Ask the Dentist: Don't underestimate the power of blood
Dentist Lucy Stock of Gentle Dental Care in Belfast highlights the role of blood in the healing process
BLOOD gets a bad rep. Are you squeamish about the idea of blood or faint at the sight of it? If so I would encourage you to give blood a second chance. Blood heals – it contains all the nutrients that allow our bodies to recover from a trauma.
It’s especially important after having a tooth out. If blood doesn't clot in the socket, you can experience pain, sometimes excruciating, for up to two weeks afterwards. This is known as a ‘dry socket’ or, to give its posh term, alveolar osteitis. So it's actually good to see a small bit of blood after having a tooth out.
About 2 per cent to 5 per cent of people develop a dry socket after a tooth extraction. The pain is often accompanied by bad breath and a foul taste. It happens because the normal healing process has gone awry.
Dry sockets are due to a combination of factors which include disruption of the blood-clotting process and the release of substances known as kinins. Kinins are proteins found in blood and are released in abundance especially when a tooth proved to be more difficult to remove. They cause inflammation, stimulate pain receptors and can vaporise blood clots.
After the tooth has been removed the blood clot can be accidentally dislodged or dissolved. This leaves the bone exposed to air, resulting in the severe pain. Unfortunately you’re more likely to get a dry socket if you smoke as this reduces the blood vessels in the bone.
Preventing a dry socket isn't easy. The general idea of covering the bone is helpful. One way to achieve this is to use plasma rich growth factor (PRGF) gels, formed after blood has been spun in a centrifuge, which are placed into the socket. This reduces pain in many but not all cases.
Avoid over rinsing the day of the extraction so as not to wash the clot away. If painkillers aren't enough, your dentist can place a soothing dressing to promote healing. Very rarely pus comes out of the socket and it needs anaesthetised and cleaned out again. Ultimately the old adage “time heals all wounds” is true in this case.
Dry sockets can really impact on a person emotionally. So if you’re going to have the tooth replaced by an implant rest assured that the process of tooth removal and its after effects are normally much worse than having an implant placed.