"Dr. Jarvis, what is a dry socket?"
a tooth has been extracted, the socket is filled with a blood clot.
Slowly, the clot shrinks and fills in. That is, a skin or a covering
with tissue similar to the rest of the mouth (mucous membrane)
begins to cover the clot and the tissue in the clot area is ingrown
by bone cells and tissue cells. Eventually, the area shrinks and the
socket is eliminated and replaced by firm tissue, and the depth of
the socket fills with bone. The healed area usually is narrower than
the site of the original
The pain following an extraction
usually lasts no more than a day or two, at the most. If the clot breaks
down or is washed away, the protective covering of the exposed bone is
lost and the bone can be exposed to the mouth bacteria. This painful
condition is known as dry socket. One of the features of its
presence is that post-extraction pain persists longer than a couple of
days and can be quite severe.
Though the causes are not known with
certainty, some factors seem to predispose individuals towards a
- those people who have gingivitis or
- those who have had lower or
mandibular extractions, particularly on posterior (back) teeth such as
molars and pre-molars.
- those who have teeth that are
difficult to extract and necessitate bone removal.
- those that are particularly
difficult to numb and so need several cartridges of local anesthetic.
Some local anesthetics contain epinephrine, which is used in
preventing rapid dissipation of the anesthetic by constricting the
blood vessels at the site. This perhaps may prevent good clot
formation. People who smoke also are predisposed towards
dry socket. Again, this may be
because of the constricting effect of nicotine and tar products on the
Rinsing the mouth within a few hours of
extraction may flush the clot out of the socket. Using a straw may have
a similar effect. That is why post-operative instructions urge the
patient not to smoke, rinse or use a straw for at least a day.
Unfortunately, there is no sure way of
guaranteeing that a dry socket won't occur, but there is
some evidence that placing a small piece (quarter of a square inch) of
gel foam (a clotting agent) covered with tetracycline powder (an
antibiotic) in the socket after the extraction can reduce the chance of
a dry socket. This will be absorbed over a few days and has not been
shown to induce allergies or have any other effect on the patient.
Fortunately, dry socket is a relatively easy condition to treat.
For more information regarding dry sockets, contact Parker M Jarvis DDS & Associates Inc at (614) 882-5208 today.