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 will 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.