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Dry Socket After Wisdom Tooth Removal - Causes, Prevention and Treatment

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    One of the most important parts of the recovery after a wisdom tooth extraction is the formation of a blood clot. Normally, this blood clot forms within 1-2 days following your surgery. Its role is to protect the underlying tissues from food, drink, and bacteria and allow them to heal properly.

    However, there are some cases where this blood clot dislodges or fails to form at all, leaving the nerve endings and bone exposed to external environments. This may result in painful inflammation of the extraction site, which is known as dry socket or alveolar osteitis. Sometimes, this condition may heal on its own, but it may also worsen and lead to serious complications.

    This article will discuss why and how you might develop a dry socket after wisdom teeth removal. We will also provide you with information about how to treat this condition and what you can do to prevent its occurrence.

    What causes dry socket?

    It is not clear why some people are more susceptible to developing dry sockets after the removal of their third molars. According to research, approximately 38 % of wisdom tooth extraction cases develop dry sockets.

    It has been also found that this condition may be related to bacterial contamination. When food particles and bacteria accumulate inside the socket, they may cause dislodging of the blood clot and eventually dry socket.

    Another thing that has been claimed to lead to the formation of a dry socket is difficult tooth extraction. Some teeth may require more complicated surgery, as it is with impacted wisdom teeth. This can cause trauma at the extraction site and prevent the formation of a blood clot, resulting in dry socket.

    Dry socket (alveolar osteitis) can be divided into two types based on its symptoms. The first occurs when a blood clot does not form, leaving an empty tooth socket. The exposed bone can be easily seen in this instance. The second is when the clot has formed and there is bleeding and dark tissue in the area where the extraction was performed. However, this clot is disrupted by an external cause such as tobacco or food debris accumulation.

    Risk factors for developing dry socket after wisdom tooth removal

    Tooth care and oral hygiene products

    Some patients have an increased risk of experiencing dry sockets after having their wisdom tooth removed. Why is this so? There are certain things that may lead to dislodging of the blood clot which actually serves as a protective barrier. And when this happens, it is much easier for food particles and bacteria to get inside the socket and cause bacterial infection or dry socket.

    Here are some of the predisposing factors that can increase your chances of developing this condition.

    • Poor oral hygiene
    • Smoking
    • Using a straw when drinking
    • Virgos chewing or biting on the surgical site
    • Eating, drinking, or rinsing mouth out too soon after having a tooth extracted
    • Hormonal fluctuation due to menopause, pregnancy or because of taking oral contraceptives.

    It is more likely that you will experience a dry socket after the removal of your wisdom teeth, especially if it is in the lower jaw, compared to the removal of other teeth. Furthermore, women are typically more prone to encountering this condition than men.

    What are the symptoms of wisdom teeth dry socket?

    You can develop dry socket one or two days following your wisdom tooth surgery. In many cases, the condition causes intense, worsening pain. This is actually the most common complication associated with dry sockets after wisdom tooth extraction.

    What else you may experience when you have a dry socket and what does it feel like? Here are some other symptoms to look out for:

    • Bad breath. The unpleasant smell is usually caused by the presence of bacteria and infection at the surgical site.
    • Bad taste. The foul breath is often accompanied by an unpleasant taste which lingers in your oral cavity.
    • Swollen glands under the jaw and around the neck. You should expect some swelling following the removal of your third molar. However, if it does not improve and even worsens a few days after your surgery, it could be a sign of dry socket.

    What does dry socket pain feel like?

    It is normal to experience some discomfort and pain after wisdom tooth removal as the anaesthesia wears off. These symptoms, however, are easily managed with over-the-counter pain medications and should improve significantly within the next 2 to 3 days.

    If you have developed a dry socket, on the other hand, you are more likely to have persistent, throbbing pain, which does not fully go away even after taking painkillers. Many patients report that this condition causes them severe pain, which is even worse than their original toothache.

    You will usually feel intense pain at the extraction site, near the exposed socket. However, the discomfort can also extend to your ear, neck or even the eye. If you don’t treat the condition in time, you may face serious difficulties and complications.

    If you are experiencing any of the dry socket symptoms, it is best not to delay your dental visit. Though it is sometimes possible for the condition to heal on its own, it is usually best treated by a dental specialist.

    What is the treatment for wisdom teeth removal dry socket?

    Dentist adjust dental surgical light

    A dry socket should be treated by a dentist or oral surgeon. Typically, your provider will provide you with proper medical care at the dental office as well as recommend at-home care to help you manage the condition.

    Here are the possible treatment options for a dry socket.

    Cleaning of the affected area

    Your dentist or oral surgeon will clean and flush the socket out using special dental products and equipment. The provider will make sure to remove all food particles and debris from the empty socket. The doctor may use warm saline and a powerful analgesic to clean and disinfect the area. You will probably feel an immediate relief in the area.

    Dressing of the socket

    The dentist will also pack the socket with a medicated dressing. It does alleviate the symptoms and aids in keeping food residue out of the socket. The dressing should be changed every few days until your symptoms have subsided. Mild cases of dry socket usually improve after one or two post-op office visits, or within a few days.

    Taking pain medication and/ or antibiotics

    Depending on the severity of your case, the oral surgeon may prescribe antibiotics. These will assist you in reducing infection on the surgical site. For pain management, you will also be suggested to use over-the-counter medications.

    At-home cares

    Your dentist or oral surgeon will instruct you on how to properly care for the extraction site at home. Once your symptoms are improved and your dressing is removed, you may be recommended to irrigate the area with a saline solution using a syringe provided by your dentist.

    How to clean wisdom teeth sockets with a syringe?

    Take a cup and fill it with warm water. You can use either salty water or just plain water. Insert the tip of your syringe into the cup and draw down until you fill the syringe with water. Put the tip of the pre-filled syringe directly into the surgical site, inside the socket, and flush it out. Repeat the same procedure, if needed.

    Continue cleaning your socket with the syringe until the debris can no longer accumulate within the healing socket, which usually takes 3 to 4 weeks.

    How to prevent a dry socket after wisdom teeth removal?

    There are some simple things you can do after wisdom tooth extraction to avoid the formation of dry socket.

    • Avoid smoking during the healing process after your third molar surgery.
    • Maintain proper oral hygiene, particularly ensuring that there is no food residue near the tooth extraction site.
    • Chew on the opposite side of the extraction for at least a week to keep a blood clot intact.
    • Do not eat hard and crunchy foods during your wisdom tooth recovery. Replace them with soft foods like smoothies, shakes, yoghurt, etc.
    • Avoid consuming alcoholic beverages in the days following the extraction procedure.
    • Avoid strenuous exercise or heavy lifting for the first 2-3 days after tooth extraction.
    • Carefully follow your dentist's instructions.

    Last but not least, make sure to carefully choose an oral surgeon who will perform your wisdom tooth extraction. Even though your general dentist may be able to perform this operation, it is best to leave it to oral and maxillofacial surgeons, especially in cases of problematic wisdom teeth or impacted wisdom teeth.

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