It’s become almost a rite of passage for many Americans, particularly teenagers and young adults – the removal of wisdom teeth.  Around five million people every year have this procedure done at estimated cost of $3 billion for their removal.  Wisdom teeth, also known as third molars, are four teeth that grow at the very back of each corner of the mouth and there’s a good chance most of you reading this article have had yours removed.    

Wisdom teeth do not always have to be removed if they are healthy, have grown in completely, are positioned correctly and in line with the other teeth, and they can be cleaned as part of daily hygiene practices.

They begin to grow usually during the teen to young adult years and are often recommended to remove for various reasons:

· If they are crowding or could damage nearby teeth due to lack of room to grow in properly

· If they only partially emerge through the gums.  Then they become a magnet for bacteria causing gum disease or oral infection since this area is hard to reach and keep clean.

· If they become impacted or trapped unable to emerge normally.  This could result in an infection or cyst damaging the teeth roots or bone support.

Dry socket after wisdom teeth removal

The vast majority of people who have their wisdom teeth removed experience minimal swelling, discomfort or pain.  But there will be between 2-5 percent of the population who after the removal of their wisdom teeth, experience what is known as dry socket. 

Dry sockets occur when the blood clot that formed to protect the bone and nerves becomes dislodged.  This means the socket is no longer protected by the clot thus exposing it to air, along with food, saliva and bacteria which can become lodged where the clots originally were.  This can lead to pain and discomfort and will delay the healing process since blood clots are crucial to healing. 

It is generally the lower wisdom teeth that were removed that are more likely to develop dry sockets than extracted, upper teeth. 

How will you know if a dry socket has occurred?

A person who has recently had their wisdom teeth removed and is experiencing dry socket, will have the following symptoms:

· Within two days, pain will begin that can radiate from the socket itself and in some cases, all the way to the ear.  The pain is often described as dull and throbbing.

· There will be a dry opening where the tooth was removed where the blood clot should have been.

· Bad breath

· Unpleasant taste in the mouth

 

Causes and treatment of a dry socket

The main cause of a dry socket is food or other debris that becomes lodged in the place of the blood clot.  Other causes of a dry socket can include the following:

· Drinking from a straw and smoking can create suction causing the clot to become dislodged. 

· Coughing, sneezing, or spitting can also dislodge the blood clot. 

· Poor oral hygiene or touching the area where the teeth were removed can increase the risk of dry socket. 

· Women who take birth control medication as this can increase the risk of developing dry socket by 30%

Anyone who is experiencing the symptoms of dry socket needs to see their dentist or oral surgeon who removed the wisdom teeth right away.  The treatment for dry socket is as follows:

· Anti-inflammatory medicine for pain

· Debris may need to be removed that has become lodged in the socket.  It will be filled with a medicated paste that promotes healing

· The paste is to be removed and reapplied every day for several days

· If the socket has become infected, antibiotics will be prescribed

 

Preventing dry socket

There are several steps one can take to prevent the development of dry socket:

· Practice good oral hygiene and follow the instructions on how to care for the area after the surgery

· Use any medicated oral rinse as prescribed

· Rinse mouth with salt water after eating to remove excess bacteria

· Avoid touching the wound other than changing the gauze after the procedure

· Do not smoke for at least 24 hours after the surgery

· Avoid eating anything that leaves a residue in the mouth such as popcorn, peanuts, and pasta for several days

· Choose soft foods to eat such as clear soup, mashed potatoes, and pudding or yogurt

· Avoid carbonated beverages and do not drink through a straw