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Also known as alveolar osteitis, dry socket can sometimes occur after someone has had a permanent tooth extracted.
Dry socket happens when a blood clot either fails to develop, dissolves or dislodges before the wound has a chance to heal. Without a protective layer, bone and nerve are left exposed, leading to intense pain inside the socket and along the side of the face.
What Is Dry Socket?
When a tooth is extracted, a blood clot will usually develop to protect tissue and promote healing. Among other things, this blood clot creates a protective layer that shields bone and nerve endings until the wound has an opportunity to heal. Blood clots also create a foundation for the growth of new bone and the development of fresh soft tissue.
As mentioned above, dry socket happens when this blood clot either fails to develop, dissolves or dislodges before the wound has a chance to heal. Without a protective layer, bone and nerve are left exposed, leading to intense pain inside the socket and along the side of the face.
The most common complication after a tooth extraction, dry socket can occur with any tooth. That said, it is more common with the removal of third molars (wisdom teeth). When dry sockets develop, food can collect within them, causing further irritation.
What are the signs and symptoms of dry socket?
Dry socket comes with some common telltale symptoms, including:
- Severe pain occurring in the few days following the extraction
- Partial or total loss of a blood clot at the extraction site
- A throbbing pain radiating from the socket to the eye, ear, neck or temple area
- Unpleasant taste, bad breath or foul odor coming from the mouth due to the bacteria and food debris in the mouth
- Tissue around the extraction may appear to be gray in color, indicating improper healing
- The jawbone may be visible within the socket
What are the causes of dry socket?
While they don’t know the exact cause of dry socket, experts believe it usually stems from bacterial infections or surgical trauma related to difficult extractions. There are, however, certain known factors that can increase a person’s risk of dry socket, including:
- Tobacco Use: Chemicals within tobacco may slow or prevent healing, while also contaminating the wound.
- Smoking and drinking through straws: The act of sucking can dislodge a blood clot.
- Oral contraceptives: High estrogen levels can increase the risk of dry socket by disrupting normal healing processes.
- A history of dry sockets: If you’ve had a dry socket in the past, you are more likely to have one again.
- Gum or tooth infections: Previous or current infections around an extracted tooth could increase the risk of dry socket.
How do I prevent dry socket?
The best way to prevent dry socket is by following your dentist’s instructions after an extraction. You should also practice good oral hygiene and avoid drinking from a straw. If you smoke or use tobacco products, try to stop until your wound has healed. If you feel you will have trouble with this, at least try to suck lightly on cigarettes to reduce your risk.
Since dry socket can leave your mouth vulnerable to dangerous bacteria, it’s important to contact your dentist the moment you notice a problem. Any delay can complicate treatment and increase the risk of serious infections.
How is dry socket treated?
Dry socket remedies focus on pain relief and promoting healing. Treatment may include:
- Flushing the empty socket to eliminate food or debris, which could lead to infection
- Packing the socket with medicated paste or gel to relieve pain and promote healing
- Prescribing pain medications to alleviate severe pain and help with sleep
Once treatment has started, patients tend to feel quick pain relief. That said, it’s important to practice self-care to promote healing and prevent debris from accumulating. Usually, dentists provide plastic syringes with curved tips, which patients can use to clean their dry sockets using a prescription rinse or salt water. This should continue until the socket heals.
Once dry socket sets in, it typically takes between 7 and 10 days for the healing process to create new granulation tissue to cover and protect the socket’s exposed bone. Since dry socket healing time can vary, it’s important to keep any scheduled follow-up dental appointments, even if things appear to be getting better.
