What are dry sockets?
A dry socket, more formally referred to as alveolar osteitis by dentists, is a fairly common complication associated with tooth extractions. The formation of a dry socket involves a scenario where the blood clot which forms in the tooth socket's after the extraction isn't properly retained (either it disintegrates by way of fibrinolysis or becomes dislodged). Since this blood clot is an important factor in protecting the boney socket and initiating the healing process, the healing of the extraction site is interrupted and becomes delayed.
Dry socket signs and symptoms .
The pain associated with a dry socket can be moderate to severe in intensity and often has a throbbing component. The pain can be just localized to the extraction site or it may radiate from the extraction site to the patient's ear or eye (on the same side of their face). Additionally, the dental patient may notice a foul odor or taste emanating from the tooth socket. Upon visual inspection (when possible) the tooth socket will appear to be empty (minimal or no blood clot or granulation tissue present) and when looking down into the socket exposed bone is visible. The term "dry socket" is derived from this empty socket appearance. The lymph nodes in the patient's jaw or neck may become enlarged.
How often do dry sockets occur?
The frequency of occurrence for dry sockets, when considering for all tooth extractions collectively, is roughly on the order of 1 to 3%. Extractions involving lower teeth, especially molars, are statistically more likely to result in dry socket formation. Dry sockets may occur in as many as 20% of the cases involving the extraction of mandibular (lower) impacted wisdom teeth.
What causes dry sockets?
The exact pathogenesis of dry socket formation has yet to be determined. There are, however, several contributing factors that have been suggested which seem to place the dental patient at greater risk for experiencing a dry socket.
Dental patients who don't follow their dentist's postoperative instructions have a greater incidence of dry sockets.
Dental patients who have experienced dry sockets with past tooth extractions are at greater risk for developing a dry socket with future tooth extractions.
Traumatic tooth extractions are more likely to result in dry socket formation.
Patients who smoke tend to have a greater incidence of dry socket formation.
Women who take oral contraceptives are at greater risk for dry sockets.
The presence of bacteria may play a role in dry socket formation.