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Causes
By Mayo Clinic staffNormally, a blood clot forms at the site of a tooth extraction. This blood clot serves as a protective layer over the underlying bone and nerve endings in the empty tooth socket. The clot also provides the foundation for the growth of new bone and for the development of soft tissue over the clot.
Dry socket occurs when the clot doesn't form properly, dissolves too soon or is physically dislodged before complete healing. With the clot gone, the extracted tooth's root space does not fill in with new tissue. The bone and nerves in the socket are then exposed to air, fluids and food. This can cause intense pain, not only in the socket but also along the nerves radiating to the side of your face.
The precise cause of dry socket remains the subject of study. Researchers suspect that several issues may be at play, including:
- Bacterial contamination of the socket
- Severe bone and tissue trauma at the surgical site due to a difficult extraction
- Very small fragments of roots or bone remaining in the wound after surgery
- Benko P. Emergency dental procedures. In: Roberts J, et al., eds. Clinical Procedures in Emergency Medicine. 5th ed. Philadelphia, Pa.: Saunders Elsevier; 2009. http://www.mdconsult.com/das/book/body/214478851-3/0/2083/0.html. Accessed Aug. 13, 2010.
- Noroozi AR, et al. Modern concepts in understanding and management of the "dry socket" syndrome: Comprehensive review of the literature. Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology & Endodontics. 2009;107:30.
- Blum IR. Contemporary views on dry socket (alveolar osteitis): A clinical appraisal of standardization, aetiopathogenesis and management: A critical review. International Journal of Oral and Maxillofacial Surgery. 2002;31:309.
- Preparing for third molar removal. NIH Clinical Center. National Institutes of Health. http://www.cc.nih.gov/ccc/patient_education/tests_procedures.html. Accessed Aug. 13, 2010.
- Cardoso CL, et al. Clinical concepts of dry socket. Journal of Oral and Maxillofacial Surgery. 2010;68:1922.
- Wisdom teeth. American Association of Oral and Maxillofacial Surgeons. http://www.aaoms.org/wisdom_teeth.php. Accessed Aug 13, 2010.
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