Question: I have heard about a “dry socket” after wisdom tooth extraction, what is this about?

Answer: A dry socket is a common condition that happens after a tooth is extracted. It happens when the blood clot that is supposed to cover the socket of the tooth has dislodged; this exposes the wound along with the blood vessels, nerves and bone. A dry socket is very painful and this type of pain may not be relieved by ordinary pain killers. Your dentist may advice you to follow-up as soon as possible to treat a dry socket.

Why do dry sockets happen?

Dry sockets, as the name implies, is an empty socket after a tooth extraction or wisdom tooth extraction where a blood clot is supposed to be. Naturally, any type of wound forms a clot which is the basis for the formation of new tissue and eventually healing the wound completely.

But there are some cases when the blood clot is prematurely removed or may dissolve too soon. This results to an empty socket where tissue should be but instead there are nerves and bone exposed. There are so many theories on how a dry socket is formed and the most common are the following:

  • There are remaining tooth or root fragments in the socket which is why the clot cannot completely cover the wound/socket resulting in removal or dissolving prematurely. It is therefore important that dentists make sure that all the bits of tooth and root are completely removed and to schedule follow-ups as frequently as possible to assess wound healing.
  • There is possible tissue trauma on the site which is why the clot cannot completely cover the wound. This is mostly the case of complicated wisdom tooth extractions since this kind of tooth mostly impacts or may partially erupt. Your dentist may scrape tissue covering the tooth or drill bone when wisdom tooth is embedded on bone. All of these practices can significantly affect the formation of blood clot on the area.
  • Infection may also affect the way blood clots form and this is a huge possibility when a wisdom tooth is extracted. Infection happens when food and dirt particles settle in the socket of the tooth. Bacteria prevent the formation of clots and may also affect wound healing time.
  • Wrong practices after tooth extraction may also lead to an open socket even when it is a regular extraction. If you brush the area or pick the area with a tool or a toothpick to remove food particles then you are placing yourself at risk of developing a dry socket. Eating or chewing on the affected area will also increase the possibility of removing the blood clot. If you gargle too hard or use strong mouthwashes, you may also increase the possibility of removing the clot too soon.
  • Certain illnesses that affect the clotting of blood may predispose a person to develop a dry socket every time he undergoes tooth extraction.

What are the signs and symptoms of a dry socket?

The most common symptom of a dry socket after wisdom tooth extraction is pain which appears after a few days following the extraction. Pain is described as severe and may not respond to over-the-counter pain relievers. Pain may be so intense that it can be felt over the extracted area, along the eyes, on the temples and on your neck. There is a noticeable empty socket on the area as well as visible bone. On your neck, there are swollen and painful lymph nodes. These lymph nodes may be very painful and tender to the touch.

You may also experience an unusual taste in your mouth and a powerful odor or bad breathe that is coming from your mouth as a result of a dry socket formation.

The treatments for dry sockets:

It is very hard to manage pain from dry sockets. You need to consult your dentist right away for the best treatment possible.

  • Flushing the socket is the most important thing. This is done by using and instrument that will first carefully pick any foreign material or food debris on the surface of the wound or socket. Flushing is done by using a stream of sterile water applied in the area with a syringe. After the procedure the patient is instructed to avoid eating certain foods that can contaminate the area and to avoid eating or chewing on the area.
  • Some dentists apply dressing on the area to prevent exposure of nerve and bone which are often the cause for pain and infection. Medicated dressings may be applied at home; it should be changed several times a day.
  • Pain medications sold over the counted may not work in this condition and your dentist may prescribe a stronger pain reliever to reduce pain. You may also do self-care measures at home; self-care treatments like using cold compresses on the site may help to naturally alleviate pain.
  • Your dentist will schedule another appointment to evaluate your response to the treatments. Wounds that have begun to be infected could heal longer. You will surely be started with antibiotics to take care of infection since open wounds are great places where bacteria can live and thrive.

There are some lifestyle changes that your dentist may recommend you start to help your wound heal properly. Most dentists will tell you to avoid smoking if you smoke and to reduce alcohol intake as well. Nicotine and alcohol will affect wound healing and will also reduce your immune system function. Smoking does not benefit the body at all and will even increase your risk of developing cardiovascular diseases and respiratory illnesses.

It is also important to keep yourself healthy and fit since people who are ill may have poor wound healing abilities. You can significantly improve your health by consuming a healthy diet, exercising and staying away from bad habits like smoking and drinking. Ask your dentist for more information about dry sockets.

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