A common worry for patients
facing a tooth extraction is the dreaded "dry socket". While
dry sockets do occur, they are far from inevitable and often avoidable
with proper care.
When a tooth is removed
it leaves a hole in the bone (the tooth socket). As the socket fills
with blood, the blood congeals forming a protective clot that covers
the exposed bone left by the extraction. If the blood clot is dislodged
after the bleeding has stopped, another clot is unable to form. This
may lead to alveolitis, or dry socket.
Without a protective
blood clot, the freshly exposed nerve endings in the tooth socket
are left to sense every change in the mouth's environment. Changes
in the mouth can be from food, liquid, and even cooler air entering
the mouth when the jaws are opened. Each change stimulates the exposed
nerves resulting in extreme pain and discomfort. Sometimes, even without
any stimulation, the nerves will be stimulated and fire pain signals
to the brain.
Dry sockets are treated
by placing a medicated, synthetic clot in the tooth socket. The artificial
clot, made from gauze or a spongy material called gelfoam, is usually
replaced every day or every other day. The treatment is uncomfortable,
requiring a local anesthetic when changing the artificial clot. If
the pain is severe enough, a prescription analgesic is prescribed
until the tooth socket heals enough for the pain to start to subside.
Painful dry sockets can
be avoided by carefully following postoperative instructions given
to you by your dentist. Faithfully following the instructions and
careful treatment of the extraction site, should lead to a quick and
relatively painless healing period.
