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Pay Attention to Dry Socket after Long-Term Toothache after Tooth Extraction

Dry socket is also known as alveolar process osteitis. It is a serious complication after tooth extraction. The incidence of various studies reported varies. Dry socket disease manifests as severe local pain three to five days after surgery, often accompanied by radiation pain or systemic symptoms, which seriously affects the work and life of the patient and increases the number of follow-up visits and medical expenses.

What are the specific symptoms of dry socket?

  1. There is an empty or dark gray clot in the alveolar socket, and the necrotic tissue gradually falls off, which is the exposed alveolar bone.
  2. 3-4 days after tooth extraction, I feel persistent severe pain locally, and the disease involves ear and temporal pain.
  3. The necrotic material covered in the alveolar socket has a rotten smell, and the probe can directly touch the bone surface and cause sharp pain.
  4. There may be swollen and tender lymph nodes under the mandible.
  5. Restricted mouth opening, low fever, and general malaise.

Causes of dry socket

It should be the result of multiple factors. First of all, due to the special anatomical structure of the impacted third molar, the bone is dense, the blood supply is poor, and the ability to resist infection is weak. Secondly, it is related to the trauma of tooth extraction. In the past, the method of knocking osteotome to remove bone and knocking the collar to increase the gap was generally used to extract the impacted third molar. Both deboning and increasing the gap will damage the alveolar bone, especially the increase It will squeeze and compress the alveolar bone wall, resulting in poor blood supply to the site after the tooth extraction, and further weakening of the postoperative anti-infection ability; in addition, the third molar is removed after the bone cavity is larger, blood clots are not easy to adhere, and the wound is not closed. Strict food saliva is easy to enter, thus causing infection of the tooth extraction wound.

The correct reason why blood clots cannot be converted into granulation is still unknown. It is suspected to be related to the toxins produced by the original bacteria in the tooth extraction area or the hormone secretion of female patients or the surgical trauma of the tooth extraction area. Therefore, it is more likely to occur in women, poor oral hygiene or have Tooth extraction wounds of patients with smoking habits, and teeth that have been infected or have peri-crown inflammation are also more prone to dry alveolitis after extraction.

Smoking has a considerable relationship with the occurrence of dry alveolitis. The reason is that the nicotine in tobacco will hinder the speed of vascular regeneration, thus greatly increasing the chance of early shedding of blood clots.

How to prevent dry socket?

  • To avoid dry socket, protect the blood clot in the wound after the tooth is extracted. Do not rinse your mouth on the same day to avoid washing it away, let alone touch the wound with your fingers or tongue. Before the wound is healed, it is best to eat soft food, do not chew on the side of the tooth extraction, pay attention to the cleanliness of the diet, and rinse your teeth with cold boiled water.
  • After tooth extraction, you should act according to the doctor’s instructions. It is strictly forbidden to brush your teeth, rinse your mouth, spit, or touch the wound with your tongue within 24 hours after extraction.
  • Do not drink other beverages that are not conducive to healing. You need to avoid the following beverages: caffeinated beverages, alcoholic beverages, carbonated beverages, hot beverages, these beverages will loosen the scar tissue on the gums. Do not use straws when drinking fluids. The act of inhalation will put pressure on the wound and prevent scar tissue from forming.
  • Tobacco is strictly prohibited within 24 hours after the operation. If you are a woman taking birth control pills, you can schedule the tooth extraction operation on the 23rd to 28th day of your menstrual period, during which your estrogen level is lowest.
  • Tooth extraction is not recommended during severe cold or when the physical or mental condition is not good, especially the difficult posterior teeth.
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