September 12, 2011 by dailybolusoflr
Dry Socket (also known as alveolar osteitis)
· This is a pain syndrome that develops about 2-4 days after a tooth extraction
· The pain is often so severe that patients visit the ED in 10/10 pain
· The patient may also complain of foul taste or odor, which should not be mistaken for infection
· Dry socket is caused by the loss of the physiologic blood clot that sits in the post-extraction socket as well as a focal inflammatory process
· Patients who smoke often have delayed healing and are at higher risk
· Patients are discouraged from drinking through straws because the negative pressure in the oral cavity that results can lead to dislodging of the clot
· Treatment involves a dental block before proceeding with any other treatment. This is because the local manipulation of the site can be extremely painful.
· After the patient has adequate pain control, the socket should be irrigated with saline and packed with ¼ inch iodoform gauze (dental kits often contain clove oil (eugenol) which is thought to be an antiseptic and local anesthetic. . .the gauze can be soaked in this before it is packed into the socket)
· Follow within 24-48 hours with their dentist or oral surgeon.
Ref: Buttaravoli and Stair. Minor Emergencies: Splinters to Fractures.