What Are Dry Socket Causes?
Dry socket is a painful complication that occurs when something interferes with the normal clotting process after tooth extraction. Sometimes, the clot fails to form properly. In other cases, the clot is dislodged or disintegrated after formation. In either case, the empty socket in the jaw bone is left unprotected. The exposed nerves are extremely sensitive and cause significant discomfort and inflammation from contact with air, food, or liquids. The area is also prone to infection from oral bacteria which can cause additional soreness and more serious complications.
How Often Does Dry Socket Occur?
Estimates for dry socket complications range from .5 to 5 percent of extractions. However, this statistic can be deceiving. Dry socket is actually very unlikely with a simple extraction of a fully erupted tooth. For example, if you have a front tooth pulled, complications rarely occur. Problems with blood clot formation or retention are much more common after a complex extraction such as a molar. If you have a wisdom tooth that is partly or completely covered by jaw bone, you are at the highest risk for dry socket because the procedure involves very invasive surgical extraction. The more trauma the surgery causes to the gums and jaw bone, the more likely it is that you will experience problems with clotting. So, your actual risk is determined by the type of tooth extraction you have done.
What Other Factors Contribute to Dry Socket Causes?
Besides the extent of surgery needed for extraction, there are a number of other risk factors that increase your chances of developing dry socket. Be sure to speak with your dentist or oral surgeon about ways to minimize these risks:
- Tobacco Use: Smoking and smokeless tobacco use introduce several complicating factors. First, smoking decreases normal blood oxygenation which interferes with healing. Second, the motion of chewing tobacco or sucking on a cigarette can dislodge the clot. Tobacco can also contribute to contamination of the socket with foreign matter and toxic substances.
- Birth Control: Use of birth control medication has been found to increase both post-operative pain and the risk of dry socket in some (but not all) clinical studies. Estrogen hormone levels may impact blood flow, blood clotting and tissue sensitivity. This doesn’t mean you must stop taking birth control prior to extraction surgery. But you may wish to schedule your procedure for the week in your cycle when you are taking the placebo pills.
- Age at Time of Tooth Extraction: Wisdom teeth are much more difficult to extract in older patients. If you wait past your mid-twenties to have impacted third molars removed, your jaw bone is very dense. This means getting the teeth out of the jaw requires more force. That’s one reason to have problematic wisdom teeth taken as soon as possible.
- Dentist’s Skill: Unnecessary trauma to the extraction site or leaving a chip of tooth in the wound can increase the chances of complications during clotting and healing. Choose your dentist with care if you have an impacted wisdom tooth. An oral and maxillofacial surgeon has more experience and training in complex surgical extractions than a general dentist and may be your best bet for reducing the risk of dry socket.
- Pre-existing Infection: A tooth abscess or gum infection in the extraction area may be contributing dry socket causes. Any pre-existing infection or inflammation should be addressed before your surgery if possible.
What Activities Can Dislodge a Blood Clot?
Post-procedure behavior is a key risk factor in whether you develop dry socket. Here are some of the activities that could disrupt your blood clot after a tooth extraction:
- Vigorous rinsing and spitting
- Coughing, sneezing or any sudden forceful movements including strenuous exercise
- Drinking through a straw or other activities that create suction near the extraction site
- Touching or probing the socket with your tongue or finger
- Drinking alcohol or soda in the first day or two after surgery
- Taking aspirin or other medications that interfere with normal clotting
- Eating crumbly, hot, spicy or sticky foods before the site has healed
- Chewing on the side of your mouth where the tooth was extracted
It’s well worth your time and effort to baby the extraction site after your procedure. Follow your post-extraction instructions to the letter for best results!