Dry socket (alveolar osteitis) is a condition that occurs when a blood clot at the site of a tooth extraction becomes dislodged, exposing underlying bone and causing increasing pain. It's the most common complication following tooth extraction, but with meticulous postoperative care and avoidance of risk factors, dry socket can sometimes be prevented. When it does occur, treatment usually provides immediate relief.
Dry socket has several tell-tale signs and symptoms, including:
Normally, a blood clot forms at the site of a tooth extraction. This blood clot serves as a protective layer over the underlying bone and nerve endings in the empty socket. The clot provides the foundation for the growth of new bone.
In some cases, though, the clot doesn't form properly or is physically dislodged before complete healing. With the clot gone, bone and nerves in the socket are exposed to air, fluids and food. This can cause intense pain, not only in the socket but also along the nerves radiating to the ear and eye on the same side of your face. However, the biological process of a dry socket remains the subject of study. Some researchers believe that several issues may be at play, including:
Dry socket occurs in about 3 percent to 5 percent of all tooth extractions, but it's much more common after extraction of wisdom teeth and impacted wisdom teeth in particular.
Certain factors can increase your risk of developing a dry socket after a tooth extraction. These include:
When you've had a tooth extracted, any discomfort you experience normally gets better with each passing day. If you develop new or worsening pain in the days after your tooth extraction, don't try to tough it out. Contact Mr. Erasmus right away so that you can get properly assessed and treated.
In order to determine if you have dry socket, or another condition, Mr. Erasmus will ask about your symptoms and examine your mouth. He will check to see if you have a blood clot in the socket and whether you have exposed bone.
Dry socket can cause a variety of complications. Pain, of course, is the major complication. Because of the pain and repeat trips to see Mr. Erasmus for treatment, you may miss time at work or school.
Dry socket also delays the healing process after a tooth extraction. Gum tissue normally takes three to four weeks to heal, while bone can take up to four months to heal, and dry socket can delay this process.
Dry socket can also interfere with the placement of dental implants or with other dental procedures, and these may need to be rescheduled until you've healed completely.
Treatment of dry socket is mainly geared toward reducing its symptoms, particularly pain. Treatment includes:
Once treatment is started, you may begin to feel some relief in just a few hours. Pain and other symptoms should continue to improve over the next few days. Complete healing typically goes smoothly and generally takes about 10 to 14 days.
Steps that both you and Mr. Erasmus take may go a long way in helping prevent dry socket or to reduce your risk.
What Mr. Erasmus can do
Although dry socket has been recognized since the late 1800s, medical science has yet to develop a surefire way to prevent it. Some research suggests that treatment with certain medications such as antibiotics before or after oral surgery may reduce your risk of dry socket. However, this practice remains controversial, and some believe that preventive treatment with antibiotics isn't appropriate because it may contribute to problems such as antibiotic-resistant bacteria.
Talk to Mr. Erasmus about using these medications or precautions when you have tooth extraction surgery:
What you can do before tooth extraction surgery
What you can do after tooth extraction surgery
Dry socket rarely results in infection or serious complications. But getting the pain under control is a top priority. You can help promote healing and reduce symptoms during treatment of dry socket by: