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DRY SOCKET

      Dry socket is the most common complication of an extraction. It develops in about 5% of tooth extractions. It is very painful condition that is easily treated.  

 A dry socket is: 

Any socket in which a patient is having pain due to the loss of the blood clot thus exposing the bone to air, food, and fluids along with an offensive odor.  This often occurs two or more days after an extraction and can last about 5-6 days.  It is normal to have soreness and discomfort following an extraction.

       However, pain should be lessening by the second day.

     This condition exist when a blood clot is dislodged from the surgery site thus exposing the bone and fine nerve endings. The blood clot helps in the stopping of bleeding and lays the foundation or framework for new tissue and bone to develop over a two-month healing process.  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.

     It usually takes gum tissue about 3-4 weeks to heal where as the bone can take up to six months to heal.

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    This condition is most often found:

1.  In individuals who smoke before their recommended time.  Smoking: decreases healing, decrease blood supply to the protective blood clot, brings toxic products to the area, injuries the gum tissue and the negative pressure of sucking removes the blood clot from the surgery site.

2. If you do not care for your extraction site as instructed by staff.  

3. Not following your home care instruction. 

4. Sucking action from smoking, sneezing, coughing, spitting or sucking,  within the first 24 hours.  

5. Women taking oral contraceptives are more susceptible.

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    Prevention of dry socket:

     If you have a dry socket contact us immediately. 

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     Treatment could include the following:

     Patients usually notice pain relief in about 5-10 minutes after the dressing is applied.

     We have experienced fewer cases of dry socket since every patient is asked to rinse with an antimicrobial mouthwash and each patient is instructed on how to care for their extraction site through CD ROM patient education, verbal instruction and home care instruction handouts. We highly recommend patients use Breath RX in their daily oral hygiene routine to help control oral bacterial

     Continue these instructions for the next 3-4 days:

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News Updates on Dry Socket

Oral contraceptive may increase pain after wisdom tooth extraction 

That tests on 267 women showed that those on the birth control pill were more susceptible than non-users to both postoperative pain and a condition known as 'dry socket.' In this condition, normal healing of the vacant tooth socket is delayed by the failure of a blood clot to form. Infection instead causes the socket to remain empty. In the study, pain on the day after the operation was experienced by 30 percent of pill takers compared to just 11 percent of non-users. Five days after the operation the difference was 14 percent compared to 5 percent. The researchers said these results suggest that the pill may reduce the pain threshold. The differential was similar when the development of dry socket was compared. Here, 11 percent of pill users were affected compared to 4 percent of non-pill users. 
SOURCE: British Dental Journal 2003;194:453-455.

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*Ms Flossy
* Dr. Leonard.  Dental Products Report March 2001.
** Academy of General Dentistry.
Dentalnotes Fall 2002 pg3.

February 06, 2008