The symptoms of a dry socket are pain, foul odor and foul taste emanating from the tooth extraction site. These symptoms characteristically do not appear until some days after the tooth has been removed. Clinical experience and dental research have identified a number of factors that seem to place dental patients at greater risk for experiencing dry sockets. If the dentist and dental patient keep these factors in mind when planning for and then proceeding with a tooth extraction they may help to minimize the risk for dry socket formation.
The use of analgesics (pain pills), either non-prescription or prescription, is typically not the most effective solution for controlling the pain and discomfort associated with dry sockets. In most cases the best treatment involves a dentist inserting a medicated dressing, daily if needed, into the dry socket. The idea is that this treatment dressing helps to control the level of pain the dental patient experiences until the (delayed) healing process is able to progress and resolve the symptoms of the dry socket.
What are dry sockets?
A dry socket, more formally referred to as alveolar osteitis by dentists, is a fairly common complication associated with tooth extractions. The formation of a dry socket involves a scenario where the blood clot which forms in the tooth socket's after the extraction isn't properly retained (either it disintegrates by way of fibrinolysis or becomes dislodged). Since this blood clot is an important factor in protecting the boney socket and initiating the healing process, the healing of the extraction site is interrupted and becomes delayed.
What are the symptoms of a dry socket?
With most tooth extractions a dental patient will experience some level of discomfort at the extraction site (no matter how minor) on the day the tooth has been removed and then, with each day that passes, less and less pain as the healing process progresses. In those cases where a dry socket forms, the patient typically notices that their level of discomfort does progressively diminish for the first few days but then, between three and five days after the extraction, pain from the extraction site begins to intensify.
Dry socket signs and symptoms ...
The pain associated with a dry socket can be moderate to severe in intensity and often has a throbbing component. The pain can be just localized to the extraction site or it may radiate from the extraction site to the patient's ear or eye (on the same side of their face). Additionally, the dental patient may notice a foul odor or taste emanating from the tooth socket. Upon visual inspection (when possible) the tooth socket will appear to be empty (minimal or no blood clot or granulation tissue present) and when looking down into the socket exposed bone is visible. The term "dry socket" is derived from this empty socket appearance. The lymph nodes in the patient's jaw or neck may become enlarged.
How often do dry sockets occur?
The frequency of occurrence for dry sockets, when considering for all tooth extractions collectively, is roughly on the order of 1 to 3%. Extractions involving lower teeth, especially molars, are statistically more likely to result in dry socket formation. Dry sockets may occur in as many as 20% of the cases involving the extraction of mandibular (lower) impacted wisdom teeth.
What causes dry sockets?
The exact pathogenesis of dry socket formation has yet to be determined. There are, however, several contributing factors that have been suggested which seem to place the dental patient at greater risk for experiencing a dry socket. We discuss them on our next page...
Topic Index for :
Dry sockets / Alveolar osteitis
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