Dry Socket: Post-Wisdom Tooth Extraction Pain Explained

Q: Dry Socket: Post-Wisdom Tooth Extraction Pain Explained

Hello： 1. <br>If you still have "fever" and unbearable swelling after more than 48 hours, it is recommended to "return for a follow-up appointment as soon as possible" to confirm whether there is an issue with wound infection. <br>2. <br>Extraction of wisdom teeth will involve su

Is it dry syndrome?

Hello, doctor.
I had my impacted wisdom tooth surgery on September 27th, which was close to the nerve, and the extraction was done in several parts.
Today, September 29th, is the third day post-surgery, and the pain in the extraction site feels worse than the first couple of days.
It’s a very tingling pain, similar to nerve pain, and I also have a slight headache on the side where the tooth was removed.
The pain relief medication is effective, but I can't sleep without it.

1.
I just noticed that there don’t seem to be any stitches in the extraction site.
Is that normal?
2.
There are some white substances, and I'm not sure if it's debris from the tooth.
Could you please take a look at the picture? https://ibb.co/34FjbTN Thank you!

Youjia, 20~29 year old female. Ask Date: 2021/09/29

Dr. Lin Jiayong reply Dentistry

Hello: 1.
If you still have "fever" and unbearable swelling after more than 48 hours, it is recommended to "return for a follow-up appointment as soon as possible" to confirm whether there is an issue with wound infection.
2.
Extraction of wisdom teeth will involve suturing the wound.
Stitches will be removed one week later.
3.
The image is very unclear, and a diagnosis of dry socket cannot be made based solely on one image.
Sincerely, Lin Chia-Yung, Department of Dentistry, Taichung Hospital, Ministry of Health and Welfare.

Reply Date: 2021/09/29

More Info

After wisdom tooth extraction, experiencing pain is not uncommon, especially if the procedure was complex, such as when the tooth is impacted or close to nerves. The pain you are describing, particularly if it feels like a sharp, nerve-like pain, could be indicative of a condition known as dry socket (alveolar osteitis). This occurs when the blood clot that forms in the socket after the tooth is removed either dissolves or becomes dislodged, exposing the underlying bone and nerves, leading to significant pain.

1. Absence of Stitches: Regarding your concern about not seeing stitches, it is important to note that not all wisdom tooth extractions require sutures. If the extraction site is clean and the dentist believes it will heal properly without stitches, they may opt not to use them. However, if the extraction was more complicated, stitches might be necessary to aid in healing. If you are unsure, it is best to consult your dentist for clarification.

2. White Material in the Socket: The white material you are observing in the extraction site could be a few things. It might be a normal part of the healing process, such as granulation tissue, or it could be a sign of infection or necrotic tissue. It is crucial to avoid self-diagnosing and to seek professional evaluation. Your dentist can provide a definitive diagnosis and appropriate treatment.

Managing Pain and Discomfort
Here are some strategies to help manage your pain and discomfort post-extraction:
- Pain Management: Continue taking the prescribed pain medications as directed. Over-the-counter pain relievers like ibuprofen or acetaminophen can also be effective. Make sure to follow the dosage instructions carefully.

- Cold Compress: Applying a cold compress to the outside of your cheek can help reduce swelling and numb the area, providing some relief from pain.

- Avoiding Certain Activities: Refrain from sucking through straws, smoking, or spitting, as these actions can dislodge the blood clot and exacerbate the pain.

- Dietary Adjustments: Stick to soft foods and avoid anything too hot, spicy, or crunchy that could irritate the extraction site. Foods like yogurt, smoothies, and mashed potatoes are good options.

- Oral Hygiene: Maintain good oral hygiene, but be gentle around the extraction site. Rinse your mouth with warm salt water after 24 hours to help keep the area clean and promote healing.

When to Seek Help
If your pain worsens or if you notice any signs of infection, such as increased swelling, pus, or fever, it is essential to contact your dentist immediately. They may need to clean the socket, provide additional treatment, or prescribe antibiotics if an infection is present.

In conclusion, while some discomfort is expected after wisdom tooth extraction, severe pain, especially if it feels nerve-related, should be evaluated by your dentist. They can assess your healing progress, determine if dry socket is present, and recommend the best course of action to alleviate your pain and promote healing.

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