What is dry socket?
Dry socket (alveolar osteitis) can occur in adults after having a tooth removed. When your dentist or oral surgeon removes a tooth, a blood clot forms in the socket (hole in the bone where the tooth was). Dry socket happens when that blood clot does not develop or dislodges (moves). Without the clot, the bone and nerves are exposed to the air.
Dry socket can be painful and make it hard for the area to heal. It happens more often in the lower teeth than those in the top of the mouth. Research shows women are slightly more likely than men to develop dry socket, likely due to estrogen.
Symptoms and Causes
What causes dry socket?
Dentists do not know what causes dry socket. Risk factors associated with it include:
- A difficult tooth extraction (removal)
- Poor oral hygiene
- Not following mouth care instructions after the tooth is removed
- Using tobacco products
- Taking oral contraceptives (birth control)
- Drinking through a straw after the tooth is removed
What are the symptoms of dry socket?
Pain in the mouth and face is the most common symptom of dry socket. It can be mild, but it is often severe. Other symptoms include:
- Foul odor
Diagnosis and Tests
How do doctors diagnose dry socket?
Dentists typically suspect dry socket when a person experiences severe pain three days after having a tooth removed. They can confirm the diagnosis simply by looking at the spot where the tooth used to be.
In rare cases, your dentist might take an X-ray (a test that provides images of the mouth bones) to make sure no tooth fragments were left behind.
Management and Treatment
What are the common treatments for dry socket?
Treatment for dry socket aims to reduce pain and promote healing. Your dentist may recommend:
- Rinsing and cleaning the socket with salt water
- Putting medicated gauze (soft dressing) in the socket to ease pain
- Over-the-counter pain and anti-inflammatory medications can be used for pain control
- Applying ice to reduce discomfort
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. Your dentist will prescribe medicines called antibiotics to destroy the infection.
Can dry socket be prevented?
People who smoke have an increased risk of developing dry socket. To reduce this risk, do not smoke for at least three days after your doctor or dentist removes the tooth.
You can take other steps to prevent dry socket after having a tooth removed, including avoiding drinking carbonated or warm beverages, drinking through a straw and following all other instructions from your dentist.
Outlook / Prognosis
What is the outlook for people with dry socket?
With proper care, including keeping the socket clean, 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 the mouth healthy and reduces the risk of infection. People who have had dry sockets in the past are more likely to get them again.
When should I call my dentist?
Call your dentist if you feel severe pain for more than four days after having a tooth pulled.