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4.16 Dental Pain Post Extraction (Dry Socket)


Presentation

The patient develops severe dull throbbing pain two to four days following a tooth extraction. The pain is often excruciating, may radiate to the ear, and is not relieved by oral analgesics. There may be an associated foul odor and taste. The extraction site is filled with necrotic tissue which is delaying wound healing.

What to do:

What not to do:

Discussion

Dry socket results from a pathologic process combining loss of the healing blood clot with a localized inflammation (alveolar osteitis). It is most common with extraction of the mandibular molars. This condition may be encouraged by smoking, spitting or drinking through a straw, which create negative pressure in the oral cavity. Intractible pain usually responds to nerve block with long acting local anesthetics.

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from Buttaravoli & Stair: COMMON SIMPLE EMERGENCIES
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Craig Feied, MD
Mark Smith, MD
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