DRY SOCKETS

What is it?

A Dry Socket is a painful inflammation that can develop in the open tooth socket after a tooth has been removed (extracted). Dry sockets often develop 3-4 days after an extraction. This condition can cause severe pain extending up to the ear. The socket may smell bad. The pain from a dry socket may last for several days to two weeks, but is most often resolved within 10 days of extraction.

How does it occur?

A “dry socket" occurs when the blood clot is lost from an extraction site prematurely from disintegration or dislodgment. Basically, the blood clot in the socket serves the same two functions as a "scab" on a skin surface cut. First, it assists in the cessation of bleeding and second, it protects underlying structures during the healing process. Like the child who "picks at a scab" the area heals in time but is painful for far longer than if the "scab" had been left alone. When the blood clot is lost before the underlying structures have had time to heal, bone is exposed to the oral environment along with fine nerve endings.

Who gets it?

Any extraction sites can develop dry sockets. This condition is more common in the mandibular area and in back teeth due to poorer circulation in this area, with wisdom teeth being the most common site.  Dry socket delays the healing process. Women tend to get dry socket more than men. Patients over 30 are more susceptible. There are some activities which may increase the propensity for dry socket formation...smoking, drinking carbonated beverages in the first 24 hours after surgery, spitting or drinking through a straw in that same time period...but often "dry sockets" occur for no particular reason at all.

How do you treat it?

This is an exquisitely painful but otherwise relatively harmless situation. There are packing materials which we can place to help ease the discomfort both by physically blocking the wound and by the action of the chemicals in the pack on local nerve endings. Generally, patients return to have the pack changed every couple days and most patients do not require more than 2 or three dressing changes. Some patients require no dressing while others may require 4 or 5 changes of packing. Fees associated with this are charged per dressing we apply. We often prescribe pain medication to manage the symptoms. Time and good oral hygiene usually resolve the situation.