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24 Feb, 2021
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Dry socket

Dry Socket? – Ask Dr. Farooq Sorathia

What is a Dry Socket?

A dry socket is a complication that can occur after tooth extraction. The medical term for dry socket is “Alveolar Osteitis”. It is a very painful condition and will require the dentist to intervene to manage the pain. The dentist would have to revisit the extraction site and clean and place a locally acting sedative.

Not everyone is lucky to go through an uneventful extraction and to minimize the risks of complications, your dentist would find out about your medical history, what medications you are taking and some of your habits, such as smoking. Some medications can make one susceptible to developing a dry socket.

When an individual goes for tooth extraction, the dentist will use anaesthesia to numb the area and then extract the tooth from the socket that holds the tooth. After an extraction, just like when we get injured on any part of our body, the site of the extraction fills with blood and forms a clot. The dentist would provide post-operative instructions to the patient so that healing would occur at the quickest and hopefully pain-free. A dry socket develops when this all-important blood clot gets detached or dissolves before the wound has healed, leaving the underlying bone dry and exposed. This is where the concept of a dry socket comes from, as the socket is void of blood.

So how does one know they have a dry socket? Firstly, the patient would have had a tooth extraction a few days prior. There would be severe pain that radiates to the ear, eye, or neck on the same side that the tooth was extracted. An individual would also notice bone visible in the socket and would have an unpleasant and foul smell coming from the mouth. If the patient has any of these symptoms after a tooth extraction, they need to go see their dentist so that the dentist may intervene and help manage the pain. It is important to remember not to eat or drink anything until the anaesthesia has worn off so that you don’t end up chewing your cheek or tongue in the process.

What can I do to prevent a dry socket, some may ask? Like I said earlier, your dentist will give you some post-operative instructions to minimize the risk of getting a dry socket. That clot needs to form, and we need to protect it. One way is not to spit out saliva or blood as this may dislodge the blood clot. On the day of the extraction, it is important to avoid any strenuous activity as this would increase the blood pressure and risk detaching the clot. You would also need to avoid eating any hot foods as this may cause a new bleed and that also may dislodge the clot. Therefore warm, soft foods will keep that clot in place. I normally recommend the patient should have something cold, like yoghurt, or ice cream. The cool temperature is soothing to the inflamed extraction site. It is important to mention that one shouldn’t use a straw after an extraction because the negative pressure that builds in the mouth could disrupt the clot and cause a dry socket. The patient needs to avoid smoking for at least 48 hours as tobacco use would delay the healing process and may increase the risk of complications. Last, but not least, 24 hours after the extraction, gentle rinse of the mouth with lukewarm salt water as many times a day as possible for about five days.

 

Article Written by Dr. Farooq Sorathia (BDS – University of the Witwatersrand, Johannesburg)

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