If you have ever had a tooth removed or survived the removal of your wisdom teeth, then you have probably been warned about dry sockets. You hear horror stories of your neighbor getting dry sockets after having his wisdom teeth removed, and you quiver at the thought of getting them yourself. They sound painful, but what exactly are dry sockets, and what can you do to prevent them?
What is a Dry Socket?
Dry socket or alveolar osteitis occurs after an adult tooth extraction when the blood clot fails to develop and, instead, dislodges before the wound is healed properly. Generally, when a tooth is removed, a blood clot forms at the extraction site to create a protective layer over the bone and nerve endings within the now-empty tooth socket. The clot is an integral part of the healing process, providing the basis for new bone growth and soft tissue development. However, dry sockets result in exposed bone and nerves. When left untreated, this exposure can cause pain and further complications.
What Does a Dry Socket Look Like?
While having a tooth extraction is never a pain-free process, the pain should not be unmanageable, nor should it extend for any significant time. If the pain worsens, becomes unbearable, or lasts days after the initial extraction, you could be dealing with a dry socket. Other symptoms include exposed bone at the extraction site, bad breath, a nasty taste in your mouth, and loss of the blood clot where the tooth was removed. If you have worsening pain or if it spreads from your surgical site to your ear, eye, temple, or neck, it is high time to see a doctor.
Does a Dry Socket Cause Severe Pain?
Yes, a dry socket can be extremely painful! Unfortunately, when nerve endings and bone are left unprotected by a proper blood clot barrier, they are exposed to the gnawing of the jaw and any food particles that may become lodged. This process can cause severe pain within a patient’s mouth and delay healing. In addition, if food particles stay lodged for extended periods, they can infect the socket and may lead to an infection of the bone.
Will a Dry Socket Heal by Itself?
It is generally recommended that you see a dentist when dealing with dry sockets to prevent the spread of infection. A dentist can also help manage pain by cleaning the socket and packing it with a medicated dressing. But there are some at-home options to keep infection at bay, such as using a saltwater rinse and taking over-the-counter pain medications. Seek a medical professional if the pain persists or worsens.
Dry Socket Predisposing Factors
Some people are more likely to suffer from dry socket pain after tooth extraction. For example, those who smoke, have poor oral hygiene, or use birth control pills are more likely to get a dry socket. Furthermore, it is more common to get a dry socket after the removal of wisdom teeth or for those who already have a history of getting dry sockets after tooth extraction. The more trauma occurs during or after the extraction surgery, the more likely the patient will suffer from dry sockets.
#1: Poor Oral Hygiene
Poor oral hygiene after a tooth extraction increases the risk of getting a dry socket. In order to have successful post-surgery healing, the area must remain clear of any food debris or buildup. Following your dentist’s instructions regarding post-surgery care is especially important in reducing your risk of getting a dry socket.
#2: Tobacco Products
Using tobacco products after oral surgery can hinder the healing process and increase your risk of developing a dry socket by 8%. By breathing in smoke quickly, you may dislodge any forming blood clots. You should at least reduce your tobacco usage for a couple of weeks before any oral surgery.
#3: Oral Contraceptives
While it may seem odd to include oral contraceptives as a cause of dry sockets, the high estrogen levels within these pills can cause disruptions in the ability of the blood to clot. Therefore, it is recommended that you speak with your doctor before a tooth extraction to find an adequate substitute for birth control during the recovery process.
Infection after Tooth Extraction
The extraction site can become infected after tooth removal. Having food debris lodged in the empty socket can hamper the healing process and cause infection. Some signs of infection are fever and chills, swelling, redness, and pus or discharge from the socket. If any of these signs occur, call your dentist immediately, as infections can spread through the bone or gum if left untreated. Keep the extraction site clean and sanitized using proper post-surgery care to prevent infection.
What are the Symptoms of Dry Socket?
It is crucial to monitor for dry socket signs after tooth removal surgery. A properly healing removal site will have a dark red blood clot. If you begin to see a dried-out hole within the socket or the white of your bone becomes visible, you may have the beginning signs of a dry socket. While discomfort after oral surgery is common, it should not persist. Dry sockets can cause intense pain about two days after removing the tooth. You probably have a dry socket if the pain becomes more severe or travels to your ear, neck, or eye. One last symptom is an unpleasant smell and taste in your mouth.
How to Treat and Prevent Dry Socket
The first step toward dry socket treatment is for your dentist to clean the tooth socket of any debris and fill it with a medicated dressing. You may also be prescribed antibiotics to further fight infection within the socket.
At home, some patients are recommended to rinse with warm salt water to help gently clean the area. Preventing dry sockets is relatively easy, depending on your pre-established habits and propensities. An oral surgeon can better evaluate your personal risk factors for dry sockets.
Following your oral surgeon’s instructions for post-surgery recovery is the best way to prevent dry sockets. Some of these recommended instructions include no smoking around the time of the surgery, no drinking of hot or acidic beverages, avoiding any mouth trauma during recovery, avoiding food that is sticky or may get lodged within the socket, no sucking on straws or spoons for about a week after the surgery, and avoiding birth control pills. The American Dental Association also recommends keeping the gauze on the extraction site for 30 to 45 minutes after surgery to aid blood clot formation.
Cleaning and Medicated Dressing
After the empty socket is cleaned of debris, a medicated dressing is placed within the socket to help fight infection and relieve pain. Sometimes taking the form of a paste, the dressing fills the socket and is changed by your dentist every few days until the socket begins to heal and the pain decreases.
While it is recommended that you go to a dentist to treat the infected area, you can take over-the-counter anti-inflammatories and pain medications such as aspirin or ibuprofen to relieve dry socket pain. However, these medications are not always strong enough to relieve throbbing pain; therefore, your oral surgeon can provide prescription medications as heavier pain-relieving options. Other pain relief methods include placing cold packs on the outside of your face following the first day after extraction and warm packs after the first day to reduce pain and swelling.
Oral surgery is any operation completed on teeth, gums, jaw, or the surrounding oral and facial structures. Some procedures under the umbrella of oral surgery include teeth extractions, dental bone grafts, gum grafts, and corrective jaw surgery. Tooth extraction, such as wisdom teeth removal, is the most common type of oral surgery.
A dry socket is one of a few complications that can occur after oral surgery. You can help decrease the risk of getting dry sockets by following recommended procedures before and after tooth removal.
Build a Diet around Soft Foods
It is important to keep the socket clean of food debris to help with healing. Thus, eating only soft foods such as yogurt and applesauce is recommended. Food that is chewy, crunchy, or can become easily stuck is not recommended.
When chewing, use the side of your mouth opposite that of the removal site. Avoid any food with a sucking motion, such as soup, as it may pull apart the blood clot. If the clot is damaged or removed because of food, dry sockets are more likely to occur.
Avoid Carbonated Beverages
Acidic and carbonated beverages such as sodas are higher risk factors for dry sockets as they can disintegrate the blood clot. Similarly, avoid alcoholic, caffeinated, or hot beverages until your dentist says it is safe to consume them again. As with food, do not drink with a straw as it causes a sucking motion which may prevent proper healing.
Limit Your Intake of Tobacco Products
According to the Mayo Clinic, it is recommended to cease tobacco use for at least 48 hours after surgery. Tobacco products can also hurt the healing process and increase the risk of dry sockets. Post-surgery, inhale very gently when smoking habits are resumed or use an alternative such as a nicotine patch.
Improve Your Oral Hygiene
The most effective way to prevent and manage dry sockets is through proper oral hygiene, limiting bacterial contamination. Following your dentist’s instructions will be the best way to keep your mouth healthy and clean. Gentle brushing and rinsing are generally recommended, and if possible, use an antibacterial mouthwash. You can use gauze pads as directed.
When preparing for oral surgery, ensure you know the proper methods of preventing post-surgery complications, such as dry sockets, as implementing simple oral hygiene methods can save you from the dreaded pain of dry sockets.
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