Don’t worry- as painful as this condition is, it is not serious and doesn’t suggest anything was wrong with the extraction.
If left the condition would heal up on its own but could put you through a couple of weeks of ‘not exactly fun’ in the process.
The bone will eventually be covered by healing tissue (we call this ‘granulation tissue’)- this grows in from the sides to cover the bone and fill the socket.
The top layer of bone in the socket is dead (non-vital) and eventually gets pushed out by healthy living bone underneath. To heal in this way takes much longer and is far more uncomfortable than when a nice solid clot forms to begin with, promoting rapid healing from all directions.
Go and see your dentist- The treatment is very simple and takes only a couple of minutes and will have you feeling a bit better in no time.
The dentist is likely to use one (or a combination) of the following treatment options:
- Painkillers
As mentioned before, over the counter medication may not be strong enough to relieve the pain, in which case the dentist may prescribe something with a bit more kick, but even that is likely to have only a minimal effect.
- Washing and dressing
In nearly all cases, all that is required is washing out the socket with saline or an antibacterial wash (e.g. chlorhexidine) to get rid of any food bits etc. and placing a sedative dressing that will cover the bone and promote healing.
We use a dressing called Avogel – which has clotting factors and contains Eugenol and oil of cloves to help settle things down. Tastes pretty gross mind you, but that is far outweighed by the relief that it offers.
This can be left in place and doesn’t need to be removed. it will either be incorporated into the clot and broken down by the body, or fall out after a few days- by which time it will have done its job and the pain will have subsided. You will often feel better within a matter of minutes or at most an hour.
- New Clot
Sometimes, in the case of a particularly bad dry socket the socket may need to be washed and dressed a couple of times. If it is still not healing, it can be a good idea to try and start from scratch again by making the socket numb; cleaning the inside of the socket and stimulating a new blood clot to form. It is important that you follow the extraction aftercare instructions once again.
- Antibiotics
As a rule these are of no use when treating this condition. Although If there is super-imposed infection that has spread and you are feeling unwell (fever and glands are up), then antibiotics may be needed at this point.
If you are prone to getting infections, such as people with diabetes or HIV, or you suffer from any disorder that means delayed healing, the dentist may decide to provide you with antibiotics as a prophylactic (preventative) measure but that is up to them and will depend on the individual case.