Dislodged blood clot

[Blue Mermaid]

Hi, I had a tooth extracted on Wednesday. The dentist could not save it, as it was severely infected, with a large abscess at the root (I have advanced gum disease). During the night, I felt something on my tongue. On a tissue, it looked like a lump of red jelly. I suspected it was the blood clot and looked online to confirm, where I read about dry sockets. I took a picture of the blood clot on the tissue and sent it to the dentist for advice. The next day, he confirmed it was the blood clot but just said, it was normal and not to touch it. I didn't feel reassured, having read that the socket would now be unprotected. So, I asked my dentist for further advice, explaining that I was still concerned after reading about dry sockets. He didn't like me questioning further and sent a very curt and what I consider a rude reply, repeating that it was normal and to stop contacting him with questions, with immediate effect. He said I was not in pain (which wasn't true, I had been in severe pain that night following the extraction but painkillers had helped and I appreciate that this was just post extraction pain) and he suggested I refrain from searching on the internet for issues that I do not have, or will not have. He himself, confirmed the picture I had sent him was the blood clot, so I don't know why he was saying I do not have the issue. I appreciate that not everything you read on the internet is true but I was looking at official sites (such as NHS sites) and when they are all stating the same things, then I believe them to be correct. So, I am left without any further advice from the dentist himself. Could a professional here be kind enough to explain to me, whether I should be concerned that my socket is now left without the protection of a blood clot? Do I now have a dry socket? Should it be cleaned and covered by a gauze or whatever a dentist uses to protect the open socket? Or, is this only if I start to experience new or worse pain? If my dentist had given me a full explanation, as to why he was saying this was normal, then I wouldn't have to look on the internet for advice!

 

[Dr M]

Good day

If you disturb the socket, even unknowingly in your sleep, the blood clot can be dislodged yes. The blood clot is part of the normal healing process. This being said, this doesn't mean that the socket will turn into a dry socket.
A dry socket usually appears after about 3 to 4 days, and is accompanied by a severe pain, sometimes difficulty in opening, and a bad smell.
My advice would be to leave the socket alone. Don't brush over the socket to clean it. And then follow the post-op instructions which should have been given to you by your dentist. Keep the area clean, by rinsing with some luke-warm saltwater ( very gently ) about 3 times a day. Keep to a soft diet for the first few days and chew mostly on the opposite side as much as possible.
The socket will gradually be filled with granulation tissue as healing progresses and then close normally.

 

[MattKW]

Loss of a blood clot per se does not cause a dry socket. Rather, the release of chemicals during an extraction can cause early breakdown of the clot by fibrinolysis. Dry sockets occur most often in lower extractions, in difficult or surgical extraction, and in patients who smoke. If it’s going to happen, then it’s already too late to prevent it. The only technique that has been shown to make a small reduction in the risk of developing a d.s. is to start rinsing pre- and post-opratively with a chlorhex mouthwash,

 

[Blue Mermaid]

Thanks so much to both of you for your replies and for reassuring me.
It is good to learn that losing the blood clot does not automatically mean you have a dry socket. Now, I won't worry in the future, if the same thing happens again.
All I have left now is some soreness, so I am still eating on the other side and not brushing over the socket. I stopped the salt water rinse after 7 days, as per the instruction leaflet from dentist but I am being meticulous with keeping whole mouth as clean as possible.
Many thanks again for your kind help and advice.