Dry Socket (Alveolar Osteitis)
Dry Socket (Alveolar Osteitis)
The socket is the hole in the bone where the tooth has been removed. After a tooth is pulled, a blood clot forms in the socket to protect the bone and nerves underneath. Sometimes that clot can become dislodged or dissolve a couple of days after the extraction. That leaves the bone and nerve exposed to air, food, fluid and anything else that enters the mouth.
What to look for
This is a very painful condition, first noticed a few days after the extraction.
There is no blood clot in the socket and often it is filled up with food.
The patient will be in considerable pain and a foul smell will come from the socket.
Treatment
You will need to clean the socket to remove any food debris.
Either use a syringe with warm water (which has been boiled and then cooled) and a dilution of hydrogen peroxide (see p.53 of Teeth Relief manual) or you can also use a pair of tweezers and a small ball of cotton wool, soaked in warm water.
If possible, see patient again in 1-2 days to check healing, repeat the cleaning and refresh the dressing. This process may need to be repeated for up to 10 days – but the pain should improve after 1-2 days.
Painkillers such as Ibuprofen and Paracetamol together should be given (see page 51 of the Teeth Relief manual).
How to prevent dry socket
Before extraction: try to stop smoking before your extraction because smoking and using other tobacco products increase your risk of dry socket. Also make sure that all medications that you are taking are known and the person taking the tooth out is experienced.
After extraction: Rest after the extraction and avoid rigorous exercise as this might dislodge the blood clot in the socket. Drink lots of water after the surgery; don’t drink alcoholic, caffeinated, carbonated or hot beverages in the first 24 hours. Eat only soft foods, avoid hard, chewy, hot or spicy foods that might get stuck in the socket or irritate the wound. Following extractions, gently rinse your mouth with warm salt water. Don’t smoke do for at least 48 hours after surgery.
Risk factors
Those more likely to get dry socket after having a tooth extracted may:
- Be a smoker
- Have poor oral hygiene
- The tooth extracted is a wisdom tooth
- Have greater than usual trauma during the tooth extraction surgery
- Use contraceptive pills
- Have a history of dry socket after having teeth extracted
- Washed the mouth (socket) too vigorously after the extraction
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