What is Dry Socket: Causes, Symptoms, & Treatment

After the extraction of a tooth, a blood clot should form in the extraction site to protect the bone. However, in a dry socket, also known as alveolar osteitis, that blood clot can dislodge prematurely or not form properly which leaves the bone exposed to the oral environment. This is a slower healing process. Typically, dry socket happens about the 4^th or 5^th day after surgery and can be extremely painful.

Luckily, only a small percentage of patients, about 2%-5%, develop dry socket after tooth extraction.

Risk Factors for Dry Socket

• Smoking or using Tobacco products including Vape with Nicotine
• Poor oral hygiene
• Patients taking birth control pills
• Diabetes that is not well controlled
• Straw usage for the first 4-5 days after surgery
• Forceful rinsing and spitting
• Not following after-care instructions
• Having Dry socket in the past
• Traumatic extractions, especially wisdom teeth in the lower jaw
• Previous infection such as periodontal disease or pericoronitis
• Patients older than 30 years of age

Symptoms of Dry Socket

• Severe throbbing pain that radiates through the jaw and to the ear 3-5 days after surgery on the same side of the surgery
• Foul odors and taste
• Exposure of bone in the extraction site; visible bone in the socket

Treatment for Dry Socket

• Pain medications such as Ibuprofen or prescription pain meds
• Placement of a dressing with medicament (done in the office)
• Flush out the socket to remove irritating debris

Prevention of Dry Socket

• Abstain from smoking, chewing tobacco, vaping after surgery
• Rinse GENTLY with warm salt water or prescription mouthwash
• Avoid sharp, hard foods as well as spicy foods
• Avoid carbonated beverages
• Good oral hygiene but avoid brushing the teeth in the immediate area of surgery for the first day after surgery

The good news is that a dry socket will heal over time. The average healing time is 7-10 days. This is the timeframe for new tissue to grow and heal over the exposed bone in the socket.

Written by Sarah Bong-Thakur, DDS, Oral and Maxillofacial Surgeon

References:

• https://www.webmd.com/oral-health/guide/dry-socket-symptoms-and-treatment
• https://www.medicinenet.com/dry_socket_overview/article.htm