Most patients heal very quickly when it comes to oral surgery; however, some people who have a tooth extracted will return reporting severe discomfort, which turns out to be a painful condition called dry socket. Also known as alveolar osteitis, this is a pocket in the place of the extracted tooth that often becomes impacted with food and plaque debris and is very painful and sensitive to touch.
When the condition becomes difficult for a patient to manage at home, they need the professional help of a dentist to apply a dry socket paste to the area. Dry socket paste is a great treatment that should provide relief to the patient and prevent future instances of alveolar osteitis from occurring.
What is Dry Socket Paste?
It is usually a petroleum based product with a small amount of eugenol and guaiacol incorporated. Eugenol is beneficial because it has anti-bacterial and anti-inflammatory properties.
It is highly recommended among pain relievers to relieve tooth socket discomfort. Some practices purchase a ready made dry socket paste and some practices prefer to create a custom paste. The main idea is to treat and pack the dry socket so that it’s protected for the duration of healing time for the patient. It is also a great prevention tool for developing symptoms associated with dry socket.
Identify and Treat Dry Socket
Before applying dry socket paste, the condition must first be identified and treated. Dry socket is identified by the following symptoms:
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Throbbing pain at surgical site
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Poor taste
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Visible bone in socket
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Empty wound site
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Partial or complete loss of blood clot at surgical site
Patients that complain of pain at an extraction site are not always experiencing dry socket. Treating it before applying the paste is imperative for proper healing. The dry socket is a hole in the exposed bone left after extraction. Some things that increase your risk for dry socket include:
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Chronic smokers or people who use smokeless tobacco products. The motions employed while using these products and the ingredients themselves are among the most common causes of dry socket.
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A dry socket happens when the blood clot that protects a hole in the bone after extraction is dislodged. This can happen when taking certain types of birth control pills.
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Using a straw or eating/drinking things that require a sucking motion.
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Previous experience with dry socket.
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Infections in the gums or teeth surrounding the extraction site can create conditions for dry socket to occur. Patients prone to infection or who develop an infection shortly after an extraction should be monitored.
Treat the area before applying dry socket paste
Once the dry socket has been identified in the patient, the dentist needs to treat the area prior to packing it with the medicated paste. The area needs to be carefully debrided and food particles removed. It is a gentle process as the condition is very sensitive.
The dentist will flush the socket with sterile water or a medicated rinse like chlorhexidine. This helps prevent any secondary infection and encourages healing of the wound site.
Prep the dry socket paste by mixing up your own version or having it ready to go on a sterile tray with all necessary tools sterilized and ready to go.
Be sure to check for any swelling or irritation before applying the dry socket paste. This could be an indication of an infection or some other condition aside from the dry socket.
Other ways to treat a dry socket before a medicated dressing is applied includes:
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Pain medication: a prescription for pain medication may be necessary if over-the-counter medication is not sufficient.
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Flushing of the socket: A patient may have to syringe salt water or a prescription rinse into the socket at home to keep the area clean and free of food and plaque debris.
Apply Dry Socket Paste to the Affected Area
Use a flat bladed instrument to pack dry socket paste into the affected area. This replaces the blood clot that used to sit in the socket before it was dislodged. Not only will this protect the socket as it heals, but many dry socket pastes also include compounds for quick pain relief, for promotion of healing, and to prevent infections.
After the paste is applied, the rest of the area should be packed with gauze. This helps keep the area sterile and allows for the dry socket paste to stay in the socket instead of possibly coming out over time.
The patient will need to be advised about how to change this gauze dressing regularly. Typically, the medicated dressing is applied every 24 to 48 hours and used for a few days depending on the patient's comfort level.
You should return to your dentist for a follow-up appointment. Sometimes a non-dissolvable gauze carrier needs to be removed. Other times a dissolvable material is inserted. Either way, your dentist should ensure the extraction site is healing properly and there is no secondary infection or inflammation.
FAQs for different dry socket pastes:
1. Does the dry socket paste need to be mixed in office?
No. There are many kinds of pastes that are available pre-mixed and ready to use. Some providers prefer to mix their own as they have a specific type of ingredients aside from the standard eugenol that they like to use to promote the patient’s healing.
2. Why is a compounded dental paste sometimes used?
This is a dry socket paste that is made specifically for each patient by the dental provider. Every provider knows their patient best and so they know if maybe an extra dose of pain relief is needed or if the patient is prone to infections and needs an agent to treat that. The dry socket paste is made up to ensure the best chance at healing for that patient.
3. Does every dry socket need to be treated with dry socket paste?
No. Sometimes other treatments can be used for pain relief or to gauze dressing may be used to keep the area packed. Sometimes the socket needs to be derided of food and foreign matter and that alone relieves the pain. Every patient is different and the provider will know best how to treat pain from a dry socket.
Prevent Dry Socket Before Paste is Necessary
There are some easy ways to prevent dry socket so that this whole process is never necessary. Patients will need to be vigilant at home and a follow up call is usually a good idea to make sure they’re employing these practices.
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One of the most important things that a patient can do to prevent dry socket is to avoid tobacco products of all kinds. Along with the sucking motion that comes with using cigarettes, the nicotine and other irritants are among the most common contributors to dry socket. Advise patients to avoid use of tobacco products before and after their extraction.
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Advise patients to drink warm liquids instead of cold or hot, and never through a straw. The area will be very sensitive after extraction and any extreme temperature changes can contribute to pain and dry socket.
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Use a cool compress on the side of the face where the extraction occurred and prescribe NSAIDS to the patient for pain relief and relief from swelling. The irritation that occurs from pain and swelling can cause behaviors that lead to dry socket.
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If the patient is on oral birth control, speak to them about the possibility of not using it before and for a few weeks after surgery to help decrease the chances of dry socket occurring.
All in all, it is up to the patient to care for themselves at home so be sure to go over post-operative care instructions with them and anyone who may be helping to care for them. This will prevent dry socket from occurring as well as a host of other issues that can cause pain and further necessary treatment.
