Dry socket (alveolar osteitis) is a temporary dental condition that sometimes occurs after extraction of a permanent adult tooth. Dry socket occurs when the blood clot at the site of the tooth extraction is dislodged, exposing underlying bone and nerves and causing increasing pain. Dry socket is the most common complication following tooth extractions, such as the removal of impacted wisdom teeth. When it occurs, dry socket usually strikes one to three days after a tooth extraction. The most common hallmark of dry socket is significant pain.
Complications of Dry Socket
Complications and problems that dry socket may cause or be associated with include:
Causes of Dry Socket
Normally, a blood clot forms at the site of a tooth extraction. This blood clot serves as a protective layer over the underlying bone and nerve endings in the empty tooth socket. The clot provides the foundation for the growth of new tissue and bone. In some cases, though, the clot doesn't form properly or is physically dislodged before complete healing. With the clot gone, bone and nerves in the socket are exposed to air, fluids and food. This can cause intense pain, not only in the socket but also along the nerves radiating to the ear and eye on the same side of your face. But the precise cause of dry socket remains the subject of study. Some researchers suspect that several issues may be at play, including:
Dry socket occurs in about 3 to 5 percent of all tooth extractions. It's much more common after extraction of wisdom teeth and impacted wisdom teeth in particular.
Signs & Symptoms of Dry Socket
Signs and symptoms of dry socket can include:
Diagnosis of Dry Socket
Severe pain following a tooth extraction is often enough for your dentist or oral surgeon to suspect dry socket. Your dentist or oral surgeon also will ask about your other symptoms and examine your mouth. He or she checks to see if you have a blood clot in your tooth socket and whether you have exposed bone. You may also need to have X-rays taken of your mouth and teeth to rule out other conditions.
Treatments of Dry Socket
Treatment of dry socket is mainly geared toward reducing its symptoms, particularly pain. Dry socket treatment includes:
Once treatment is started, you may begin to feel some relief in just a few hours. Pain and other symptoms should continue to improve over the next few days. Complete healing typically goes smoothly and generally takes about 10 to 14 days.
Prevention of Dry Socket
Steps that both you and your dentist or oral surgeon take may go a long way in helping prevent dry socket or helping reduce your risk.
What your dentist or oral surgeon can do
Although dry socket has been recognized since the late 1800s, medical science has yet to develop a surefire way to prevent it. Some research suggests that treatment with certain medications such as antibiotics before or after oral surgery may reduce your risk of dry socket. However, this practice remains controversial, and some say that preventive treatment with antibiotics isn't appropriate because it may contribute to problems such as antibiotic-resistant bacteria.
Talk to your dentist and oral surgeon about using these medications or precautions when you have tooth extraction surgery:
What you can do before tooth extraction surgery
What you can do after tooth extraction surgery
When to seek Medical Advice
When you've had a tooth extracted, any discomfort you experience normally gets better with each passing day. If you develop new or worsening pain in the days after your tooth extraction, don't try to tough it out. Contact your dentist or oral surgeon right away so that you can get properly evaluated and treated.