hygiene problems
• A difficult extraction
• Taking birth control pills, which can impede healing and cause blood clots
  Tobacco use or smoking retards healing.
• Consumption of alcoholic beverages, which slows healing
• Dry sockets in the past
• After the tooth has been extracted, drinking through a straw may dislodge the clot.
• A lot of rinsing and spitting after tooth extraction can help dislodge the blood clot.

SUMMARY

The most common symptoms of dry socket formation are throbbing pain, bad breath, and an unpleasant taste in the mouth.

Treatment of Dry Sockets

A dentist or oral surgeon will typically treat a dry socket, which consists of the following steps:

1. Remove any food or debris from the socket.

2. Apply medical dressings to the socket.

This keeps new food particles and debris from entering the tooth socket.

3. Following the application of the dressing, you must return to your dentist on a regular basis to have it changed during the healing process.

4. Your dentist may prescribe antibiotics, pain relievers, a special mouthwash, and/or irrigation solutions to aid in healing.

Pain relievers that are available without a prescription can also be used.

5. Rinse your mouth with salt water several times per day to remove bacteria and food particles.

SUMMARY

Dry sockets are a relatively simple condition to treat (but require prompt treatment). To prevent the formation of another socket, the procedure includes flushing it and dressing it.

Dry Socket Home Remedies

To avoid dry sockets, patients should follow their dentist’s instructions, which may include:

• No smoking is permitted.
• No rinsing or disturbing the socket area for at least 24 hours.

Cotton gauzes are changed over the socket as they become soaked with blood.

To care for a dry socket at home, patients should do the following:

• Take pain relievers and antibiotics exactly as prescribed.
• Apply ice to your jaw.
• As directed by the dentist, carefully rinse the dry socket.
• Apply clove oil to the extraction site to relieve pain.
• Eat soft foods until you are completely healed.
• Avoid smoking and drinking alcohol.

Oral antibiotics do not significantly reduce the risk of dry sockets because the mouth contains hundreds of different types of bacteria. As a result, even if patients practise good oral hygiene, dry sockets may develop.

SUMMARY

If you have a dry socket, do not smoke or rinse the area. As needed, take over-the-counter pain relievers and ice your jaw. Consult your dentist as soon as possible.

How to Avoid Dry Sockets

A dry socket can be avoided in several ways. The most important preventative measure is to rinse your mouth several times per day. Make sure to rinse your mouth gently because vigorous rinsing/spitting can cause the blood clot to fall out.

Also, do not brush the extraction site for at least a week after surgery. Smoothies, eggs, soup, and mashed potatoes are the only foods you should eat. Avoid drinking hot liquids, carbonated drinks, alcohol, and caffeine until the extraction site heals.

Tobacco use can also increase the risk of infection and dry sockets.

SUMMARY

If patients experience severe pain a few days after tooth removal, they should contact a dental or healthcare professional. Dry sockets are easily diagnosable and treatable.