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A guide to Dry Sockets

Ever wondered what happens when you have a tooth extracted? How does the gum heal? Is there something else which fills the gap? How long does it take to get better? And are there any common complications that you need to watch out for?

One of the complications that comes from having a tooth extracted is known as dry socket. Alternatively, you can call it by its medical name: alveolar osteitis. Dry socket is a fairly commonplace occurrence but it can also be painful. After all, when you’ve just had an aching tooth removed, the last thing you want is for the pain to continue afterwards! The pain should go away!

So what causes a dry socket? Before we answer that question, we need to take a closer look at what happens when you have a tooth extracted. Normally, when the tooth is removed, a blood clot forms at the extraction site which helps the gum to start healing. It works in the same way as when a cut scabs over – the scab helps it to dry out and protects it from further infection.

Sometimes, however, the blood clot can dissolve or become dislodged. This means that the extraction site does not heal as quickly. Once again, a parallel can be drawn with other types of wounds, cuts and scrapes. If the scab is removed, then the cut is opened up again and takes longer to heal.

Normally, a tooth is removed because it is decayed, fractured or split and causing pain. Once it has been removed, the gum at the extraction site may feel tender and sore. Yet it will usually heal quickly and, in the course of a few days, the pain will disappear.

When a patient suffers from a dry socket, the pain does not gradually disappear. Instead, it gradually intensifies. Other symptoms can be bad breath resulting from an odour coming from the extraction site, as well as a bad taste in the mouth. Usually, these symptoms are very apparent around a week after the tooth was initially extracted.

The pain can be intense. Often, the pain does not simply emanate from the extraction site but feels as though it is consuming an entire side of your face. Patients have reported feeling pain in their eye and ear, which has been attributed to the presence of a dry socket.

As yet, nobody knows exactly why dry sockets form or how we can stop them. However, research has shown that there are a number of scenarios that seem to contribute to the development of dry sockets. Therefore, there may be certain patients who are more susceptible than others.

The first group of patients who are more susceptible to dry sockets are patients who do not follow their dentists instructions after their extraction. Usually, your dentist will give you basic instructions to aid your recovery. For example, you must retain a piece of gauze in place over the extraction site for at least an hour after the tooth has been removed. This should allow the blood clot to form. Once the clot has formed, you must also be careful not to dislodge it. So your dentist will recommend that you avoid vigorous brushing or using a mouthwash. You must also be careful what you eat a drink. Hot drinks such as coffee and hot soups should also be avoided.

There is also evidence to suggest that dry sockets are more likely to form after a traumatic tooth extraction. Dental experts believe that this is because of the tissue damage caused. When the tissue is damaged, it releases chemical compounds which delay the formation of the blood clot.

Extractions can be traumatic for different reasons. It could be that the tooth has been knocked out. However, it could also be that a wisdom tooth extraction requires a large part of the tissue to be cut away so that the tooth can be reached. In fact, research shows that around 20% of cases of dry socket formation involve the extraction of impacted wisdom teeth.

Finally, what should you do is you start experiencing pain after an extraction? Return to your dentist so that they can take a look at the affected area. The best treatment is usually a combination of pain relief tablets and a medicated dressing on the extraction site. This allows the healing process to continue. The dressing will need to be changed regularly – in some cases every day – so prepare to spend a little more time back in the dentist chair.

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