Everything About Dry socket after wisdom teeth removal
Dry socket after wisdom teeth removal
Hi everyone, In this blog, we are going to discuss one of the hottest topics of dentistry. The most common postoperative complications of tooth extraction, the Dry socket after wisdom teeth removal.
Before you go ahead and invest your time in it. I want you to Decide, Is this article going to be worthwhile for you or not?.
- This article will take your precious 10 minutes.
- This blog is not for those who believe in half-knowledge because getting half-knowledge is even more dangerous than any disease.
- You have to read this blog completely to understand things more clearly
- Include everything about dry socket after wisdom teeth removal:
- How does it occur?
- Why does it occur?
- What are the symptoms?
- What is the treatment?
- How to avoid it?
- How to manage it?
If you agree with all the above points then this article is written especially for you, read it go ahead!
What Is A Dry Socket?
A Dry socket or alveolar osteitis is one of the most common postoperative complications that occur because of partial or total dislodgement of a blood clot.
In this condition, you will feel mild to moderate pain and it appears after 3 to 4 days of wisdom teeth removal.
Dry socket after wisdom teeth removal is a hot topic in the field of dentistry because it is more common in the case in most common surgery of dental field wisdom tooth extraction.
Although it can occur after any tooth extraction or removal but lower wisdom teeth are it’s favorite.
How does the dry socket after wisdom teeth occur? (PATHOPHYSIOLOGY)
- After the wisdom tooth extraction, a blood clot forms on the socket of the removed or extracted tooth as you can see in the picture, mainly to reduce blood loss due to the removal of a tooth and also to prevent the alveolar bone from getting exposed to the oral environment.
- When this blood clot fails to form or is physically lost from the socket, the alveolar bone gets exposed to oral saliva, bacteria, and food debris result in an inflammation of the socket.
- This results in localized inflammation of the alveolar bare bone as you can see in the image above. leading to a severe throbbing pain that can radiate to the jaws, ears, and eyes of the affected side too.
Let’s understand the dry socket and the normal healing process more clearly.
Dry socket Vs Normal Healing
We will first talk about the normal healing process to understand what exactly happens and then will compare it with a dry socket to make it more clear.
on the day of the extraction, the tooth is removed under all aseptic conditions using local anesthesia.
As soon as the tooth is removed blood fills the socket and begins to form a clot, this clot will serve as a protective barrier that covers the underlying nerves and bone, It also provides a foundation to lay down new bone and heal the soft tissue.
In case of premature loss of this clot, the underlying nerve and bone are exposed to the oral environment food debris, saliva, bacteria enter into the socket, and causes the inflammation of the socket.
Due to this inflammation intense pain arises not only in the socket but also radiating all along the nerve in just 24 to 72 hours after the extraction means 3 to 4 days after wisdom teeth extraction.
It means the inflammation of the socket is an actual cause of localized pain and swelling, this painful condition where the socket is devoid of its contents and become dry is called dry socket.
If the clot is retained after the wisdom teeth removal, the normal healing process will take place.
Process of Normal Healing process
From day 1 up to 3 weeks, initial angiogenesis (formation of new blood vessels) takes place, forming a framework for bone formation.
By four weeks new bone starts forming on this framework.
By six weeks rapid bone growth begins and continues until the socket is closed after this.
the bone begins to reorganize and becomes hard and mature at around four months post-extraction with complete soft tissue healing.
so this is how normal healing occurs after any tooth extraction if the patient takes care of all the precautions.
Cause of dry socket after wisdom teeth removal
Explanation of this image
For example, If extraction becomes difficult or traumatic it will cause inflammation of bone marrow in the alveolar bone (A bone present around the teeth).
This inflammatory process releases the tissue activators of the plasminogen.
A clot that forms after extraction is made up of Fibrin. In the case of a dry socket, this fibrin is degraded by an antifibrinolytic substance called plasmin.
In a normal situation, the clot forms in the socket, and the healing process will take place as we discussed above.
There are so many reasons behind the dislodgment of the clot. It can be smoking after extraction, rinsing the mouth after an extraction, poor oral hygiene but most common is traumatic extraction.
Summary: Traumatic surgery causes inflammation, activation of plasminogen takes place in the newly formed clot, then this activated plasminogen will convert into plasmin which further will break the fibrin and dislodgement of the occur, the dry socket appears.
Sign and Symptoms of Dry Socket after wisdom teeth removal
- Severe pain
- Onset:2-3 days after extraction.
- Radiation: Pain radiates to the jaws, ears, eyes, and neck of the affected t0oth.
- Intra-oral Odor (Halitosis)
- Bad taste in the mouth.
- Regional Lymphadenopathy (Rare).
- Trismus or difficulty in opening of the mouth (rare)
Signs of Dry socket after wisdom teeth removal[/su_highlight]
- An empty socket that is partially or totally devoid of a blood clot.
- An exposed bone may be visible which is extremely painful and sensitive to touch.
- Trapped food debris inside the socket that may hide the exposed bone
- Inflammation of the soft tissues around the socket.
- Delayed Healing of the socket.
Risk Factors of Dry socket
Smoking and tobacco use: Smoking elevates the temperature of the mouth making more chances of clot dislodgement.
It also slows down the process of healing by contaminating the wound, Apart from this smoking causes the formation of negative pressure in the mouth that can easily dislodge the clot hence all forms of smoking should be avoided for at least one week after the surgeries.
Trauma during or after the extraction: Wisdom teeth are the teeth with so many irregularities like Having Multiple roots, changes in shapes, erupt in many irregular positions because of less space in the jaw, and many more.
All these difficulties make this surgery little hard, especially when done by inexperienced or new dentists.
The chances of trauma increases which can lead to dry socket procedures are explained above.
Oral contraceptives: High estrogen levels from oral contraceptives may disrupt normal healing processes and increase the risk of dry socket.
Poor oral hygiene: Patients with poor oral hygiene are more prone to complications after wisdom teeth removal.
Having a dry socket in the past: If anyone has a history of dry socket and goes for the extraction again, there are more chances they will face the dry socket again.
Periodontal disease: Disease of gums rarely can also play part in the development of dry socket.
Use of corticosteroids: These types of medications, such as prednisone, may increase your risk of dry socket.
Prevention Of Dry Socket
- No Smoking before & after tooth extraction.
- No spitting, eating, washing, or using a straw for drinking.
- Good oral hygiene and gently brushing the teeth near the wound.
- Using a warm saltwater rinse to keep the clean area.
- Don’t touch the wound with your fingers or other objects.
- Eat soft foods and avoid foods that could lodge in the wound, such as popcorn, peanuts, rice, or pasta.
- Follow all instructions as exactly as recommended by your dentist after the extraction.
What is the treatment for a dry socket?
If a dry socket happens so how will we treat it?
So first of all, after examining the patient do gentle irrigation of the socket with saline, clean food debris, or other material if impacted into the socket.
Now secondly we’ll medicate it, for medication we use Eugenol.
Eugenol is an analgesic it has an ingredient that can easily relieve your pain with this dentist also use a local anesthetic solution, local anesthetic solution relives by anesthetized the socket.
and for placing it into the socket we use a vehicle, so for that, the dentist mostly uses zinc-oxide eugenol.
He or she first mix zinc-oxide and eugenol well than take it on gauze or cotton including this he also takes the anesthetic solution and places it into the socket.
Pre-formed solutions are also available named as alvogyl or dry socket paste, they can also be used.
Your dentist will change this dressing every day or after one day with this he will examine your socket time to time also he or she can prescribe antibiotics and analgesics with this if they required
Generally, the dry socket heals within 7 to 10 days if care is taken.
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