Introduction:
A dry socket can be defined as a painful condition that occurs after tooth extraction. It occurs when the blood clot at the extraction site becomes dislodged. It can last for about one week. When a tooth is removed, a blood clot forms. This blood clot is a protective layer over the nerve endings and underlying bone in the empty tooth socket. The blood clot contains cells that are needed for properly healing the site. Intense pain can happen when underlying bone and nerves are exposed. The socket can contain food debris that shoots up the pain. The pain begins 1-3 days after the extraction.
Causes:
The suction force of drinking through a straw can cause the dislodgement of blood clots.
Swishing too vigorously can also cause dislodgement of the clot
Poor oral hygiene
Taking birth control pills: Oral contraceptives containing estrogen can interfere with the body’s natural healing process.
Bacterial accumulation in the socket
Injury at the extraction site when the extraction is difficult. Usually, this happens with an impacted wisdom tooth.
Symptoms:
Pain at the extraction site
Halitosis
Bad taste
Pain that extends from your head to your neck.
Empty socket
Visible bone in the socket
Risk factors:
Smoking and tobacco use
Birth control pills
Tooth or gum infection
Diagnosis:
A dry socket usually manifests with pain between the second and fourth day following a dental extraction. Conversely, other sources of post-extraction pain often arise immediately after the anesthesia wears off (e.g., normal surgical trauma or mandibular fracture) or have a delayed onset (e.g., osteomyelitis, typically causing pain several weeks after extraction) Typically, the diagnosis involves softly rinsing with warm saline and examining the socket with probing.
Occasionally, pain may stem from retained root or bone fragments within the socket, leading to delayed healing. In such cases, a dental radiograph (X-ray) may be necessary to identify and confirm the presence of such fragments.
Management and Treatment:
Rinse the socket with salt water
Placement of medicated gauze in the socket to relieve pain
Use of anti-inflammatory medications
Apply ice to reduce discomfort
In suspected cases of infection, antibiotics are prescribed
Prevention:
Avoid smoking
Avoid carbonated drinks
Don’t drink through straw
Conclusion:
Addressing dry sockets necessitates swift action and meticulous care from dental practitioners. Treatment commonly entails cleansing the socket to eliminate debris and administering medicated dressings to ease discomfort and foster recovery. Pain relief methods may encompass the utilization of prescribed or over-the-counter medications.
Moreover, preventive measures like maintaining good oral hygiene habits and abstaining from smoking play pivotal roles in diminishing the likelihood of dry socket occurrence.
Although discomfort accompanies a dry socket, it typically proves transient and amenable to proper management and time, facilitating the eventual healing of the socket.
References:
1. Coulthard, P; Horner K; Sloan P; Theaker E (2008). Master dentistry. volume 1: Oral and maxillofacial surgery, radiology, pathology, and oral medicine (2nd ed.). Edinburgh: Churchill Livingstone/Elsevier. p. 90. ISBN 9780443068966.
2. Parthasarathi, K.; Smith, A.; Chandu, A. (2011). "Factors Affecting Incidence of Dry Socket: A Prospective Community-Based Study". Journal of Oral and Maxillofacial Surgery. 69: 1880–1884. doi:10.1016/j.joms.2010.11.006. PMID 21419540.
3. Eshghpour, Majid; Rezaei, Naser Mohammadzadeh; Nejat, AmirHossein (2013-09-01). "Effect of menstrual cycle on the frequency of alveolar osteitis in women undergoing surgical removal of a mandibular third molar: a single-blind randomized clinical trial". Journal of Oral and Maxillofacial Surgery. 71 (9): 1484–1489. doi:10.1016/j.joms.2013.05.004. ISSN 1531-5053. PMID 23866782.
