A dry socket is a post-operative complication of wisdom tooth removal.
Most dry sockets occur in the lower jaw. You may feel like you’re healing from the extraction, and then two or three days after the extraction, you get a sharp pain in the jaw, radiating to the ear.
Rarely, it can occur with other tooth extractions besides wisdom teeth, but almost always occurs in the lower jaw. It is more common with women, and is more common when the surgery occurs during a woman’s period.
What you should do if this happens to you is go back to the dentist or oral surgeon who took out the wisdom tooth. He or she will confirm the diagnosis of dry socket with an examination. The socket where the tooth was will be bare bone, and the blood clot that was there right after the surgery will be gone. That is the origin of the name of this malady. There will also be an unpleasant smell coming from the hole. To treat it, the surgical site is irrigated and a soothing dressing is usually placed in the hole and then changed every couple of days until it feels better.
There are a lot of “old wives’ tales” about the causes of dry socket that are not based on anything scientific. For example, this condition is characterized by the loss of the blood clot, so some people have reasoned that you must have sucked something through a straw. Others theorize that smoking must have something to do with it. But there are no studies to corroborate these theories.
What recent studies have found out is that dry socket appears to be associated with an infection of the surgical site. It also seems to occur more when the surgery is more traumatic—when a lot of pressure is placed on the wisdom tooth in order to get it out. It appears that it can be prevented with a gentle surgical technique and by placing an antibiotic dressing in the hole at the end of the surgery.
In my office I did hundreds of wisdom teeth extractions, including many full bony impactions. Once I made it my routine practice to never use great force during the extraction and to place a clindamycin dressing in the socket after all extractions of lower wisdom teeth, I didn’t have a single case of dry socket in my patients. I did that for over ten years. Other dentists including oral surgeons, would have dry socket as a complication after their surgery in as many as ten to fifteen percent of their cases, but I was able to completely eliminate that complication in my patients.
This content was written by Dr. David Hall
Read about toothaches.