Dry socket after tooth extraction - symptoms and treatment

Dry tooth socket: features of the disease

A dry socket appears in two cases after tooth extraction. In the first, a blood clot may fall out or dissolve, while in the second, it may not form initially (usually due to severe bleeding). On average, a similar diagnosis is made to two to five percent of people who have undergone a tooth extraction procedure, but dry socket after wisdom tooth removal is much more common. In the absence of timely treatment, the disease can progress to the stage of alveolitis, which in turn threatens the appearance of phlegmon or an abscess. What does a dry socket look like? Visually, a dry tooth socket is easy to identify: in the absence of a blood clot, part of the bone is exposed.

Symptoms of dry socket

• After 2 - 3 days, the gums begin to become inflamed and pain appears.
• As the inflammatory process develops, pain increases and manifests itself not only in the oral cavity, but also in the cervical region, as well as in the ear area.
• The appearance of an unpleasant odor and specific taste in the mouth is another characteristic symptom.
• Partial hearing loss may occur.

Alveolitis photo of the hole

Often the hole may look normal, that is, without pronounced deviations, but this can be seen in the photo. But here you can consider the presence of a narrow inlet. It is also not very clear whether a clot is present in this case. Of course, making a diagnosis under such circumstances is very difficult. To do this, the doctor will have to conduct a full examination, which is performed using modern technology. And only because of the constant, very often in the form of increasing pain, smell from the open socket, tumor of the gingival tissue, can alveolitis be suspected.

Causes of dry socket after tooth extraction

• Smoking (especially immediately after tooth extraction).
• Poor oral hygiene over a long period of time.
• Poor blood clotting or taking blood thinners.
• Frequent rinsing of the mouth.
• Mechanical impact on the socket and soft tissue in its area.

In addition to the factors mentioned above, much depends on the extraction procedure itself: improperly performed tooth extraction contributes to a number of complications, including dry socket and alveolitis. To prevent this unpleasant phenomenon, dentists recommend limiting physical activity for a few days after tooth extraction, and also not chewing on this side of the jaw (especially hard foods). Under no circumstances should you touch the hole and the area around it with your hands or foreign objects. Bad habits (drinking alcohol and smoking) should be eliminated during healing. The doctor usually prescribes anti-inflammatory drugs for rinsing the mouth (miramistin, chlorhexidine or furatsilin), but this procedure should be carried out no more than 2 - 3 times a day.

What can you do at home -

After the acute symptoms of inflammation have subsided, there is no need for antiseptic turundas inside the socket, because they do not help the wound to heal (epithelialize) faster. At this stage, the best treatment method will be to fill the hole with a special Dental adhesive paste (Solcoseryl). This drug has an excellent analgesic effect (after 2-3 hours the pain will practically stop, and after 1-2 days it will go away completely), and also speeds up healing many times over.

Scheme of use - this paste is added to a hole that has been washed with an antiseptic and slightly dried with a dry gauze swab (completely filling the hole). The paste is perfectly fixed in the hole and does not fall out of it. There is no need to remove the paste from the hole, because... it slowly dissolves on its own, giving way to growing gum tissue. The only thing that may be required is to periodically add it to the hole.

How to rinse the hole from food debris -

In some situations (when the turunda has fallen out of the hole, and there is no way to see a doctor right away), it may be necessary to wash the hole. After all, after each meal, the hole will become clogged with food debris, which will cause new inflammation. Rinsing will not help here, but you can easily rinse the hole with a syringe.

Important : from the very beginning you must bite off the sharp edge of the needle from the syringe! Next, bend the needle a little and fill a 5.0 ml syringe with a solution of Chlorhexidine 0.12-0.2% (it is sold ready-made in every pharmacy for 20-30 rubles). Screw the needle tightly so that it does not fly off when pressing the syringe plunger! Place the blunt end of a bent needle into the upper part of the socket (do not insert too deeply to avoid injuring the tissue), and rinse the socket under pressure. If necessary, do this after every meal.

In principle, after this the hole can be dried with a gauze swab and treated with Solcoseryl. We hope that our article on the topic: Alveolitis after tooth extraction, symptoms, treatment - turned out to be useful to you!

Sources:

1. Higher prof. the author’s education in surgical dentistry, 2. Based on personal experience as a dental surgeon, 3. National Library of Medicine (USA), 4. “Outpatient surgical dentistry” (Bezrukov V.), 5. “Propaedeutics of surgical dentistry” (Soloviev M. .).

Treatment methods for dry tooth socket

If you discover symptoms of a dry socket, immediately contact your dentist: in this case, you should not self-medicate, although on the Internet you can find a lot of advice on how to treat a dry socket at home. Can a dry socket heal on its own? Without therapeutic and preventive measures, the healing process is not always successful and takes longer. What kind of dry socket treatment will be carried out after tooth extraction depends on the degree of development of the inflammatory process.

Treatment of a dry socket after the removal of a wisdom tooth is carried out in the same way as in the case of other teeth, however, access to the area of ​​​​inflammation can be complicated due to the distance of the “eight” location.

Associated symptoms

Dry socket may be accompanied by symptoms such as:

1. High temperature accompanies acute and purulent inflammation, a dangerous symptom that requires immediate attention from a dentist.
2. Swelling of the cheek indicates the accumulation of pus, the development of a dangerous purulent form of the disease.
3. Severe pain is an obligatory companion of alveolitis and increases with exposure of the bone and purulent inflammation.

How long does it take for a dry socket to heal?

Many people are interested in the question of how long it takes for a dry socket to heal. In the absence of complications, the wound heals in 5 - 7 days, and within a month the hole is filled with epithelial tissue. If you have dry socket, the healing process may take longer than two weeks (with proper treatment, of course). As already mentioned, extensive inflammation may occur and even require surgical hospitalization of the patient: in this case, the healing of the dry socket may be very delayed.

Possible forms

The table shows the forms of alveolitis:

A few words about the procedure

Tooth extraction is a full-fledged surgical procedure. The operation consists of four stages.

1. Treatment of the area around the tooth that is to be removed.
2. Anesthetic injections - ampoules in carpules, where an anesthetic is combined with drugs to constrict blood vessels. Usually local anesthesia is used in the area where the nerve that innervates the problem tooth exits; if this is not enough, anesthetics are added without additional effect. When the medicine is injected into the inflamed gum with an acidic environment, part of it is inactivated, so additional anesthesia is used.
3. Tooth extraction after the anesthesia has started working (the gums become numb, the blood vessels narrow). A scalpel is used to cut off the ligaments that fix the tooth. The choice of instruments and duration of the procedure depend on the condition of the tooth.
4. Treatment of the oral cavity after removal: sutures (if the wound is torn or its edges are located far from each other) and a gauze swab soaked in a hemostatic agent (it must be held in the teeth for 20 minutes, since the effectiveness of the hemostatic drug increases compression of the wound). Do not rush to remove the tampon.

Gum section

Preparing for removal

Removal of a tooth

Installing a tampon

Stitching

Bleeding from the hole itself does not pose a mortal danger. In medical practice, only one case of death was recorded when blood from a wound entered the respiratory tract because the patient was intoxicated. The bleeding was complicated by cirrhosis of the liver, which interferes with clotting, and the woman had three teeth removed at once.

Consequences

If during the first two days after tooth extraction pain appears, swelling does not subside and the temperature rises, then most likely these are signs of inflammation. In this case, you should immediately consult a doctor, as dry socket syndrome can lead to serious complications. Such as:

• flux.
  It begins to form when an infection gets into the hole. Characterized by severe swelling and pain. Requires immediate specialist intervention.
• alveolitis
  This is a deeper penetration of the infection - deep into the gums. Bacteria spread quickly and, if this process is not stopped in time, there is a risk of tissue necrosis. In this case, the losses can be very serious.

Attention!

The consequences of untimely or incorrect treatment can be irreversible. Do not neglect your doctor's advice. A wound on the mucous membrane is always a vulnerable area, subject to attack by bacteria and their rapid spread.

The main functions performed by such a “thrombus”

If a clot has formed at the site of the extracted tooth, then this is a good sign. It is this that protects a fresh wound from the aggressive environment of the oral cavity, where a large number of bacteria live. It also prevents saliva and food debris from entering injured tissues, protects them from the inflammatory process and related complications (alveolitis, abscess, gumboil, phlegmon, osteomyelitis).

The clot promotes the natural healing process of areas damaged during surgery. Moreover, some researchers claim that it even accelerates the process of tissue regeneration, and if it is not formed or falls out ahead of time, the rehabilitation period lasts longer.

After operation

After three hours, the painkillers are still strong, so patients do not feel pain or it is mild. All this time, pure blood or ichor may be released from the hole. If a figure eight was removed, this can last all day, since the surgical area of ​​the wisdom tooth is larger than that of other teeth.

Bleeding from the socket

On the second day, the hole has an unattractive appearance: a blood clot with a grayish coating. It looks like pus, but you shouldn’t be afraid of it: it’s fibrin, a substance that facilitates wound restoration. If everything goes well, the pain will be aching and will subside by the end of the day. If the nature of the pain is different - sharp, pulsating, and there is scarlet blood from the wound, you should urgently see a dentist.

At first, the hole may smell foul. There is no need to be afraid of this: blood accumulates there, and since it cannot be rinsed out, bacteria settle in the wound. If you feel normal, there is no fever, there is no reason to worry.

The rehabilitation process is normal if:

• What medicine is put into the hole after tooth extraction?

• when touching the wound, the ichor does not appear;
• the aching pain gradually disappears;
• feeling normal (temperature up to 38° is possible only in the first two hours);
• swelling on the cheek decreases (if it was not there before extraction, it should not appear at all);
• after 3 days the wound no longer bleeds.

2 weeks after removal

To reduce bleeding, you can make a tampon yourself. Positioning it so that the edges do not injure the blood clot, hold the napkin for half an hour. In the pharmacy chain you can buy a hemostatic sponge, which can be used in cases of heavy bleeding, for example, in liver failure.

Hemostatic sponge

The hole is closed with a hemostatic sponge.

You can take one or two tablets of Dicinone or Etamzilate (no more than 8 pieces per day).

Dicynone tablets

You cannot experiment with hydrogen peroxide: it reacts with blood components, destroying the blood clot and increasing blood flow.

Why is pathology dangerous?

If you do not pay close attention to the problem, then within a few days after the operation severe pain will begin, indicating inflammation of the socket of the extracted tooth, that is, alveolitis. The disease is dangerous because, if treated improperly and not seeing a doctor in a timely manner, it can lead to the development of gumboil, when the cheek swells and an abscess appears on the gum. But flux is not the worst thing. Advanced alveolitis can lead to a purulent abscess, phlegmon of the soft tissues of the face and osteomyelitis of the jaw, damage to internal organs, sepsis (blood poisoning), and death.

What to do to prevent alveolitis

Alveolitis most often develops after the removal of third molars - wisdom teeth. This is due to the high traumatic nature of the doctor’s manipulations. Often, additional cutting is required, peeling off the gums, sawing the tooth into several parts to make it easier to remove it if the roots are bent.

After 30 years, alveolitis in the current situation occurs several times more often, since the jaw itself becomes denser, not enough blood flows into it, and the socket often remains dry.

After the removal of third molars, the doctor may recommend the implementation of prophylaxis. The main goal is to prevent complications. To do this, you need to strictly follow all the dentist’s advice so that the blood clot in the socket is preserved and healing proceeds as it should.

What to do for prevention:

• avoid intensive rinsing;
• avoid foods that are too hot, because heat provokes inflammation;
• do not chew on the operated side;
• do not touch the wound with your hands;
• do not pick the hole with improvised objects;
• do not try to remove the blood clot;
• organize proper care.

The patient should visit the dentist twice a year for preventive examinations.

When performing an operation, the doctor observes the following precautions:

• proper treatment of the patient’s hands, instruments, and mouth;
• carrying out the operation in accordance with the regulations and stages;
• after removal, the edges of the hole must be connected so that it fills with blood;
• placing a hemostatic sponge in the socket to prevent alveolitis and stop bleeding;
• suturing in cases of severe soft tissue injury.

The most common complication after tooth extraction is dry socket. You should know why this disorder occurs and what to do when symptoms appear.

Dry socket syndrome (alveolitis) is the definition of a disorder when a blood clot does not form after tooth extraction.

This is dangerous because it is accompanied by bleeding and the risk of infection. Complications are possible for two reasons: when a clot does not form at all, and when it falls out after a while.

General rules for caring for the tooth socket after surgery

It is important to pay attention to oral care in order to avoid infection. Thanks to antiseptics (Chlorhexidine or Furacilin), unsanitary conditions and inflammatory complications can be avoided. In order to use antiseptic solutions, you should know that use is prescribed after 24 hours from the date of tooth amputation.

The rinsing is gentle, so as not to wash the protective layer in the hole. After a few days, the antiseptic can be replaced with folk remedies: herbal infusions, soda or salt solutions, strong tea. The solution should be of such a consistency that it does not cause additional drying or damage to the oral mucosa. Don't overuse antibiotics. They should be prescribed by the attending physician only in case of severe symptoms in the form of inflammation or suppuration.

List of other means and methods for care and treatment of the affected area in case of complications:

• rehabilitation, i.e. medical therapy to remove pus, dead tissue and tooth fragments from the socket;
• drainage procedures (installation of a drainage tube to drain purulent deposits);
• suturing.

What should everyone know after tooth amputation?

Here are the rules that must be followed. Abuse of bad habits or an indifferent attitude towards such wounds can turn out very badly and affect the health of not only the oral cavity, but the entire body as a whole. What rules do you need to know?

Wait 2-3 hours after tooth extraction and do not take any food or water.

1. Find the strength to hold the gauze under pressure for 20 minutes, which the doctor left in the wound after the amputation of the tooth.
2. Ban yourself from visiting steam rooms and swimming pools; you will be forced to give up even sports and active recreation.
3. Consuming alcohol, tobacco products, as well as eating hard, hot, spicy or sour foods will have an extremely negative impact. This can irritate or dry out the oral mucosa, increasing pain and increasing the risk of developing inflammation or infectious diseases.
4. Protect the affected area of ​​the mouth from damage and temperature changes, and try not to sleep on that side.
5. Remember the most important thing: a blood clot formed in the socket of an extracted tooth performs protective and antiseptic functions. Removing it will lead to the wound opening and suppuration.
6. Do not drink liquid from a straw. This will also help remove the blood clot.
7. Try to protect the affected part of the jaw from damage by chewing food only in the untouched area.
8. On the first day after tooth amputation, refrain from brushing your teeth. In the following days, it is advisable to brush your teeth twice a day, paying special attention to the affected areas of the gums.
9. Your immunity will be weakened, try to avoid contact with sick people, as well as visiting cool places.

wisdom tooth
Thus, your health and consequences after tooth extraction directly depend on your attitude to care and proper treatment. Don’t be afraid to visit your doctor often and in a timely manner; this can protect you from serious illnesses and serious consequences. If you find that:

• bleeding does not stop after amputation;
• unbearable pain is felt for several days;
• 4 or more days body temperature is above average;
• noticeable inflammation forms, the formation of a malignant odor from the oral cavity - do not hesitate. You urgently need a doctor’s consultation, and perhaps the right course of treatment!

Prevention at home

After the operation, certain rules should be followed that will significantly reduce the chance of alveolitis occurring:

• do not rinse your mouth on the day of the operation;
• eliminate smoking;
• Avoid eating hot and spicy foods , as well as foods that require effort to chew;
• do not touch the hole even with your tongue>;
• exclude physical activity and visiting the sauna.

Stages of socket healing by day

• The bleeding that occurs after tooth extraction stops after a few minutes , and a blood clot is formed that protects the wound from the penetration of microbes. Under the clot, damaged tissue is being restored, so it is so important to maintain its integrity until the hole heals completely.
• Day 1 – the processes of epithelization (healing) of the wound surface begin.
• Day 3 - signs of epithelization become noticeable, healing begins from the edges of the wound and moves towards the center.
• Day 4 - granulation tissue begins to form - a type of connective tissue that is formed in the body only during wound healing by secondary intention, when there is a strong defect in the skin.
• Day 7 - granulation tissue replaces part of the blood clot, it remains only in the center of the hole. Osteoid (bone) beams begin to appear, indicating bone formation. At the same time, epithelial tissue grows significantly from the edges of the gums.
• 14th -18th day - epithelization of the wound is completely completed, its surface is tightened and heals completely. By this time, the hole is completely filled with granulation tissue, and osteoid tissue is actively developing.
• After a month, a significant part of the hole is filled with new bone tissue. By the end of the second, sometimes third month, this process is completely completed.
• 4th month - bone beams in the newly formed osteoid tissue calcify, it matures: it becomes spongy and does not differ from the rest of the bone. At the same time, the edges of the socket dissolve, the alveolar edge in the area of ​​the extracted tooth becomes thinner and lower than it was before surgery.

Methods for diagnosing alveolitis

How long the alveolitis will take to heal depends on timely diagnosis and treatment. Therefore, at the first signs of illness, you should consult a dentist. Identification of pathology occurs after listening to complaints, collecting anamnesis (where there is recent tooth extraction) and examining the socket cavity.

Sometimes the doctor prescribes an x-ray examination, which helps to detect tooth fragments and other foreign fragments in the alveolus. In rare cases, when alveolitis of the tooth socket , computed tomography is prescribed for the purpose of differential diagnosis of other diseases (trauma, tumor, etc.).

Pathology prevention measures

Every patient can protect himself from the occurrence of an unpleasant problem. To do this, you must initially choose professional dental surgeons who specialize in surgical interventions. At the stage of planning the operation, you need to inform the specialist about the diseases you have and the medications you are taking, so that the doctor, based on the data received, can draw up an individual treatment plan.

At home, you need to follow all the recommendations of specialists without exception. It is especially important to follow those that prevent damage and dissolution of the protective clot. Namely: you need to stop eating hot and solid foods, you shouldn’t engage in sports or physical activity, and you shouldn’t touch the wound with any objects or hands. For a while, you should stop smoking and drinking alcohol, as well as actions that lead to overheating, a rush of blood to the head and severe swelling of the tissues.