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Dry Socket (Alveolar Osteitis)

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space placeholder.What Is It?.
space placeholder.Symptoms.
space placeholder.Diagnosis.
space placeholder.Expected Duration.
space placeholder.Prevention.
space placeholder.Treatment.
space placeholder.When To Call a Professional.
space placeholder.Prognosis.
space placeholder.Additional Info.
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space placeholder.What Is It?
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Dry socket is a problem that can occur after you have a tooth extracted. Usually, after a tooth is removed, a blood clot forms in the socket, or hole where the tooth was. As the area heals, bone and gum tissue gradually replace this blood clot. If the blood clot gets washed away, the bone is exposed to air and food. This is called a dry socket. It can be extremely painful.

Dry socket is more common in people with diabetes, smokers and women who take birth control pills. It occurs after 3% to 5% of tooth extractions. It is more common after the removal of premolar or molar teeth, especially impacted wisdom teeth (third molars) in the lower jaw.

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space placeholder.Symptoms
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Dry socket causes pain in and around the site where the tooth was extracted. The pain usually starts on the third or fourth day after surgery and can spread out from the site. Many people who have lower back teeth removed feel pain in the ear on that side. The pain is severe. Over-the-counter painkillers usually can't relieve it. Dry socket can also cause bad breath and a bad taste in the mouth.

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space placeholder.Diagnosis
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Your dentist will make a diagnosis based on your symptoms and a clinical examination. The dentist will examine the extraction site to see if bone is exposed. You may need to have an X-ray taken to show whether fragments of the tooth or bone are in the socket.

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space placeholder.Expected Duration
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A dry socket can last from one to several weeks. Treatment can stop or significantly reduce the pain during this time. A tooth socket that does not heal after a few weeks of treatment may be caused by other medical conditions.

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space placeholder.Prevention
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Several steps can help to decrease your risk of dry socket:

  • Practice good oral hygiene.
  • Have your teeth cleaned before an extraction.
  • Do not drink through a straw or spit frequently after an extraction. This can cause the blood clot to dislodge.
  • If you smoke, try to stop before surgery. If that is too difficult, stop the day of the surgery. Also, don't smoke for at least two weeks afterward. Smoking can slow healing and cause infections.
  • If you are using birth control pills, try to schedule the surgery during days 23 to 28 of your tablet cycle.
  • Avoid vigorously rinsing your mouth for the first 24 hours after the surgery to allow the blood clot to become stable. Brush and rinse gently for the next week. Your dentist may prescribe an antibacterial rinse to be used before and after surgery.
  • Follow all of your doctor's instructions before and after your surgery.
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space placeholder.Treatment
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Your dentist will rinse the socket with a saline solution or an antiseptic solution to dislodge any debris in the socket. You may receive an injection of local anesthesia to minimize any discomfort. Then the socket will be packed with a medicated dressing or paste. You may need to see your doctor daily or every few days until the problem is resolved.

Some dressings melt on their own. Others need to be changed or removed. Some dentists use a dissolvable sponge soaked with an antibiotic solution. You may also be prescribed pain relievers or told to take over-the-counter medicine for pain relief.

Once your dentist decides that dressings are no longer required, he or she will explain how to rinse the socket.

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space placeholder.When To Call a Professional
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Call your dentist if you have severe pain that starts a few days after you have a tooth pulled and that seems to come from that site.

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space placeholder.Prognosis
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Once treatment is started, the pain subsides quickly and the socket usually heals completely within a few weeks. Most patients require placement of only one or two dressings.

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space placeholder.Additional Info
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American Association of Oral & Maxillofacial Surgeons
9700 West Bryn Mawr Ave.
Rosemont, IL 60018-5701
Phone: 847-678-6200
Toll-free: 1-800-822-6637
www.aaoms.org

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