What is a Dry Socket?

After getting your wisdom teeth removed, you may get what is called a Dry Socket 


    What is a Dry Socket?

·A dry socket occurs when, in the early stages of clotting and clot organization, certain bacteria attack the clot and feed off it.  This happens somewhere between the third and fifth day following the extraction.  These germs exist in all mouths and can prevent the blood clot from progressing to normal healing.  As the bacteria begin to digest the clot, there is a typical odor and taste that is foul and characteristic of a dry socket.

·Once enough of the clot has been “digested” by the bacteria, the walls of the tooth socket become exposed and inflammation sets in.  Tis causes the pain of a dry socket and can make the entire jaw ache, even causing an earache.

·The two most common signs of a dry socket, therefore, are pain in the jaw and ear, and the foul taste and odor from the blood clot.

·A dry socket can either be partial or complete, that is, only a portion of the blood clot is destroyed or the entire blood clot is affected.  The pain often will radiate to the ear and is caused by exposed bone that is not covered by a clot or new tissue.  A dry socket is neither an infection or an ear problem.

·It is believed by experts that normal surgical injury to the socket, combined with certain bacteria, and an inflammatory process are the causes of a dry socket.

·Other factors that influence the incidence of dry sockets are female hormones, the birth control pill and smoking.  It has been shown that cigarette smoking can increase the incidence of dry socket by approximately four times.  For this reason, we ask all of our patients to refrain from smoking for at least six hours prior to surgery and for three days post operatively.

How a Dry Socket Heals:

Simply stated, a dry socket is a defective, abnormal healing, generally in the molar extraction site.  When a tooth is removed, the empty socket fills with blood.  This blood becomes the forerunner to the future permanent tissue that will eventually fill the socket.

·Once the blood clots, it organizes and microscopic blood vessels penetrate it carrying in nutrients and a variety of different cells that are part of the healing process.  As time passes, the blood clot is converted to fibrous scar tissue, which then becomes calcified with conversion to bone.

·An x-ray of an extraction site taken several months later shows virtually no evidence of the former tooth socket because new bone has filled the area.  This is the process of normal healing of an extraction site.


     Ways to prevent Dry Socket from happening:

  • Do not suck through a straw or expectorate for approximately three days.
  • Do not smoke for at least three days. 
  • Do not disturb the clot during healing.
  • Be aware that birth control medications may contribute to dry sockets.

Treatment of a Dry Socket:

Should you develop an increasing amount of post-operative pain, a possible earache, and a bad taste, you have probably developed a dry socket.  Treatment centers itself around replacing the missing clot with medication that will help to soothe the socket and eliminate the pain, while stimulating the formation of new healing tissue. It is important for you to return to the office if the symptoms of a dry socket persist. 

The Oral Surgeon treats the dry socket by gently rinsing the wound and placing an antiseptic and soothing dressing into the wound.  This will greatly reduce the discomfort and foul taste.  In most cases, an effective dry socket dressing will last for approximately seven days and will no longer be needed after this time. Most patients require no other treatment and will proceed to normal healing with the help of home daily rinses by using a specially shaped plastic syringe to keep the socket cleaned.  Some patients require repeated placement of dressings in the socket, if the dry socket, in fact, is 100% or without any natural clot left.There is no surgical treatment for a dry socket, nor are antibiotics of much value. We hope this information helps. you to understand this occurrence.





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