Are you up late at night with a really bad toothache after having a tooth removed a day or two ago?  Wondering why you are in so much pain?  Unfortunately you may have a dry socket.

The term dry socket is a term used frequently in dentistry, but as a patient, if you have ever experienced a dry socket, it is likely you will never forget the pain.

Dry sockets are extremely painful, but they will heal with or without treatment.  Treatment is palliative, in that it reduces the pain.  Treatment for a dry socket usually entails the placement of a medicated packing material one or more times.

Awareness of the complication “dry socket” usually occurs 1-3 days after a difficult or traumatic tooth extraction.  Lower teeth extractions are more prone to the dry socket complication, as are people who smoke.  For unknown reasons, there is a higher incidence of dry socket in those who have experienced a previous dry socket complication.

Dry sockets tend to have an unpleasant odor, this may be due to the fact that there is jawbone exposed to the oral environment.  this exposed, dead jawbone should be covered by a blood clot.  Loss of the blood clot leaves the bone in the tooth socket exposed.  Healing is delayed.

If you are in pain now, give your dentist a call.  I am a dentist in Palm Harbor, the Tampa area of Florida.

What is a dry socket?

Dry socket is a commonly used term for one relatively uncommon complication following tooth extraction.  Following uncomplicated tooth extraction some discomfort is expected.  When severe pain and a foul odor is present, dry socket is a possibility.

After a tooth is removed, it is normal for the hole (socket) left behind to fill with blood and clot.  Many factors influence clotting time, including medications taken by the patient.  The blood clot has a vital role in normal healing.  The blood clot covers the exposed bone and provides a “scaffold” for the body to bridge the gap with hard (bone) and soft (gum) tissue.  If this clot is not present / lost, the patient will typically experience severe pain beginning 2 – 3 days after tooth extraction.  In addition healing time is prolonged.

Dry sockets do heal, they just take longer, smell worse and really hurt.  The patient should return to the treating dentist to be evaluated.  The common use of bisphosphonates (drugs used to treat osteoporosis and osteopenia) has created another type of abnormal healing after tooth extraction.  The use of this class of drugs should be discussed with the treating dentist PRIOR to tooth extraction

Tooth #18 was extracted in my Palm Harbor dentist office on July 31, 2012.  As is typical with dry socket complications, the patient was relatively comfortable for two days but began to experience pain 3 days later on August 1, 1012.  The patient was seen in my Tampa Bay area dentist office on August 7, 2012.  This photograph was taken on 7 August 2012, the patient was pain free today – this is not typical dry socket.  The site appears to be healing normally.  If the patient experiences pain once again the dry socket will be irrigated and a medication packed into the site.

Post extraction #18

Dry Socket Pain

By most estimates, dry sockets occur between 1% and 3.2% of all tooth extractions.  At times the dry socket is a result of normal extraction of an erupted tooth resulting from the disintegration of loss of the blood clot in the post tooth extraction socket.  When dry sockets occur, it is normally 2- 3 days after the tooth extraction, but has beet known to occur a week or longer after extraction.  Some studies suggest that teeth which fracture during extraction are more prone to dry socket complication that those teeth which are removed in one piece.  Smokers show a higher incidence of dry socket complication.

Put quite simply: Dry sockets really hurt, they smell terrible and take along time to heal.

Complications in the Healing of Tooth Extractions:

“Dry Socket”

Alveolitis Sicca Dolorosa; Alveolalgia; Postoperative Osteitis; Localized Acute Alveolar Osteomyelitis; Alveolar Osteitis

The most common complication in the healing of human tooth extraction is that condition commonly known as a “dry socket.”  The “dry socket” is a localized osteomyelitis in which the blood clot in the post tooth extraction site has disintegrated or been lost, with the production of a foul odor and severe pain.  The condition derives its name from the fact that after the clot is lost the socket has a dry appearance because of the exposed bone.

The “dry socket” is extremely painful and is usually treated by the insertion of a medicated packing material.  The exposed bone is necrotic.  The healing of such infected wounds is extremely slow, and little can be done for the patient other than to relieve the pain.