One of the most severe types of oral pain that one can experience is associated with a condition called dry socket. I therefore feel that this is an important topic upon which to shed some light, as knowledge can help reduce people’s chances of having to experience the miserable consequences of this dental condition.
What is dry socket?
Also known as alveolar osteitis, dry socket is a complication that can occur after a tooth extraction. When a tooth is pulled, a blood clot typically forms where that tooth was. This clot is important in that it serves as a protective layer over the underlying bone and sensitive nerve endings in the tooth’s now empty socket. The clot’s other function is to provide a growth medium for new bone and tissue. Sometimes however, the clot becomes dislodged after an extraction or simply dissolves before the wound from the extraction has had an opportunity to heal The absence of this blood clot creates a condition known as dry socket which leaves those nerves and bone exposed, thereby creating significant and intense pain.
How common is dry socket?
The chance of getting dry socket after a routine dental extraction ranges from about 0.5 to 5%. However, the odds increase significantly to 25 to 30% for impacted wisdom tooth extractions.
Signs and symptoms
Symptoms of dry socket to watch for after undergoing a tooth extraction include:
- Visual evidence of an empty tooth socket. Sometimes you can actually see where the blood clot partially missing or altogether absent and you might even be able to see the bone itself.
- Throbbing pain on the side of your face where you had a tooth removed. The pain usually starts from the socket and radiates to your eye, neck, ear or temple. Typically the pain starts on the second to fourth day after the extraction.
- Bad breath.
- An unpleasant taste in your mouth.
- A slight fever.
- Swelling in your neck or jaw area.
- Severe pain from which you can’t seem to get any relief, despite taking medications that were provided to you post-extraction.
Only your dentist can reliably diagnose a case of dry socket so if you feel that you might have it, see him or her immediately.
Causes and risk factors
While sometimes dry socket is simply unavoidable, there are some factors that can increase one’s chances of getting it. These include:
- Tobacco use. Research has determined that use of any type of tobacco makes one more predisposed to this condition. If you are a smoker, stop smoking a few days before and at least a week after an extraction to help mitigate risk.
- Radiation Treatment. Some radiotherapy directed at jaw bones can decrease blood supply and therefore increase one’s chances of getting dry socket.
- Use of straws or spitting forcefully. Never drink through a straw or spit forcefully after undergoing a tooth extraction as both of these actions create a negative pressure within your mouth which can in turn force blood clots out of their sockets.
- Oral contraceptives. The high levels of estrogen created by this type of birth control can often disrupt the normal healing process, thereby increasing the risk of dry socket.
- Certain medications like prednisone can increase one’s risk. If you take any medications regularly, talk about your risks of dry socket with your pharmacist, dentist or oral surgeon in advance of having a tooth extracted.
- Hot drinks, which should be avoided for at least several days after an extraction.
- Having had dry socket in the past. If you have had dry socket once, you are more likely than those who have not, to get it again.
- Oral infections. Similarly, if you have had or currently have any type of gum or tooth infection, your chances of getting dry socket increase.
Treatment
Most of the treatments for dry socket are directed at reducing pain. These include:
- Flushing out the socket. Your dentist might do this to remove any particles that might be contributing to the pain. You might also be provided with equipment to continue cleaning out the socket at home.
- Medicated rinses and dressings. These provide relatively fast pain relief and can be used multiple times throughout the day.
- Pain medicine. In most cases, you will require a prescribed medication.
Once treatment has commenced, your pain should gradually diminish and likely be completely gone within approximately one to three weeks.
Steven Deskin is a Brantford Dentist in general practice.
