Socket Preservation after Tooth Extractions

Tooth extraction

Socket preservation after tooth extraction is an important part of the healing process because it helps the patient recover more quickly while preventing an especially painful condition called dry socket. Also known as alveolar osteitis, dry socket is an inflammation of the alveolar bone (the thick ridge of the jaw bone which contains the tooth sockets) following a tooth extraction. For patients who have had or will soon have a tooth extracted, it’s important to understand what dry socket is, what causes it, and how it can be prevented or treated. 

Signs, and Symptoms of Dry Socket

Dry socket usually occurs when a blood clot either fails to form, is lost from the socket, or space left in the gums after tooth extraction. This, in turn, leaves the bone exposed, which can be painful and complicate the healing process. Dry socket can also lead to bone deformities and flaws that may complicate the installation of a dental implant to replace the extracted natural tooth. It’s important to remember dry socket is relatively uncommon, with somewhere between 0.5 – 5.05% of routine dental extractions resulting in the condition. However, the chance of dry socket is higher for impacted wisdom teeth—up to 30%. Your results will depend on your individual situation, and your dentist can best inform you as to what you might expect.

So, how do you know if you have dry socket after having a tooth extracted? There are a couple of key signs and symptoms to look for:

  • The socket may be empty, which means it will be either partially or wholly devoid of a blood clot.
  • The exposed bone may be visible.
  • Surrounding soft tissue—e.g. the gums—may be sensitive to the touch.
  • There may be pain, ranging from a dull ache to severe throbbing pain. The pain may spread to other parts of the jaw, mouth, or neck.
  • The patient may experience halitosis (bad breath) or a bad taste in the mouth.  

These symptoms may occur as soon as a day or two following an extraction. If you experience any of them, you should contact your dentist and ask them what you should do next.

Causes, Prevention, and Treatment of Dry Socket

The causes of dry socket aren’t always clear. Some contributing factors include the size and nature of the extraction—impacted wisdom teeth are especially vulnerable, bacterial infection, tobacco use, some vasoconstrictor pharmaceuticals, or the patient’s menstrual cycle are all contributing factors. The critical step for patients is following their dentist’s instructions regarding care of the extraction site after an extraction. Socket care is a vital part of promoting both the healthy healing of an extraction and in avoiding the pain and inconvenience of dry socket. Your dentist may ask you to use a soft-bristled toothbrush, avoid activities like smoking or drinking with a straw which can create pressure in the mouth, or avoid eating hard foods.

The Role of Socket Preservation

Another option is socket preservation, which is a treatment your dentist may suggest should you develop dry socket. Intended to improve patient healing and post-operative success, socket preservation involves installing a bone graft into the socket after the tooth has been removed. This bone graft may be made of a variety of materials ranging from natural bone to a synthetic substance. Once the graft is in place, the dentist will usually cover it with a protective membrane and then suture the socket closed.

Socket preservation accomplishes a number of goals. Primarily it prevents bone damage, which can complicate future dental implants or even move natural teeth out of alignment. It prevents dry socket by covering the site completely, avoiding the possibility of a lost blood clot. It may also speed or improve the healing process in some patients.

Your dentist can tell you whether or not socket preservation is the right step for you—it’s not always necessary. However, when needed it can prevent painful dry socket and promote healing so your extracted tooth truly makes way for something even better.