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DRY SOCKETS

One of the most frustrating sequals to the extraction of a tooth can be the acquisition what is known as a "dry socket". A dry socket, also known as alveolar osteitis, delays the healing of the extraction site and surrounding bone. Moderate to severe localized pain near the extraction site developing on or after the third or fourth day after the extraction is a sure sign of a dry socket. There may be an apparant improvement on the second day post-extraction only to be followed by a sudden worsening of symptoms on the third day. That pain consists of a dull aching sensation, usuallyy throbbing and radiating to the ear. Often, it is painful for the patient to fully open his or her mouth. Examination usually reveals an empty socket, exposed bone and a partially or completely missing blood clot. A foul odor and taste mayy or may not be present as well. The placement of medications into the socket, which isn't much fun the first day or two, usually brings dramatic relief rather quickly. This medication needs to be repeated the following day and, usually, several days after until the bone has begin to cover and healing can progress.

"Fibrinolysis" is the breakdown or failure of normal blood clot formation due to high levels of cell-destroying enzyme activity in and around the socket. Fibrinolytic activity results in the blood clot being dissolved and a subsequent exposure of the bone. Dry sockets tend to be more common in the lower jaw and in back teeth (molars). The peak age for dry sockets is 30 to 34 years of age and most cases occur between the ages of 20 and 40. Women have a 20 percent higher chance to develop dry sockets than men with oral contraceptives being linked to a higher incedence of this problem. Also, smokers are four times more likely to develop dry sockets than non-smokers.

Again, treatment is fairly simple and is focused upon relieving the pain. When the bone is covered, the pain quits and healing can progress. This sometimes takes a couple of weeks to complete but most cases are resolved in just a few days.
posted by Steve at 8:23 AM