What is a Dry Socket?

A dry socket is a dental condition that occurs in adults after the extraction of the tooth. The socket is a small hole in the oral cavity where teeth are present.

When the tooth is extracted, a blood clot forms in the socket which helps in healing the wound. If the blood clot fails to form then the condition is called dry socket [1]. Without the formation of clots, bone and nerves are exposed. It is a painful condition. Without the formation of a clot, healing time is increased and this can be painful.

The exact cause of the dry socket is not known. But several factors can increase the risk of dry socket. These factors include poor tooth removal surgeries, poor oral hygiene, and the use of tobacco [2].

Severe pain on the face and mouth, foul-smelling odor, and tenderness are the presenting symptoms of dry socket. It is diagnosed by a general examination and taking X-rays of the mouth and teeth of the patient.

Certain anti-inflammatory medications are given that help in reducing inflammation. Untreated dry sockets can lead to bacterial or fungal infections. The healing time of a dry socket is about 7 to 10 days.

 

What are the Causes of Dry Socket?

The exact cause of the dry socket is not known but some of the other causes of dry socket are described below:

• Poor blood supply of mandible
• Extraction of lower wisdom tooth
• Some pre-existing infections
• Smoking and tobacco use after the extraction of a tooth
• The use of local anesthetics.
• Radiotherapy in the jaw bone area
• Women who use oral contraceptives can develop dry sockets after tooth extraction surgery.
• Surgical trauma
• Treponema pallidum
• Dry socket is caused after tooth extraction surgery in immunocompromised individuals.
• People who have Paget disease

 

What are the Symptoms of Dry Socket?

Symptoms of dry socket vary in intensity from person to person. Some common symptoms of dry socket are described below:

• Severe pain.
• A low-grade fever.
• An empty pocket with no blood clot.
• The foul-smelling breath.
• Bad taste.
• If the jaw bone in the socket turns grey.
• Regional lymphadenopathy.
•  Trismus is the presenting feature in the extraction of the mandibular third molar.
• Pain may also radiate to the neck and ear.
• Necrosis and sequestration of bone are common.

 

What are the Diagnostic Criteria for Dry Socket?

The diagnostic criteria for dry socket are described below [3]:

• General examination of the patient.
• The patient with a previous history of dry socket.
• X-ray of the mouth and teeth.

 

What is the Treatment of Dry Socket?

In a dry socket, severe pain may occur. In the case of dry socket, symptomatic treatment is given to reduce the severity of the symptoms [4]. Treatment options for dry socket are given below:

• The affected area is irrigated with normal saline or chlorhexidine [5].
• Medicated dressings.
• Non-steroidal anti-inflammatory agents.
• A mixture of some narcotics with acetaminophen and codeine is also used.
• Oral and topical antibiotics are usually given to prevent infections. Amoxicillin is an oral antibiotic that can be used.
• Surgical treatment.
• Low-level laser light therapy increases the healing time of the wound.
• The socket is usually rinsed with an antiseptic solution to prevent microbial infection.
• Hydrogel dressing.

 

 

 

 

References:

1. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5932271/
2. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4060391/
3. https://pubmed.ncbi.nlm.nih.gov/29732309/
4. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4437177/
5. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3022165/

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