A dry socket, also known as alveolar osteitis, is a common complication after tooth extractions, particularly wisdom tooth extractions. Nearly 1 to 5%1 of people develop a dry socket after having their tooth extracted. Under the normal healing process, after an extraction, the empty socket fills with blood which then clots and stops further bleeding. The body then begins to build granulation tissue to cover the wound.
Therefore, the blood clot in the tooth socket is the forerunner to future permanent tissue, and it is an essential part of the healing process. It also protects your bones and nerves from being exposed and reduces the likelihood of infection. Under the ordinary course of healing, the blood clot would eventually convert to fibrous scar tissue. However, when the clotting does not form properly or gets dislodged prematurely, you develop what is known as a dry socket.
Dry sockets are defective, abnormal healings. They can be partial or complete, depending on how much of the blood clot was affected. They can result from surgical injuries, bacterial infection or blood clot removal and cause severe sensitivity, pain and inflammation.
Signs of Dry Socket
Pain and inflammation are common after a tooth extraction, the pain after tooth extraction lasts typically for 24-72 hours only. If you experience severe pain after this period, develop facial swelling, and feel a throbbing pain radiating to your ears, you may have developed a dry socket.
Intense pain post 72 hours indicates that the protective layer from the blood clot has come off, and your sensitive bone tissue is exposed to air.
Some other symptoms of dry socket include:
- Unpleasant taste in your mouth
- Jawbone exposure in the socket
- Grayish looking extraction site due to inadequate healing
- Bad breath from food particles getting stuck in the socket
What Causes Dry Socket
While there is no precise reason for a dry socket formation, certain factors could increase your chances of developing a dry socket.
Brushing and forceful rinsing
A dry socket can form within seven days of surgery. During this time, ensure that you aren’t brushing vigorously or rinsing forcefully. Brush gently around the site of the extraction and swish water/medicated rinse gently.
Drinking through a straw, sneezing or coughing
The suction created while drinking from a straw can displace the clot, as can the force applied while sneezing, coughing or spitting.
A survey among patients showed that non-smokers stood a 4% chance of developing dry sockets compared to 12% of smokers2. The drawing-in force created by smoking increases the risks of dry socket formation.
If your extraction was a particularly difficult one, the chances of dry socket formation become significantly higher. In complicated extractions, tiny bone fragments or root fragments can get left behind in the socket and interfere with blood clot formation.
Pre-existing infections or diseases
People who already have bacterial infection or periodontitis stand a greater chance of developing a dry socket. If you’re aware of any infectious condition, speak to your dentist about taking antibiotics. Those who’ve had severe illnesses or a history of cancer3 are also likely to be more vulnerable.
Birth control pills or estrogen supplements
The hormonal changes induced by estrogen and birth control pills may make it harder for a blood clot to form, with one study suggesting that oral contraceptives create a two-fold increased risk of dry socket formation.4
How to Prevent Dry Socket
The first step to preventing dry sockets is to get your extraction done with an experienced dentist. At Rockwest Dental, our dentists will evaluate your tooth and decide between a simple or surgical extraction. They will also advise you on the key care protocol to be observed until complete healing. It’s essential to follow the doctor’s post-operative instructions carefully and maintain oral hygiene.
Days 1-3 After the Tooth Extraction
- Allow the blood clot to form by leaving the gauze your dentist placed in your mouth for a few hours.
- Take the first 24 hours slow, resting as much as possible and keeping your head raised while lying down.
- Avoid rinsing your mouth the first few hours as the clot may get dislodged.
- Avoid drinking with a straw or spitting hot liquids, alcohol, and smoking.
- Refrain from blowing your nose, coughing and sneezing.
- Take the prescribed pain relievers.
- Prevent swelling by placing an ice pack on your cheek for 10-20 minutes at a time.
Day 3 And Beyond
Once the blood clot has formed, these simple precautions can help prevent other issues and accelerate healing:
- Rinse your mouth 2-3 times a day with warm salt water or a medicated rinse to kill bacteria.
- You can resume regular brushing and use water flossers and interdental brushes; however, continue to stay away from brushing at the site of the extracted tooth.
- As much as possible, continue to eat soft, healthy foods and snacks that require minimal chewing.
Learn More About How to Treat Dry Socket in Mississauga
If you suspect that you’ve developed a dry socket, give our dental clinic a call. Until your visit, treat the affected area with an ice pack and over-the-counter painkillers.
At Rockwest Dental, most dry sockets that we encounter result from traumatic extractions or poorly followed home care instructions. If required, our dentist will clean out your socket, remove food debris and help tackle foul odour by clearing up visible signs of infection.
They will then pack the socket with a medicated dressing to relieve pain and accelerate healing. You may also be prescribed non-steroidal, anti-inflammatory drugs. Most dry socket pain will subside within 24–72 hours if treated promptly.
If the infection is severe, healing could take up to seven days. If the dry socket is total and no natural clot is left, you’d require repeated dressings. Failing to treat the dry socket rarely leads to severe complications, but it can cause a lot of pain and set your healing back by nearly two weeks. In rare cases, it could progress to osteomyelitis or chronic bone infection.If you’re in Mississauga, request a free initial consultation to evaluate your healing.
- Mamoun, John. “Dry Socket Etiology, Diagnosis, and Clinical Treatment Techniques.” National Center for Biotechnology Information, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5932271/. Accessed 10 September 2021.
- Younis, Mohammed H Abu, and Ra’ed O Abu Hantash*. “Dry Socket: Frequency, Clinical Picture, and Risk Factors in a Palestinian Dental Teaching Center.” National Center for Biotechnology Information, 2011, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3089956/. Accessed 9 September 2021.
- Levitin, Seth A., et al. “Mining Electronic Dental Records to Identify Dry Socket Risk Factors.” National Center for Biotechnology Information, 2019, https://pubmed.ncbi.nlm.nih.gov/31349334/. Accessed 10 September 2021.
- Bienek, Diane, and James Filliben. “Risk assessment and sensitivity meta-analysis of alveolar osteitis occurrence in oral contraceptive users.” Science Direct, The Journal of the American Dental Association, 2016, https://www.sciencedirect.com/science/article/abs/pii/S0002817716000660?via%3Dihub. Accessed 11 September 2021.
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