What is a dry socket after a tooth extraction?

If you’re a Chicago patient facing a tooth extraction, your oral surgeon may have mentioned the possibility of dry sockets as a complication of the procedure.

The term “Dry Socket” sounds scary, but let’s delve into exactly what it is and how your Chicago oral surgeon can remedy the problem rather easily.   Just after your oral surgeon has removed a tooth, a blood clot should form in the now empty socket as part of the healing process. That clot protects and insulates any nerve connections that were separated from the tooth during its extraction and provides an initial framework for new bone to eventually form as a patient heals from the extraction. 

Dry sockets are often associated with wisdom teeth extraction, but they can occur after any permanent tooth is removed from the mouth.

When the blood clot fails to form, or if the clot is dislodged or breaks down during the first few days after the tooth extraction was performed, the nerve is no longer shielded. Patients can experience severe pain as a result of the nerve’s exposure to the oral cavity and everything that enters it.

The technical term for a dry socket is fibrinolytic alveolitis, or alveolar osteitis.  Fibrin is fibrous protein involved in the clotting process.   The alveolus is the bony area (osteo –Greek meaning from bone) of a tooth socket that surrounds the roots of teeth.    “Lytic” – means dissolution, dissolving or breaking apart and “itis” refers to inflammation or irritation.  So a dry socket is the premature loss or breakdown of a blood clot in the tooth socket resulting in an inflammatory, irritating response to the surrounding bone, and the release of chemical pain mediators.  All of these factors result in throbbing, radiating, and difficult to manage pain.

Dry sockets primarily occur in the posterior back region and predominately with lower teeth.  Although dry sockets are among the most common issues that arise from a tooth extraction, patients can take steps to avoid the condition. For the first 48 hours after your extraction, avoid strenuous activity or high aerobic activity.  Do not smoke, drink through a straw, swish vigorously or expectorate forcefully for 4 days.  Additionally, you should avoid carbonation for 4 days as well.. Stick to pureed foods immediately after the extraction while the effects of the local anesthetic are still present and slowly advance the consistency of your diet as tolerated.

Dry sockets are often associated with wisdom teeth extraction, but they can occur after any permanent tooth is removed from the mouth. Be on the lookout for symptoms following any extraction. The onset of pain typically occurs around 72 hours after an extraction, and it may intensify without relief form medications like Ibuprofen 800mg or even narcotics.  A certain amount of discomfort, sometimes significant, can be expected with any tooth extraction, but dry socket pain is persistent and severe, and the telltale sign is that it does not respond to prescription narcotic painkillers. If you have such pain, schedule a follow-up appointment with your oral surgeon as soon as possible for evaluation and definitive treatment.  Dry socket is a self-limiting condition, meaning that even if it is not treatment you would go on to heal normally, however, you would have persistent intense pain for 10-14 days.

Fortunately this Chicago oral surgeon utilizes a few things to help prevent and also treat dry socket.  First, he usually dispenses an oral hydrocolloid gel called “Sock-it” which soothes the socket, promotes healing, decreases the incidence of dry socket, and is bactericidal.  Second,  if you were to develop a dry socket, he utilizes a special dissolvable dry socket medicated dressing that gets placed within the socket that alleviated the discomfort within a few hours.  The key is, prevention first, but if you develop a dry socket then you shouldn’t “wait it out” or be stoic about it.  Relief is just a phone call away to this Chicago Oral Surgeon at ORA Oral Surgery & Implant Studio at 312-328-9000.

On January 18th, 2012, posted in: tooth extraction by

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