WHY IN SOME CASES THEIR IS SEVERE PAIN AT THE SITE OF TOOTH EXTRACTION AFTER FEW DAYS ?!

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DRY SOCKET (ALVEOLAR OSTIETIS)


- Even after a proper extraction, in some patients they may have recurrence of severe pain after within a week at the site of extraction and does not  diminise just by medications.
- Most commonly at the lower wisdom tooth region.The pain will be more of an acute form. Sometimes dentist gets confused whether there is any remaining root peice which is not removed from the socket causing pain and infection .This can be confirmed by taking a radiograph of the region where the extraction is done.

REASON FOR OCCURENCE OF SUCH A CONDITION !!
- The main reason for dry socket is because of the exposed bone around the periphery of the socket while extraction which is not covered by blood clot or any fibrous epithelial tissue, and due to food accumulation inside the socket creating a bacterial environment leading to inflammation.

PRECAUTIONS FOR DENTIST DURING AND AFTER EXTRACTION SO THAT DRY SOCKET INCIDENCE CAN BE REDUCED
 
- Compression of socket after extraction.
-  Curettage of any exposed bone at the site and irrigation with normal saline.
- Prior antibiotic administration.
- Post extraction instruction should be given and patient should  Strictly followed  untill it heals
- Strictly advise the patient to stop smoking,spitting,usage of straw,and chewing at the site till the trauma due to extraction heals completely.
"Smoking and use of oral contraceptives increase the incidence of dry socket"
- Stenous physical activities should be limited or atleast 1 day after extraction.


HOW DENTIST MANAGE SUCH CASES IN CLINIC -TREATMENT

- Cleaning the socket by saline irrigation and removal of any debris from the socket.
- Induces Fresh blood inside the socket by probing the walls of socket
- Placement of Zinc oxide eugenol cotton pack inisde the socket for reducing pain and for better healing.
- Then the dentist may prescribe Antibiotics such as Amoxicillin and analgesics such as Ibuprofen, Diclofenac or any other NSAIDs depend upon the patient medical condition.
 

                          
                          ~Dr.Sibin Boas 

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