What is a Dry Socket
Dry socket is defined as a painful inflammatory condition of the tooth socket following extraction. It is the most studied and least understood complication of dentistry. Although described in many different ways and hypothesized to be caused by many different post-operative behaviors, a dry socket following the removal of a tooth is really nothing more than pain and swelling that’s not controlled after the first two or three days of post-operative convalescence and pain medications. Whether your doctor describes the problem as a localized infection of the surgical site, inflammation of the socket, loss of the blood clot or exposure of bone in the surgical area, the treatment of the problem remains the same and is very basic:
– Eliminate the pain
– Decrease swelling
– Promote healing
– Reestablish normal jaw function and diet
The best description of a dry socket is dull, sometimes throbbing pain that increases in intensity over the course of the 3rd, 4th and 5th post-operative day. The main symptom is the pain but other symptoms can include: limited opening, a deep bone pain that mimics a bone bruise, muscle cramping, and drainage from the surgical site. Pain is the most common symptom, therefore, pain management and infection control are the most important treatment objectives.
In my practice, pain management and infection control are priority #1. Treatment usually consists of managing the pain through the use of medicated gauze strips placed in the surgical site and the use of topical antibiotics if the is bone exposed. The medicated strips contain local anesthetics and medications that soothe and numb the surrounding tissue and adjacent teeth. The pain is generated by irritation and inflammation of the surrounding gum tissue, the teeth in the surgical area and in many cases irritation in the surrounding muscle tissue. Muscle inflammation may be the biggest culprit in post-operative pain and discomfort following wisdom tooth surgery. The movement of the muscles and jaws during talking, clenching, grinding, chewing and even swallowing can aggravate the pain associated with wisdom teeth removal. This is the theory behind the extraordinary success in minimizing dry socket pain through the use of the Cool Comfort Wrap™.
Minimizing the movement of the jaw by restricting the diet to liquids and soft food also decreases pain. If you have ever wondered why patients always complain of pain following the removal of lower wisdom teeth, but rarely complain of pain following the removal of upper wisdom teeth, it also may be because the lower jaw moves and the upper jaw doesn’t. It may be because the lower jaw is surrounded by muscle and there are no muscles attached to the upper jaw in the area where upper wisdom teeth are found. We stress a soft diet and minimal loading of the muscles used in jaw movement in combination with the Cool Comfort Wrap™. This is very effective in eliminating the potential for post-operative pain that mimics dry socket pain. Antibacterial mouth rinses and oral forms of antibiotics are also used pre-operatively and post-operatively to minimize inflammation, suppress infection, and lower pain.
What can you do to limit the possibility of a dry socket?
– Use the Cool Comfort Wrap™ for the first 48 to 72 hours post-operatively. Continuous ice therapy significantly reduces pain, swelling, and muscle inflammation. The Cool Comfort Wrap™ is available exclusively to our patients following the removal of wisdom teeth and other oral surgical procedures such as the placement of dental implants.
– Take your pre-operative antibiotics and use your topical antibacterial mouth rinse prior to surgery.
– Take your oral antibiotics after surgery and continue using your topical antibacterial mouth rinse for one week following surgery.
– Get a good night’s sleep the night before your surgery. Don’t stay up late. Lack of sleep lowers the immune system response of the body and may contribute to prolonged post-operative healing.
– Do not smoke. Smoking greatly increases post-operative pain, inflammation and infection rates. Smokers have a 4 or 5 times more pain post-operatively than non-smokers.
– Stay on a soft diet for several days after your surgery. A soft diet does not include pizza or cheeseburgers. It does include foods such as casseroles, shredded chicken, shredded beef, ground beef, pasta, baked beans, scrambled eggs, fried rice and an assortment of Mexican foods (light on the spices!).
– Take your post-operative medications and limit your post-operative activity. The more active you are, the more jaw movement you will experience. The more jaw movement you experience, the more pain you will have. Remember, lower jaw pain is 10 times more common than upper jaw pain following the removal of all 4 wisdom teeth. Why? Because the lower jaw moves!
– Keep your post-operative appointment with us. Usually, you will be seen on the fourth or fifth post-operative day, the time that most “dry sockets” occur. At this point, if you have post-operative pain that is not controlled by over-the-counter pain medication with prescription narcotic pain pills for occasional break through pain, you probably need a dressing placed in the surgical site and a change in your medications.
– Get plenty of sleep following your surgery. Lack of sleep or poor sleep causes clenching and grinding and more post-operative pain.
– Use your Cool Comfort Wrap™ for the first 48 to 72 hours post-operatively. Continuous ice therapy significantly reduces pain, swelling and muscle inflammation. The Cool Comfort Wrap™ is available exclusively to our patients following the removal of wisdom teeth and other oral surgical procedures such as dental implant, reconstruction and jaw reconstruction.
If you are interested in purchasing the Cool Comfort Wrap™ click here.