Overview

What is dry socket?

Dry socket (alveolar osteitis) can happen after tooth extraction. When your dentist or oral surgeon removes a tooth, a blood clot forms in the socket (a hole in the bone where your tooth was). Dry socket happens when that blood clot dislodges (moves) or doesn’t form at all. Without the clot, your bone and nerves are exposed to the oral environment. Dry socket can be painful and delays the healing of the surgical site.

Dry socket vs. clot: What should my extraction site look like?

After a tooth extraction, you should develop a blood clot in the socket (hole) that’s left behind. It’ll look like a dark-colored scab. But if you have a dry socket, the clot will be absent and you’ll be able to see bone. For this reason, dry sockets usually appear white.

What does dry socket feel like?

Dry socket can be extremely uncomfortable. In addition to intense pain at the extraction site, you may experience pain that radiates to your head and neck.

Who gets dry socket?

Research shows that women are slightly more likely than men to develop dry socket. This is probably due to estrogen, as the hormone may dissolve blood clots. Additionally, dry socket happens more often on the lower jaw than the upper jaw.

Symptoms and Causes

What are the warning signs of dry socket?

Worsening pain in your mouth and face two to three days after the extraction is the most common symptom of dry socket. Discomfort can be mild, but it’s often severe. Other dry socket symptoms include:

Tenderness.
Bad breath.
Foul taste.

What causes dry socket?

Experts don’t fully understand why some people are more likely to develop dry socket. Possible risk factors include:

Trauma at the surgical site due to a difficult tooth extraction.
Poor oral hygiene, which can cause bacterial contamination.
Taking oral contraceptives (birth control).

In addition, anything that dislodges the blood clot from your extraction site can increase your risk for dry socket, including:

Drinking through a straw after your tooth is removed.
Smoking.
Swishing too vigorously.

Diagnosis and Tests

How are dry sockets diagnosed?

Dentists typically suspect dry socket when a person experiences severe pain following a tooth extraction. They can confirm the diagnosis simply by looking at the spot where your tooth used to be.

In some cases, your dentist might take dental X-rays to make sure no tooth fragments were left behind.

Management and Treatment

Will a dry socket heal on its own?

Yes, in most cases a dry socket will heal on its own. However, because most people experience moderate to severe dry socket pain, seeing your dentist for prompt treatment can help ease discomfort sooner.

How do you fix a dry socket?

Easing pain and discomfort is the main goal of dry socket treatment. Your dentist may:

Rinse and clean the socket with salt water.
Place medicated gauze (soft dressing) in your socket to ease pain.
Instruct you to take over-the-counter pain relievers and anti-inflammatory medications.
Show you how to apply ice to reduce discomfort.
Provide instructions for keeping the surgical site clean at home.

What are common complications or side effects of dry socket?

Pain is the most common side effect of dry socket. This pain can be severe enough to interfere with normal activities. In rare cases, a dry socket can become infected. If this happens, your dentist will prescribe antibiotics to get rid of the infection.

What foods should I avoid?

To reduce your risk for dry socket, avoid hard, crunchy or chewy foods. These foods can dislodge the blood clot. Instead, choose soft foods like yogurt, applesauce, eggs and pasta.

How long does dry socket last?

On average, a dry socket lasts about one week. Your dentist can give you tips for managing your symptoms in the meantime.

Prevention

Can I prevent dry sockets?

People who smoke have an increased risk of developing dry socket. To reduce this risk, don’t smoke for at least three days after your tooth extraction.

You can take other steps to prevent dry socket after having a tooth removed:

Don’t drink through a straw.
Avoid warm or carbonated beverages.
Follow all postoperative instructions provided by your dentist or oral surgeon.

Outlook / Prognosis

What can I expect if I have dry socket?

With proper care, a dry socket usually heals in seven to 10 days. In that time, new tissue grows and covers the exposed socket. Regular brushing and flossing during this time helps keep your mouth healthy and reduces your risk of infection. People who’ve had dry sockets in the past are more likely to get them again.

Living With

When should I call my healthcare provider?

Call your dentist anytime you develop severe pain that doesn’t go away with medication. They can give you instructions on how to improve your comfort level.

A note from Cleveland Clinic

If you recently had a tooth removed and are experiencing severe discomfort, it could be dry socket. This condition can be extremely painful, so it’s important to see your dentist at the first sign of trouble. The good news is that a dry socket usually heals in about one week. In the meantime, ask your dentist how to manage your symptoms.

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Dry Socket