Disease: Dry Socket

    What is a dry socket?

    The typical scenario for dry socket is the occurrence of throbbing pain about two to four days after the tooth is extracted. Dry socket pain is often accompanied by bad breath and a foul taste in the mouth. It is obvious that healing has been interrupted.

    Dry socket is a condition in which there is inflammation of the jawbone (or alveolar bone) after a tooth extraction. It is also referred to as "alveolar osteitis" and is one of the many complications that can occur from a tooth extraction. The occurrence of dry socket is relatively rare, occurring in about 2% of tooth extractions. However, that percentage rises to at least 20% when it involves the removal of mandibular impacted third molars (lower wisdom teeth).

    What causes a dry socket?

    A dry socket is caused by the partial or total loss of a blood clot in the tooth socket after a tooth extraction. Normally, after a tooth is extracted, a blood clot will form as the first step in healing to cover and protect the underlying jawbone. If the blood clot is lost or does not form, the bone is exposed and healing is delayed.

    In general, a dry socket is a result of bacterial, chemical, mechanical, and physiologic factors. Below are examples for each:

    • Bacterial: Preexisting infection that is present in the mouth prior to a dental extraction such as periodontal disease (or periodontitis) can prevent proper formation of a blood clot. Certain oral bacteria can cause the breakdown of the clot.
    • Chemical: Nicotine used by smokers causes a decrease in the blood supply in the mouth. As a result, the blood clot may fail to form in the site of a recent tooth extraction.
    • Mechanical: Sucking through a straw, aggressive rinsing, spitting, or dragging on a cigarette causes dislodgement and loss of the blood clot.
    • Physiologic: Hormones, dense jawbone, or poor blood supply are factors that prevent blood clot formation.

    What are risk factors for getting dry socket?

    Smoking is a risk factor for developing a dry socket due to the use of nicotine. Exposure to nicotine reduces the blood supply available to the healing socket and can prevent the proper formation of a blood clot at the extraction site.

    Extraction of impacted third molars (wisdom teeth) can be traumatic as some surrounding gum tissue and jawbone may need to be removed or may be adversely affected during surgery. Although the extraction is necessary, the resulting trauma can increase the chances of dry socket.

    Previous infections such as periodontal disease or pericoronitis at the site of the extraction can predispose an individual to dry socket.

    Women have been found to develop a dry socket more so than men. This may be related to hormonal factors such as use of oral contraceptives or normal hormonal changes during a woman's cycle.

    Patients older than 30 years of age with impacted third molars have an increased risk of dry socket. With age, the jawbone becomes more dense and has less blood supply available. A dense jawbone increases the risk of a traumatic extraction and less blood supply decreases the chances of blood clot formation and healing.

    What are dry socket symptoms and signs?

    A tell-tale sign of dry socket is when there is partial or total loss of a blood clot. The jawbone may be visible in the socket as a white area where it would normally be covered with a blood clot or healing membrane. Dry socket is not associated with an infection and, therefore, not accompanied with fever, swelling, or redness.

    Symptoms of a dry socket include a throbbing steady pain that presents a few days after a tooth extraction. The pain may radiate to other parts of the head such as the ears and eyes on the same side of the face. A foul smell and an unpleasant taste in the mouth may also be present due to the accumulation of food debris and bacteria in the socket. A stiff jaw is not a typical symptom of dry socket but is often a coincidental symptom after an oral surgery procedure such as tooth extraction.

    How is a dry socket diagnosed?

    Diagnosis of a dry socket is based on history of dental treatment, clinical examination, and the individual's symptoms. Timing of when symptoms begin may be an indicator for a dry socket. During normal healing, the discomfort of an extraction should lessen over time. However, if the pain increases, this is an indication that healing is delayed and could possibly be due to a dry socket. Typically, symptoms for a dry socket develop two to four days after a tooth extraction. Most dry sockets happen within the first week after tooth extraction.

    What is the treatment for a dry socket?

    Treatment usually involves symptomatic support while the socket heals. Initially, the dentist will gently irrigate to clear the socket of food debris. Next, an analgesic medicated dressing is placed within the socket to cover the exposed bone. This usually provides immediate relief. This dressing may need to be replaced every few days during the healing process. The dressing is often coated with "dry socket paste," which is made up of ingredients with pain-relieving properties, including eugenol (clove oil).

    Additionally, medications can be prescribed to manage the pain. Nonsteroidal anti-inflammatory drugs (such as Advil or Aleve) or narcotics (such as hydrocodone/acetaminophen [Vicodin]) are often used to relieve pain.

    Are there home remedies for dry socket?

    Home treatment or home remedies for a dry socket should mostly be limited to over-the-counter pain medications for pain management. If timely treatment with a dentist is not possible, the placement of a cotton or gauze packing with a few drops of clove oil placed into the socket may assist in temporary pain relief. The packing may be replaced after 24 hours as needed. A follow-up visit with the dentist or oral surgeon is strongly recommended to properly evaluate and treat the affected areas and avoid complications. Delaying a follow-up visit with a health-care professional could prolong the pain as well as the healing time.

    What are dry socket symptoms and signs?

    A tell-tale sign of dry socket is when there is partial or total loss of a blood clot. The jawbone may be visible in the socket as a white area where it would normally be covered with a blood clot or healing membrane. Dry socket is not associated with an infection and, therefore, not accompanied with fever, swelling, or redness.

    Symptoms of a dry socket include a throbbing steady pain that presents a few days after a tooth extraction. The pain may radiate to other parts of the head such as the ears and eyes on the same side of the face. A foul smell and an unpleasant taste in the mouth may also be present due to the accumulation of food debris and bacteria in the socket. A stiff jaw is not a typical symptom of dry socket but is often a coincidental symptom after an oral surgery procedure such as tooth extraction.

    How is a dry socket diagnosed?

    Diagnosis of a dry socket is based on history of dental treatment, clinical examination, and the individual's symptoms. Timing of when symptoms begin may be an indicator for a dry socket. During normal healing, the discomfort of an extraction should lessen over time. However, if the pain increases, this is an indication that healing is delayed and could possibly be due to a dry socket. Typically, symptoms for a dry socket develop two to four days after a tooth extraction. Most dry sockets happen within the first week after tooth extraction.

    What is the treatment for a dry socket?

    Treatment usually involves symptomatic support while the socket heals. Initially, the dentist will gently irrigate to clear the socket of food debris. Next, an analgesic medicated dressing is placed within the socket to cover the exposed bone. This usually provides immediate relief. This dressing may need to be replaced every few days during the healing process. The dressing is often coated with "dry socket paste," which is made up of ingredients with pain-relieving properties, including eugenol (clove oil).

    Additionally, medications can be prescribed to manage the pain. Nonsteroidal anti-inflammatory drugs (such as Advil or Aleve) or narcotics (such as hydrocodone/acetaminophen [Vicodin]) are often used to relieve pain.

    Are there home remedies for dry socket?

    Home treatment or home remedies for a dry socket should mostly be limited to over-the-counter pain medications for pain management. If timely treatment with a dentist is not possible, the placement of a cotton or gauze packing with a few drops of clove oil placed into the socket may assist in temporary pain relief. The packing may be replaced after 24 hours as needed. A follow-up visit with the dentist or oral surgeon is strongly recommended to properly evaluate and treat the affected areas and avoid complications. Delaying a follow-up visit with a health-care professional could prolong the pain as well as the healing time.

    Source: http://www.rxlist.com

    Treatment usually involves symptomatic support while the socket heals. Initially, the dentist will gently irrigate to clear the socket of food debris. Next, an analgesic medicated dressing is placed within the socket to cover the exposed bone. This usually provides immediate relief. This dressing may need to be replaced every few days during the healing process. The dressing is often coated with "dry socket paste," which is made up of ingredients with pain-relieving properties, including eugenol (clove oil).

    Additionally, medications can be prescribed to manage the pain. Nonsteroidal anti-inflammatory drugs (such as Advil or Aleve) or narcotics (such as hydrocodone/acetaminophen [Vicodin]) are often used to relieve pain.

    Source: http://www.rxlist.com

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