The Dry Socket, in all its mystery: Revealed

What happens with a dry socket?

The blood clot in the dental extraction socket is lost.

Initially the clot has an almost speckled grey colour, which then falls out, leaving an empty bony socket. There may be necrotic debris in socket.

So, how do you know it’s a dry socket?

There’s pain worse than the original toothache in and around where the tooth was removed, which increases in severity 1 - 3 days after the treatment. We see partial or total disintegrated blood clot within the alveolar socket. You might experience bad breath or a bad taste in your mouth. A dry socket can last 10-40 days.

Why is this happening?

This is where a little bit of a mystery comes in. There’s no one, singular, causative factor for developing a dry socket after tooth removal. This means that there are many, many things that add up the risks of you developing a dry socket (e.g. your immune system, previous infection, the reason why tooth was removed in the first place, degree of difficulty of tooth removal. etc.) Dry sockets are also significantly more common in smokers and in female patients.

What we do know is that fibrinolysis is an operative factor. Fibrinolysis is the destruction of fibrin and blood clots. (‘fibrino’ = protein that makes blood clots; ‘lysis’ = breakdown).

Down to the big question, how can we make it better?

Firstly, make an appointment! Always better to check with your dentist. Go back to the dentist that did the removal in the first place. They know your full medical history and exactly how the tooth removal went. Through conversation about your lifestyle and after-care, it is likely we can find the cause and, so, removal the cause and you can be back on your way to a comfortable recovery.

Practically though, you can decrease your chances of developing a dry socket. Prevention is always the best cure. In life, if you can avoid pain, why not?

When you make an emergency appointment for treatment of a dry socket, depending on the severity, we may clean out the socket with dental instruments and flush out the socket then place an antiseptic dressing, which, hopefully, encourages new blood clot formation in a clean socket. This would be repeated several times until the socket is healed.