What is dry socket?
Dry socket (alveolar osteitis) is a painful dental condition that sometimes happens after you have a permanent adult tooth extracted. Dry socket is when the blood clot at the site of the tooth extraction fails to develop, or it dislodges or dissolves before the wound has healed.
Normally, a blood clot forms at the site of a tooth extraction. This blood clot serves as a protective layer over the underlying bone and nerve endings in the empty tooth socket. The clot also provides the foundation for the growth of new bone and for the development of soft tissue over the clot.
Exposure of the underlying bone and nerves results in intense pain, not only in the socket but also along the nerves radiating to the side of your face. The socket becomes inflamed and may fill with food debris, adding to the pain. If you develop dry socket, the pain usually begins one to three days after your tooth is removed.
How common is dry socket?
Dry socket is the most common complication following tooth extractions, such as the removal of third molars (wisdom teeth). Please discuss with your doctor for further information.
What are the symptoms of dry socket?
The common symptoms of dry socket are:
- Severe pain within a few days after a tooth extraction
- Partial or total loss of the blood clot at the tooth extraction site, which you may notice as an empty-looking (dry) socket
- Visible bone in the socket
- Pain that radiates from the socket to your ear, eye, temple or neck on the same side of your face as the extraction
- Bad breath or a foul odor coming from your mouth
- Unpleasant taste in your mouth
There may be some symptoms not listed above. If you have any concerns about a symptom, please consult your doctor.
When should I see my doctor?
A certain degree of pain and discomfort is normal after a tooth extraction. However, you should be able to manage normal pain with the pain reliever prescribed by your dentist or oral surgeon, and the pain should lessen with time.
If you develop new or worsening pain in the days after your tooth extraction, contact your dentist or oral surgeon immediately.
What causes dry socket?
The precise cause of dry socket remains the subject of study. Researchers suspect that certain issues may be involved, such as:
- Bacterial contamination of the socket
- Trauma at the surgical site from a difficult extraction, as with an impacted wisdom tooth
What increases my risk for dry socket?
There are many risk factors for dry socket, such as:
- Smoking and tobacco use. Chemicals in cigarettes or other forms of tobacco may prevent or slow healing and contaminate the wound site. The act of sucking on a cigarette may physically dislodge the blood clot prematurely.
- Oral contraceptives. High estrogen levels from oral contraceptives may disrupt normal healing processes and increase the risk of dry socket.
- Improper at-home care. Failure to follow home-care guidelines and poor oral hygiene may increase the risk of dry socket.
- Having dry socket in the past. If you’ve had dry socket in the past, you’re more likely to develop it after another extraction.
- Tooth or gum infection. Current or previous infections around the extracted tooth increase the risk of dry socket.
Diagnosis & treatment
The information provided is not a substitute for any medical advice. ALWAYS consult with your doctor for more information.
How is dry socket diagnosed?
Severe pain following a tooth extraction is often enough for your dentist or oral surgeon to suspect dry socket. He or she will also ask about any other symptoms and examine your mouth to see if you have a blood clot in your tooth socket and whether you have exposed bone.
You may need to have X-rays taken of your mouth and teeth to rule out other conditions, such as a bone infection (osteomyelitis) or small fragments of root or bone remaining in the wound after surgery.
How is dry socket treated?
You can take a nonsteroidal anti-inflammatory drug (NSAID), such as aspirin or ibuprofen, to ease the discomfort. Sometimes these over-the-counter medications aren’t enough to relieve the pain. When that’s the case, your doctor may prescribe a stronger drug or will anesthetize the area.
Your dentist will clean the tooth socket, removing any debris from the hole, and then fill the socket with a medicated dressing or a special paste to promote healing. You’ll probably have to come back to the dentist’s office every few days for a dressing change until the socket starts to heal and your pain lessens.
Your dentist may prescribe antibiotics to prevent the socket from becoming infected. To care for the dry socket at home, your dentist may recommend that you rinse with salt water or a special mouthwash every day.
Lifestyle changes & home remedies
What are some lifestyle changes or home remedies that can help me manage dry socket?
The following lifestyles and home remedies might help you cope with dry socket:
- Take pain medications as prescribed
- Avoid smoking or using tobacco products
- Drink plenty of clear liquids to remain hydrated and to prevent nausea that may be associated with some pain medications
- Rinse your mouth gently with warm salt water several times a day
- Brush your teeth gently around the dry socket area
- Use caution with eating or drinking, avoid carbonated beverages, and avoid smoking or using a straw to prevent dislodging the dressing
If you have any questions, please consult with your doctor to better understand the best solution for you.
Hello Health Group does not provide medical advice, diagnosis or treatment.
An Overview of Dry Socket. http://www.webmd.com/oral-health/guide/dry-socket-symptoms-and-treatment#1-4. Accessed July 5, 2017.
Dry socket. http://www.mayoclinic.org/diseases-conditions/dry-socket/home/ovc-20305925. Accessed July 5, 2017.
Review Date: July 6, 2017 | Last Modified: July 6, 2017