Dry Socket

What is dry socket?

This is a condition more properly known as alveolar osteitis. It is a temporary dental condition that occurs after tooth extraction. This occurs when the blood clot is lost from an extraction site, prematurely exposing underlying bone and nerves and causing increasing pain. About 2% to 5% of people having a tooth extraction may develop dry socket afterward. In fact, this is the most common complication following tooth extractions.

Why is the blood clot important?

The blood clot has several roles following a tooth extraction. First, it helps to stop the bleeding by acting as a plug over the wound. Second, it protects the underlying structures during the healing process. If the blood clot is lost, the underlying bone is exposed along with the sensitive nerve endings. This will cause the pain and discomfort associated with dry socket.

How do I know I have dry socket?

The hallmark of dry socket is severe pain noted within 2 to 5 days after a tooth extraction. However, associated symptoms include:

Absent blood clot at the tooth extraction site
Visible bone in the socket
Bad breath
Swollen lymph nodes

What causes dry socket?

These activities may increase risk for dry socket:

Smoking
Drinking carbonated beverages in first 24 hours after surgery
Spitting
Sneezing
Coughing
Sucking
Drinking through a straw in first 24 hours after surgery
Poor oral hygiene
Women using birth control pills
Not following post-extraction guidelines

When do I see my dentist?

After a tooth extraction, pain or discomfort normally gradually lessens over time. However, if pain worsens within 2 to 5 days after the extraction, contact your dentist right away.

What treatment options do I have?

The goal in treating dry socket is to alleviate the symptoms, primarily the pain and discomfort that the patient might feel. Therefore, pain medications are an integral part of its management. Over-the-counter drugs may be used; however, if these have little effect on the pain, your dentist may give you stronger medication.

If you see your dentist, his/her first priority will be to put a medicated dressing over the empty socket. The dressing will help ease the discomfort both by physically blocking the wound and by the action of the medication on local nerve endings. He/She may need to flush the socket for any food or other debris trapped there. In addition, you should ask your dentist how to perform self-care.

Complete healing may take up to two weeks.

How can I prevent dry socket?

Here are a few simple steps that will reduce the symptoms of dry socket:

Apply cold packs to the face over the extraction site to help decrease pain and swelling
Take pain medications
Avoid smoking
Avoid sucking actions (drinking through straw)
Avoid carbonated drinks
Rinse gently with warm saltwater
Brush teeth gently around the affected area
Avoid touching or rubbing affected area
Eat soft foods