Dry Socket or alveolar osteitis is a very painful condition that sometimes follows difficult tooth extractions. To give you an idea of just how painful it can be, people who have had toothache, say it is the worst pain imaginable. Dry socket can be more painful than toothache! Some patients with dry socket are convinced that the wrong tooth has been removed because they still feel “toothache” type pain.
When does dry socket happen?
It commonly occurs following lower wisdom tooth extractions and difficult surgical extractions.
Why does it happen?
Dry socket is a failure of the extraction socket to heal normally. Following a tooth extraction there is a small amount of bleeding from the socket, which is normal. Provided a clot forms and remains, the gum and bone socket will heal normally. If there is a failure of clotting or the clot is lost or partially lost, the empty socket with exposed bone is exquisitely painful and sensitive to touch and takes longer to heal. This is a dry socket.
What are the signs and symptoms of dry socket?
Dry socket typically presents a few days after the tooth extraction and is characterized by moderate to severe pain that is not relieved with painkillers. Patients complain of a dull ache or throbbing pain, which sometimes spreads to the eye, ear or neck. They may also complain of a bad taste or bad breath. The dentist will see a socket, which is either empty or has food packing within it. They may also see swollen and red gums over the socket.
Are there any risk factors?
The risk increases with age, smoking and the use of the oral contraceptive pill in women.
Can it be prevented?
By following the dentist’s instructions, patients can reduce the likelihood of dry socket occurring. After extraction, avoid hot drinks and hot foods for a day or two as they interfere with the clot. Avoid smoking for 24-48 hours as this reduces blood flow to the gums which delays healing. Avoid spitting and rinsing the mouth and drinking through a straw as these can dislodge the clot.
How is it treated?
The treatment of dry socket is very simple. The dentist will need to examine the patient to confirm dry socket. They will most likely flush the socket with an antibacterial mouthwash to remove food debris, encourage blood flow back to the area and to disinfect. A dressing called Alvogyl will then be placed into the socket, which contains an analgesic, anaesthetic and disinfectant. It is preferable to do this without using local anaesthetic because local anaesthetic reduces blood supply to the area, which is counter-productive. This may need to be repeated once or twice over the next few days but the dentist will advise.
If you suspect you have dry socket, please do not do what a recent patient did and think it was normal and suffer in silence. Please contact the practice number to seek advice and come back for treatment as soon as possible. Treatment is quick and simple but very effective.