An extraction of the tooth (pulling a tooth in laymen’s terms) is considered when the tooth is either severely decayed, fractured, or when periodontitis is causing problems. In addition, common teeth pulled are wisdom teeth and primary teeth. Sometimes in these cases, the best treatment is to remove the tooth if it cannot be saved. This may be the best option to relieve any pain and prevent the spread of infection.
Dry socket occurs after a tooth extraction when the blood clot has been removed or has not formed properly. The clot is necessary to protect the socket and stop bleeding, to promote the development of new bone and gum tissues and to prevent pain. However, when the clot is removed prematurely, it exposes the tissues and the underlying bone.
Symptoms of dry socket include:
- Severe throbbing pain
- Does not respond to pain medication
- Radiates into ear
- Foul odor or taste in mouth
Several things can cause a premature loss of the blood clot:
- Smoking and tobacco use
- Spitting
- Sucking through a straw
- Sneezing and coughing
- Carbonated, hot or alcoholic drinks
- Touching clot with fingers or tongue
Treatment for dry socket:
- Rinsing socket with medications.
- Packing the socket with gauze that contains a soothing anesthetic.
- Returning to the office several times for repacking of the socket and monitoring of symptoms.
Post extraction instructions
Follow these recommendations to ensure successful healing of your tooth extraction:
- During the first 24 hours after your appointment, it’s important for a blood clot to form in the extraction site to stop the bleeding, reduce pain and speed healing.
- To help the clot form, bite on a gauze pad firmly for 45-60 minutes after the tooth has been pulled.
- If bleeding or oozing continues after you remove the gauze pad, place another gauze pad and bite down for another 45-60 minutes.
- To protect the clot and avoid a painful condition called dry socket, don’t do anything to dislodge or dissolve the clot for the first 24 hours. Don’t spit or suck on candies or through a straw. Don’t rinse, use tobacco or touch the dry socket. Don’t drink any carbonated, hot, or alcoholic beverages.
- Limit yourself to calm activities to reduce blood pressure and protect the clot.
- When the numbness from the freezing has worn off completely, drink lots of fluids and eat only soft nutritious foods, chewing on the opposite side of your mouth.
- To control discomfort, take pain medication before the anesthetic has worn off or as recommended. It is normal to experience some discomfort for several days after the extraction.
- To keep any swelling to a minimum, use an ice bag – 20 minutes on and 20 minutes off.
- After the first 24 hours or as soon as it’s comfortable, you can begin to eat normally.
- Resume brushing and flossing after the first 24 hours, but clean gently around the extraction site for about a week.
- If antibiotics are prescribed, continue to take them for the indicated length of time, even if all symptoms and signs of infection are gone.
- After the first 24 hours, you can reduce any soreness or swelling by applying moist heat. Swelling usually starts to go down after about 48 hours.
- You can further reduce discomfort after the first 24 hours by rinsing your mouth very gently 3 times a day and after meals with warm salt water (1 tsp. of salt per glass of warm water).
- Call the office if you have heavy or increased bleeding, pain or swelling that increases or continues beyond 2-3 days, if you develop a bad taste in your mouth, or if you have a bad reaction to the medication.