Dry socket

[Jean]

Hi

My dentist removed my molar tooth last Friday after it had become very broken down. He had a difficult job removing the tooth because there was not much of the tooth left for him to hold on to.

He finally managed to pull it out and he said I might have some pain after the injection wore off. I actually had no pain for the last three days but last night a really bad pain started from the extraction region. I have taken different painkillers but the pain is still there.

My friend tells me that a similar thing happened to her after she had her tooth removed and her dentist told her that she had dry socket and gave her some special medication. I would like to know if you feel that I have dry socket and if so, should I come to see the emergency dentist tonight to have the dry socket treated or can I buy medication for it from the pharmacy?

[Dr Ehsan J. Esfahani]

Dear Jean,

Thank you for your question.

I am sorry to hear you have developed pain after the tooth extraction on friday. In answer to your question you should come and see our emergency dentist tonight. From the description you have given it seems like you have a dry socket. This is a common problem after a tooth extraction. There are many potential causes for a dry socket however I will not discuss them now.

A dry socket is very painful and needs treatment at the dentist as soon as possible. The treatment involves local aneasthesia and irrigation of the socket with chlorhexidine digluconate (corsydol). Following this Alvogel dressing is placed in the socket. Alvogel has antibacterial and antiseptic agents which will ease and soothe the pain. You will then be advised by your dentist to continue with luke warm salt water and corsydol mouthwash rinsing 3 times a day. This treatment may need to be repeated as a dry socket can take upto 2-4 weeks to resolve and healing to start.

In the meantime your dentist will prescribe for you pain killers such as co-codamol, ibuprofen and paracetemol. Ibuprofen and paracetemol can also be purchased over the counter. These medications should only be used if there are no contraindications medically and manufacturers recommended doses should be followed.

Antibiotics can as a last resort be prescribed if the pain does not subside and a bacterial infection has developed.