Dry Socket, a Thing of the Past?

Posted on
July 19, 2019

Dry socket is a term that is often misapplied to pain after a tooth extraction.  This is a rare condition; an extraction site completely devoid of clot-scab equivalent on dry skin. Foul odor from bacterial invasion is usually present.  This is a significant problem.  Fortunately this almost never occurs.  What we see is complaint of pain, usually lower back teeth.  This is the area of the jaw where a big sensory nerve-inferior alveolar, courses below the teeth.  We treat with a gauze packing of Eugenol-clove oil, alone or in combination with other medicaments.  This makes it feel better, but completely stalls healing.  You can’t heal with gauze in you socket.  In the past, everyone had a different recipe for this.

Today, we can prevent this from happening with a few techniques.  First, pain and swellingcome mostly from pulling the gums off the bone-flap elevation.  Second, maceration of the bone from forceps extraction or digging around a tooth to remove cause increase pain also.  We were all taught to remove teeth this way.  Teeth are much harder than bone.  It is faster and easier to remove a tooth by making the surrounding tissues give way.  It is also horribly traumatic.

Fortunately, technology has improved greatly.  It is now possible to precisely disassembleteeth within the jaw and remove.  This is an adaptation of what medicine calls a”minimally invasive surgery”.

Grafting sockets also helps the healing process.  Dissolvable bovine collagen plugs hold the blood clot in place and quickly stop bleeding.  Your own blood can be easily processed to extract the growth and healing factors, plus defense cells; and mate with the clotting factors.  A membrane called PRF-platelet rich fibrin results.  This accelerates soft tissue healing.

It takes longer to do this, but is worth the effort.  I consistently see patients return without problems.  I don’t treat “dry sockets” now, because I don’t see them.  Everyone is happier with an uneventful recovery.

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