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Wednesday, 9 May 2018

Do I Have Dry Socket?

Dr. Vincent Wan


A tooth extraction isn’t the nicest procedure at the best of times.  However, it is usually a necessary procedure to get rid of pain, infection or both.  A dry socket after the extraction just makes the bad situation even worse.

After a tooth is removed, a blood clot forms overt the hole where the tooth used to be.  The blood clot protects the exposed underlying tissue and guides tissue healing.  A dry socket occurs when a proper blood clot does not form or more commonly, is dislodged after it is formed.  The jaw bone that was housing the tooth roots is left exposed and this is very painful.

Normally after tooth removal, most of the pain and swelling subside within 2 to 3 days.  If this does not occur, but rather the symptoms increase, there is a possibility you have a dry socket.  The pain is usually quite severe and may radiate from the tooth socket to the eye, ear, temple and neck on the same side as the tooth removal.  There may be a bad taste and smell from the area.  It may be hard for the average patient to tell, but there will be no blood clot, lack of tissue healing and visible bone exposed when the site is examined.

You will need to go back to the dentist to have the socket cleaned and healing started again with the formation of a new blood clot.  The dentist will flush the socket to remove any irritants and debris.  The socket is packed with a medication which kills infection and helps with pain and tissue healing.  More pain medication and antibiotics may be prescribed.  Home care for the socket such as rinsing it with water salt water and a soft diet need to be continued.

Dry sockets tend to occur more in patients who smoke and drink alcohol after getting the extraction.  Not following the dentist’s after care instructions, especially lack of proper socket cleaning, gives you higher risk of a dry socket.  General poor oral hygiene and untreated gum disease and tooth decay in nearby areas of the mouth are also risk factors.  Interestingly, being on oral contraceptives or hormone replacement therapy gives higher likelihood to dry sockets as well as they affect tissue healing.