Dry Socket

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 become exposed, leading to pain and slower healing. 

How common is dry socket?

Dry socket occurs after 2% to 5% of tooth extractions. While dry socket can happen after the extraction of any tooth, it’s most likely to happen after wisdom teeth removal.

What are the symptoms of a 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:

• Pain at the extraction site.
• Pain that feels like it radiates to your head and neck.
• Bad breath (halitosis).
• Bad taste in your mouth.

What causes dry socket?

Most cases of dry socket occur following a particularly difficult tooth removal. But there are risk factors that increase your chances of getting a dry socket:

• Smoking. People who smoke are over three times as likely to get a dry socket as people who don’t smoke.
• Drinking through a straw. The suction force of drinking through a straw can dislodge blood clots. Be sure to avoid straws for at least one week after your tooth extraction.
• Swishing too vigorously. Your dentist may give you an antibacterial mouthwash to help keep your surgical site clean. But vigorous swishing can dislodge the blood clot. Instead, lean your head to the side and let the mouthwash soak the extraction site.
• Poor oral hygiene. Not keeping the surgical site clean enough can result in bacterial contamination.
• Taking birth control. Oral contraceptives contain estrogen, which can interfere with your body’s natural healing process.

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 by looking at the spot where your tooth used to be.

In some cases, your dentist might take dental X-rays to make sure there are no tooth fragments stuck in your jaw.

How is dry socket treated?

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 in the socket to ease pain.
• Instruct you to take over-the-counter (OTC) 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.

Does dry socket require antibiotics?

Not always. But if your dentist suspects you have an infection, they’ll likely prescribe a course of antibiotics. Infected dry sockets are rare, but they can happen.

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 can I prevent dry socket?

You can’t always prevent a dry socket. But there are things you can do to reduce your risk:

• Don’t smoke.
• Avoid warm or carbonated drinks.
• Don’t drink through a straw.
• Stick with soft foods and avoid anything hard, crunchy or chewy.
• Follow all postsurgical instructions.

How long does dry socket last?

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 help keep your mouth healthy and reduce your risk of infection.

When am I no longer at risk for dry socket?

You’re most likely to get dry socket within three days after tooth extraction. If you haven’t developed dry socket by day five, you’re probably in the clear.

When should I see my healthcare provider?

You should let your dentist know if you have:

• Pain that keeps you up at night.
• Pain that doesn’t get better with medication.
• Bad breath.
• Bad taste.

If you can’t get in touch with the provider who did the extraction, head to your nearest urgent care facility or emergency room.

What does dry socket look like?

A dry socket looks like an empty hole in your gums with a whiteish layer at the bottom. The white color you see is exposed bone.

Dry socket vs. clot

It’s important to know the difference between a dry socket and a blood clot. Blood clots are a good thing. They help promote healing.

After your extraction, you should develop a blood clot in the socket (hole) that’s left behind. It’ll look like a dark-colored scab. If you see a blood clot, leave it alone and don’t try to remove it. It’ll help protect the extraction site.

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.