What is dry socket syndrome

  Dry socket is also known as limited alveolar osteitis and fibrinolytic alveolitis.  The incidence of dry socket is 10% to 15%, and it mainly occurs in the alveolar sockets after extraction of the mandibular third molar.  It usually occurs 3 to 4 days after tooth extraction and is an infection of the extraction socket caused by bacteria in the oral cavity, with decomposition and loss of blood clots and small dead bone formation in severe infections.  The clinical manifestation of dry socket is spontaneous pain that radiates to the auriculotemporal or anterior tooth area.  Patients should go to the hospital as soon as the above situation occurs after tooth extraction or when dry socket is suspected to occur, because taking anti-inflammatory drugs and painkillers alone is not effective in treating dry socket.  During the examination, the doctor can find that the alveolar sockets are hollow, no blood clots are clotted, the bone wall of the alveolar sockets is exposed and grayish, the pain increases when touching the bone, and in heavy cases, there is necrotic tissue in the alveolar sockets; with bad odor. If left untreated, the disease can last for more than half a month or cause the infection to spread.  The treatment of dry socket is based on local treatment. It is best to treat the socket under local anesthesia, otherwise, the infection foci in the socket will not be completely removed due to pain.  The method is: scrape the socket thoroughly under local anesthesia, then repeatedly wipe the alveolar bone wall with 1.5% to 3% hydrogen peroxide and saline cotton balls, and loosely fill the socket with iodoform gauze dipped in clove oil or dicaine, which usually relieves the pain on the same day.  The iodoform gauze is replaced once every 2 to 3 days until fresh buds grow in the alveolar sockets. In the case of early dry socket, local scraping is sufficient to stop the bleeding after the clot is filled and the gauze is re-bited.  The causes of dry socket are not very clear, and the main reasons may be related to trauma, infection, anatomical sites, etc. It is especially important to mention that the occurrence of dry socket is closely related to the post-extraction care.  Therefore, it is necessary to remind the patients again that they should act according to the doctor’s orders after tooth extraction and strictly forbid actions such as brushing, rinsing and spitting after tooth extraction to protect the blood coagulation in the extraction socket quickly and reduce all possibilities of dry socket.