A dry socket occurs when the blood clot inside a tooth socket is lost after a tooth extraction, exposing the bone. This can cause severe pain as the exposed bone is sensitive. Dry sockets are most common after wisdom tooth extractions, affecting 1-3% of all extractions but 25-30% of lower wisdom tooth extractions. Signs include pain 3-4 days after extraction and bad taste or odor. Treatment involves gently rinsing the socket and placing a pain-relieving dressing like alvogyl paste directly inside to soothe the bone and promote healing.

2. What is a dry socket?
A dry socket is a fairly common complication of
tooth extraction characterized by severe pain. It
occurs when the tooth socket loses the blood
clot that forms after a tooth is extracted and
the bone inside the socket becomes exposed. It
is one of the most painful dental problems one
can experience. A dry socket is also referred to
as alveolar osteitis.

3. What causes a dry socket?
The blood clot that forms after tooth extraction is
essential for optimal healing of the underlying tissue.
Destruction or loss of the blood clot prevents normal
healing and causes alveolar osteitis. There are a
variety of reasons why the initial blood clot could be
lost or destroyed prematurely. The body reacts to
local infection and inflammation, trauma, bacteria,
and estrogen to destroy the blood clot, leaving an
exposed socket. So it is important to minimize these
risk factors as much as possible.

4. the socket has a dry appearance because
of exposed bone. The blood clot helps in
stopping the bleeding and lays framework
for new tissues to develop there but in
case of dry socket, the clot is dislodged
and the bone is exposed. This bare bone is
exposed to bacteria in the saliva and the
food which the patient consumes and the
bone becomes infected and painful.

5. How common is a dry socket?
A dry socket will occur in only 1% to 3% of all
tooth extractions, but it becomes much more
common in the extraction of lower
(mandibular) wisdom teeth. In lower impacted
(covered) wisdom teeth, as many as 25% to
30% of cases result in a dry socket.

6. What are signs and symptoms of
dry socket?
A patient may first notice signs of a dry socket 3 to 4
days after extraction of the tooth by feeling moderate-to-
severe pain that could last anywhere from 10 to 40
days. The exposed bone of a dry socket is very sensitive
and leads to an intense dull aching pain that throbs and
radiates around the affected side of the jaw often to
the patient's ear. Frequently, the patient affected by a
dry socket will also complain of a bad odor or bad taste
in their mouth.

7. Alveolar osteitis. Note exposed bone as
marked by the arrow

9. Treatment
The pain from alveolar osteitis usually lasts for
24–72 hours. There is no real treatment for
alveolar osteitis; it is a self-limiting condition that
will improve and disappear with time, but
certain interventions can significantly decrease
pain during an episode of alveolar osteitis.

10. These interventions usually consist of a gentle rinsing of
the inflamed socket followed by the direct placement
within the socket of some type of sedative dressing, which
soothes the inflamed bone for a period of time and
promotes tissue growth. This is usually done without
anesthesia. The active ingredients in these sedative
dressings usually include substances like, zinc oxide,
eugenol, and oil of cloves.

11. It is usually necessary to have this done for
two or three consecutive days, although
occasionally it can take longer. Because true
alveolar osteitis pain is so intense, additional
analgesics are sometimes prescribed.

12. ALVOGYL PASTE

13. Alvogyl is a dry-socket treatment and post-extraction
dressing which every dental office should have on hand .
Alvogyl is a one-step, self-eliminating treatment which
rapidly
alleviates pain and provides a soothing effect throughout
the healing process.
Its fibrous consistency allows for easy filling of the socket
and good adherence during the entire healing process.
The active ingredients of Alvogyl include eugenol for
analgesic action, butamben for anaesthetic action, and
iodoform for anti-microbial action.

14. PROPERTIES
•Antiseptic and analgenic paste.
•Butamben – provides moderate anaesthetic
action .
•Iodoform – effective antimicrobial action
•Eugenol – effective analgesic action.
•Alvogyl easily adheres to the alveolus and
assisted by the patients tongue movements, it
gradually self eliminates.

15. CONTRA-INDICATIONS
• Alvogyl is not to be used on patients having a history of allergic
reactions to procaine type
anaesthetics or to iodine compounds.
• Do not suture in place.
DIRECTIONS FOR USE
Using a pair of tweezers apply 0.2g of Alvogyl to adequately
cover the bottom of the socket
and pack gently into place.

16. PRECAUTIONS
Contents should be used within 2 years.
STORAGE
To be kept in a cool dry place.
PRESENTATION
12g Paste in a Jar .