Daily Bolus of LR: Dry Socket

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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.

 

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