Dry socket is the name for a condition in which inflammation occurs in the jawbone (alveolar bone). Also known as alveolar osteitis, this uncomfortable complication is most commonly related to dental surgery for extractions of lower teeth. It can also occur when bone grafts are placed into tooth sockets after extractions.

At CCOMFS, patient safety and comfort is at the heart of everything we do. Due to our optimized best practices and expertise, our patients do not suffer from dry socket. Here’s why:

Off-label Use of ARESTIN®

Through our research of the dental literature, we have determined that preemptively using ARESTIN® in the operative site eliminates the chance for dry sockets.(Bland et al., 2010; Dean et al., 2003; Kolokythas, Olech, & Miloro, 2010)ARESTIN® contains microspheres filled with minocycline hydrochloride, an antibiotic which is slowly released thus preventing the development of a dry socket.

ARESTIN® is placed in a tooth extraction site prevent the low grade infection that is the cause of dry sockets in the lower jaw. If you are unfamiliar with the use of ARESTIN® for avoiding dry socket, it may be because it is used primarily for the treatment of periodontal disease. Since the  use of this antibiotic is off label it is  not covered under many managed care contracts. We explain all options and methods to your patients so they can make the most informed decisions about their care.

Preventative Instructions Are Part of Our Best Practices

At CCOMFS, we prepare your patients with the tools and clear instructions they need to avoid any complications, like dry socket. We explain that preventative measures—such as practicing good oral hygiene and avoiding smoking—will lead to an easier and faster recovery. Furthermore, we teach patients how to do a mouth rinse with salt water several times a day after eating to remove excess bacteria.

To dentists, these steps may sound like common sense, but patients do not deal with these things day-in and day-out. They need to be instructed against touching the wound and to avoid eating anything that can leave food particles in their mouth (e.g., popcorn or peanuts) for four days after the procedure. Instead, they should stick with softer and safer foods like soup or mashed potatoes.

Constant Care

One of the pillars on which we have built our practice is accessibility. We know that when your patients are uncomfortable with post-operative pain, their fears and concerns can exacerbate that discomfort quickly. Our mission is to address concerns before they turn into greater fears or larger problems. We explain to patients the most common warning signs for dry socket include:

  • Partial or total loss of a blood clot in the extraction site
  • Noticeably different taste or bad breath
  • Dull pain throughout the jawbone after the third day that radiates through other parts of the head and face

Often patients are referred to us that have dry sockets from extractions done at other practitioners offices.  If a patient does experience dry socket after their procedure, we can irrigate the socket, put analgesic medication within the socket to cover any exposed bone, and watch the socket carefully until we are certain it’s no longer an issue. As always, Dr. Emery is available 24/7 to help patients understand their symptoms and craft plans as needed.

Avoiding dry socket can be easy when armed with the right tools and information. Take a look at Your Smart Guide to Wisdom Teeth.




Bland, P. S., Goodson, J. M., Gunsolley, J. C., Grossi, S. G., Otomo-Corgel, J., Doherty, F., & Comiskey, J. L. (2010). Association of antimicrobial and clinical efficacy: periodontitis therapy with minocycline microspheres. J Int Acad Periodontol, 12(1), 11–19. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/20593634

Dean, J. W., Branch-Mays, G. L., Hart, T. C., Reinhardt, R. A., Shapiro, B., Santucci, E. A., & Lessem, J. (2003). Topically applied minocycline microspheres: why it works. Compendium of Continuing Education in Dentistry, 24(4), 247–50, 252–7; quiz 258. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/12769027

Kolokythas, A., Olech, E., & Miloro, M. (2010). Alveolar Osteitis: A Comprehensive Review of Concepts and Controversies. International Journal of Dentistry, 2010, 1–10. http://doi.org/10.1155/2010/249073