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Dry (empty) alveolus or post-extraction alveolar inflammation is one of the most common complications after tooth extraction. What are the causes and symptoms of a dry socket? How is his treatment going?
Dry socket( empty socket ) is the colloquial name of one of the most painful complications after tooth extraction, which is post-extraction alveolitis. This disease affects about 1-4% of patients who underwent tooth extraction. Most often, an empty socket develops after lower molars are removed, but can appear in any location. The formation of a dry socket is observed more often in the group of women than in men. It is most common in patients over 40 years of age.
Extraction is a procedure for removing a tooth (or whatever is left of it) from the oral cavity. The procedure consists of several stages performed sequentially by the dentist. During the procedure, the continuity of the mucosa is broken and a wound is formed in the place of the removed tooth. Under physiological conditions, the socket of the extracted tooth is filled with blood, which then forms a clot. The thrombus acts as a natural dressing to protect the wound. During the healing process, a number of changes taking place inside the clot restore the continuity of the bones and mucosa. Sometimes, however, this process is disturbed, it results in the development of a condition called a dry socket or an empty socket.
Dry socket symptoms
After tooth extraction, a patient who begins to develop post-extraction alveolitis, comes to the dentist's office a few days after the surgery (usually 2-4 days). This is when the first symptoms of a dry socket begin to appear. Initially, pain appears, which increases over time. It is very bothersome, often throbbing pain. It happens that it radiates towards the ear or temple. Some patients complain of mouth odor accompanied by taste disturbances. Often, due to pain, proper food intake is disturbed. A hollow socket is visible in the mouth (bone may be visible inside the socket). It happens that the wound after the extracted tooth is filled with remnants of a clot and necrotic tissues. Local lymph nodes under the lower jaw may be slightly enlarged.Patients do not report general symptoms, i.e. increased body temperature or flu-like symptoms.
Post-extraction alveolitis: causes
The etiology, i.e. the reason for the formation of an empty socket, has not been fully explained. It is not a typical infectious disease associated with the growth of microorganisms. Although they too can take part in its creation. The term empty socket very well describes a condition in which there is no blood clot in the socket. The cause of this condition may be that a blood clot does not form in the wound after the extracted tooth or it is rinsed out too early. The above-mentioned conditions often result from patients' non-compliance with post-extraction recommendations. Eating a meal immediately after the extraction or rinsing the mouth can result in premature loss of the clot in the area of the extracted tooth. The factors predisposing to an empty socket are:
- smoking
- traumatic extraction treatment
- oral infections
- hormonal disorders
- immune disorders
- blood coagulation disorders
- nutritional and vitamin deficiencies
- poor oral hygiene
Dry socket treatment
If we notice any disturbing symptoms after tooth extraction, we should go to the dentist's office. After the examination and diagnosis, the dentist will start treatment. Due to the occurring pain, post-extraction alveolitis is a disease that is very burdensome for the patient. Treatment should be symptomatic, mainly consisting of pain relief. If over-the-counter painkillers are not effective, your doctor may decide to prescribe a prescription medicine that is more effective.
The treatment procedure in the office consists in cleaning the wound of any impurities remaining in it. For this purpose, the diseased socket is gently rinsed with appropriate solutions (e.g. saline solution or sodium bicarbonate). After this step is performed, a drug with anti-inflammatory and analgesic properties (e.g. Nipas - containing aspirin in the form of inserts matching the shape of the socket) can be applied to the empty socket. The wound is covered with a dressing such as after tooth extraction. Rinsing should be repeated regularly until the pain symptoms begin to subside.
Treatment usually takes about 7-10 days. Antibiotic therapy may be necessary in the event of a bacterial infection of the socket.
In the treatment of dry socket it is very important to keep the patient outsideoffice. At home, the patient should maintain proper oral hygiene, especially around the diseased socket. It is mandatory to brush your teeth and rinse your mouth gently. Ready-made mouthwash solutions as well as herbal infusions such as chamomile can be useful.
How to protect yourself from an empty socket?
Preventing complications after tooth extraction mainly consists in following the post-extraction recommendations that you will receive from your doctor. Immediately after tooth extraction, you should not eat or drink anything for the first two hours. On the day of the treatment, consumption of hot food and drinks should be avoided, and the food consumed should have a soft, mushy consistency. Mouth rinsing can be performed only on the 3rd day after extraction. Smoking is a factor that hinders wound healing and contributes to the formation of a dry socket, therefore it should be discontinued for a minimum of 24 hours after the procedure.