Oral Surgery/Dry socket


Dr. Ryan,
 I recently had all 4 wisdom teeth removed (11/28). Everything was going smoothly until about 3 days later (12/01). I developed intense pain in/around the bottom right extraction site which eventually lead to a deep inner earache. I self diagnosed myself with a dry socket. I went back to the doctor about 8 days later (12/06) because I could no longer handle being in constant pain. The doctor packed it although he did not mention anything about a dry socket. Just walked in, asked which side, (roughfully) packed it, told me not to rise that side and walked out. I do not go back until (12/12) to have it, I assume repacked. My question is, how often should the packing be replaced? Is almost a week with the same packing alright?  Thank you for your time.

Rachel, Thank you for your question. The packing for a dry socket should changed regularly and irrigated out. Additionally, the packing should not be left in for more than a few days. If the packing is left in for too long, it will delay healing. The behavior that you describe regarding the surgeon just infuriates me. I do not believe that leaving packing in for 6 days is the standard of care. Additionally, you should ask for a nerve block to make the area numb so that you can at least get through the day not being in pain. At this point, I would recommend that they remove the packing and prescribe you some peridex oral solution to rinse with by using a syringe to possibly get any food debris out of the socket. I hope they at least irrigated the socket before they packed it. I hope that helps.

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James M. Ryan. DDS, MS; Board Certified Oral and Maxillofacial Surgeon


Dr. Ryan's expertise is in the field of Oral and Maxillofacial Surgery. Specifically, Dr. Ryan is an expert in Orthognathic Surgery. He holds uniques experience as the former Assistant Program Director of the Oral and Maxillofacial Surgery Residency Training Program at Washington Hospital Center where he trained residents to perform these complicated surgical procedures. Additionally, Dr. Ryan also has a tremendous amount of experience in reconstruction of the maxillofacial skeleton related to trauma and tooth loss. Dr. Ryan is an expert in 3 dimensional treatment planning for Orthognathic Surgery, Dental Implant Surgery and Wisdom Teeth removal. To learn more about Dr. Ryan, his full profile can be seen at www.eosdds.com


Diplomate of the American Board of Oral and Maxillofacial Surgery with current hospital affiliations at: Washington Hospital Center Holy Cross Germantown Hospital National Institute of Health/NIDCR

American Dental Association. American Association of Oral and Maxillofacial Surgeons. District of Columbia Society of Oral and Maxillofacial Surgeons. District of Columbia Dental Society. American Board of Oral and Maxillofacial Surgeons. Health Volunteers Overseas.

Journal of Oral and Maxillofacial Surgery Journal of The American Dental Association

S.U.N.Y @ Stony Brook- B.S. in Biochemistry, Stony Brook, NY. Northeastern University- M.S. in Perfusion Technology, Boston, MA. D.D.S.- New York University College of Dentistry, New York, NY. Certificate and Chief Resident- Washington Hospital Center, Washington, DC. Clinical Fellow- The Johns Hopkins Hospital, Baltimore, MD.

Awards and Honors
Dr. Ryan has received numerous awards including: 2006 American Association of Oral and Maxillofacial Surgeons Dental Student Award, Washington Hospital Center 2008 Nurses' Choice Physician Collaboration Award, 2009 Resident Research Summit Scholarship Award, and the 2011 Outstanding Surgical Attending in the Department of Oral & Maxillofacial Surgery at Washington Hospital Center. He has also authored/coauthored and published several journal articles and held several teaching positions,including assistant professor, while at NYUCD.

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