Dentists and oral surgeons remove millions of teeth every year, most without any adverse aftereffects. But about 2% of patients experience a dry socket, a condition that, although not dangerous to health, can be quite painful.

Also known as alveolar osteitis, a dry socket occurs when the blood clot that normally forms right after extraction doesn't form or becomes lost later. The clot serves as a barrier for the underlying bone and nerves during the healing process; without it these tissues can become irritated from contact with air, food or fluids.

Dry sockets (which usually occur in the back, lower molars) are fortunately rare, mainly in patients over 25, smokers or women using oral contraceptives. Patients also have a higher risk of developing a dry socket if they attempt certain activities too soon after tooth extraction like vigorous chewing or brushing that may dislodge the protective clot.

You can reduce your chances of a dry socket after a tooth extraction with a few simple guidelines. Unless advised otherwise by your dentist, avoid brushing the day after extraction and gently rinse the mouth instead. It also helps to avoid hot liquids and eat softer foods for a few days. If you smoke, you should avoid smoking during this time and use a nicotine patch if necessary.

Over the next few days, you should remain alert for any signs of a dry socket, often a dull, throbbing pain that radiates outward toward the ears, and a bad taste or mouth odor. A prompt visit to the dentist will help alleviate these symptoms, often in just a few minutes.

To treat it, a dentist will typically irrigate the socket and apply a medicated dressing, which you would need to change every other day for up to a week. After that, you'll leave the dressing in place for a while as you heal.

A dry socket doesn't interfere with the healing process: Your extraction site will heal whether or not you have one. But prevention and treatment for a dry socket will help ensure your healing after an extracted tooth is much less uncomfortable.

If you would like more information on dry socket after tooth extraction, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Dry Socket.”

There are important reasons not to smoke, like minimizing your risk for deadly diseases like heart disease or lung cancer. But here's another good reason: Smoking increases your risk of gum disease and possible tooth loss. And although not necessarily life-threatening, losing your teeth can have a negative effect on your overall health.

According to the U.S. Centers for Disease Control, individuals who smoke cigarettes, cigars, pipes or e-cigarettes are twice as likely as non-smokers to develop gum disease, and four times as likely the infection will become advanced. Your risk may also increase if you're regularly exposed to second-hand smoke.

There are a number of reasons for this increased risk. For one, smokers are less likely than non-smokers to recognize they have gum disease, at least initially, because they may not display classic symptoms of an infection like red, swollen or bleeding gums. This happens because the nicotine in tobacco smoke interferes with normal blood circulation. As a result, their gums may appear healthy when they're not.

That same circulation interference can also inhibit the production and supply of antibodies to fight infection. Not only can this intensify the infection, it can also slow healing and complicate treatment. In fact, smokers are more likely to have repeated episodes of infection, a condition called refractory periodontitis.

But there is good news—smoking's effect on your gum health doesn't have to be permanent. As soon as you stop, your body will begin to repair the damage; the longer you abstain from the habit, the more your gum health will improve. For example, one national study found that former smokers who had not smoked for at least eleven years were able to achieve an equal risk of gum disease with someone who had never smoked.

Quitting smoking isn't easy, but it can be done. If abrupt cessation (“cold turkey”) is too much for you, there are medically-supported cessation programs using drugs or other techniques that can help you kick the habit. And while it may be a long road, leaving smoking behind is an important step toward improving and maintaining good dental health.

If you would like more information on protecting your gum health, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Smoking and Gum Disease.”

As far as your appearance goes, the most important teeth you have are those in the “smile zone.” These are the teeth most visible when you smile—and the ones that awkwardly stand out if they're chipped, worn or otherwise flawed. More than any other teeth, they determine how inviting your smile is to others.

You might think you'll need extensive cosmetic dental work to fix these kinds of dental defects. But that may not be necessary: We may be able to use a dental material known as composite resin to repair the defects in your “smile zone” teeth in one office visit.

Composite resins are a combination of ceramics and plastics that have been around for some time. They've only recently come into wide use, though, with the development of new techniques to bond them to tooth surfaces. They're ideal for chips, cracks, or decayed areas where front teeth make contact with one another. They may also be used occasionally to reshape irregular or misaligned teeth.

You'll first need a complete dental examination to determine if composite resin bonding is an appropriate approach for your situation. If so, we'll begin by preparing the tooth surface to better accept the resin material. We'll then apply the liquid form of the material in layers, along with other agents to increase the material's strength. Each layer is cured (hardened) before applying the next layer.

As the layers build up, we shape the material to achieve a normal tooth appearance. We'll also incorporate your individual color shadings, so that the prepared tooth blends well with surrounding natural teeth. In effect, the procedure requires as much artistry as technical skill to create a natural look.

Though not as strong as porcelain veneers or crowns, composite resins are durable if not subjected to heavy biting forces. And for a few hours in the dentist's chair with minimal tooth preparation, a composite resin treatment can create a dramatic and exciting change in your appearance.

If you would like more information on composite resin bonding, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Artistic Repair of Front Teeth With Composite Resin.”