DRY SOCKET

TYPES

A simple dry socket can leave the bone exposed or look dark to the naked eye. It produces excessive pain that does not stop and may extend throughout that side of the face.  Rare but known symptoms of this kind of dental problem are fever and enlarged lymph nodes.

• Superficial Alveolitis Marginal or SAM is distinguished by the covering of bone tissue in the dry socket with inflamed tissue called a granuloma (inflamed grouping of tissue your body can’t get rid of). SAM makes it uncomfortable to chew.
• Suppurative Alveolitis is a more severe condition similar to a dry socket, but it does not include the clot falling from your tooth’s socket. Instead, bone fragments or bone lesions called ‘osseous sequestrum,’ the blood clot gets swollen. The pain of suppurative alveolitis, like dry socket pain, is moderate. With this type of dental problem, you’re also more likely to get a fever.

SYMPTOMS

Indications of dry socket may include:

• Foul odor coming from your mouth
• Undesirable taste in your mouth
• Evident bone in the socket
• Extreme pain within a few days after a tooth extraction
• At the tooth extraction area, half or complete loss of the blood clot that you can find as an empty-looking (dry) socket.

DIAGNOSIS

For any case of severe pain following a tooth extraction, a dentist or oral surgeon will likely suspect a dry socket but will also examine the person for signs of any other complications.

If required, to rule out a bone infection, the person will be sent for X-rays or to see if fragments of the extracted tooth’s bone or roots remain and cause pain.

TREATMENT

Since the dry socket heals on its own, drugs are used to take care of discomfort and avoid infections or treat them. The typical assortment of dry socket drugs comprises over-the-counter pain medications, topical anesthetics, saline or antibacterial rinses, and medicated dressings.

• Pain relievers: The dry socket will improve in about seven to 10 days without action, but the pain lasts for about one to three days. As the healing process continues, over-the-counter pain relievers such as ibuprofen or acetaminophen offer ample pain relief for certain patients with mild pain.

• Topical anesthetics: Several dressings of this kind of dental problem contain a topical anesthetic such as eugenol or lidocaine. Still, in extreme pain cases, the dentist can apply a stronger topical anesthetic such as viscous lidocaine or prilocaine. When treating dry outlets at home, over-the-counter clove oil (eugenol) and lidocaine can be used to numb the pain.

• Antiseptics: The rinse would contain an antiseptic, a material that destroys bacteria, as the dentist cleans out the socket. Chlorhexidine, usually used in prescribed mouthwash for gingivitis, is the most usually used antiseptic for dry socket rinsing. Highly diluted hydrogen peroxide, an antiseptic, can also be used by the dentist to promote debris removal from the socket.

• Antibiotics: Antibiotics are seldom used for dry socket therapy. A single-dose antibiotic can be administered to patients with a weakened immune system or a history of this kind of dental problem when the tooth is removed to avoid infection. Amoxicillin is the most accepted antibiotic used to prevent dry sockets, but dentists may also recommend azithromycin before tooth extraction or, after tooth extraction, apply topical clindamycin or lincomycin to the socket.