The excruciating pain that starts 2-3 days after tooth extraction, radiating to the ear and temple, and completely unresponsive to painkillers, is caused by a complication called “alveolitis” (dry socket). Its pathophysiology is entirely related to the disruption, dissolution, or detachment of the blood clot (protective barrier) that should form in the extraction socket (due to the patient constantly spitting after extraction, creating negative pressure inside by smoking, or infection of the area). When the clot is gone, the jawbone and the sensitive nerve endings there are left completely exposed and unprotected in the oral cavity. In its treatment, the socket should never be scraped vigorously; the area should be gently rinsed with saline solution to remove food particles, and special medical pastes/gauze containing clove oil (eugenol) and painkillers should be placed inside the socket to soothe the nerve endings, allowing the tissue to slowly close from below.
