Dry Socket: Causes, Symptoms & Treatment

Getting a tooth pulled is generally a routine, uncomplicated procedure. However, a painful condition called dry socket can sometimes develop during the healing process. Read on for an overview of this tooth extraction complication, including why it happens, symptoms to watch out for, and how it’s treated. 

When a tooth is removed, a hole is left behind in your gum tissue. Normally, a blood clot forms in this hole. This clot is part of the healing process. It protects the bone tissue and nerve endings underneath as the hole in your gum tissue heals. 

Dry socket happens when the clot gets loose, comes out of the hole, or doesn’t form at all. Without the protective clot, the bones and nerve endings in the tooth socket are exposed. This may be painful, especially if food particles or other debris get inside the open wound.

Dry socket is the most common complication after tooth extractions. However, it’s still fairly uncommon. It generally develops after between 2% and 5% of tooth extractions. Dry socket may happen more often after a molar or wisdom tooth is pulled.

After a tooth is pulled, the wound healing process begins. Normally, this means a clot forms in the hole that’s left behind by the tooth extraction. If you look at your extraction site in the mirror, you may notice the clot looks like a wet, red scab. 

When dry socket occurs, the wound may look very different. Instead of seeing a wet, red scab at the site of the extraction, you may notice an empty-looking hole in your gum tissue. In some cases, you may even see visible bone tissue in the hole. 

If you develop dry socket after a tooth extraction, you may wonder how long it generally lasts. With prompt treatment from a dentist, dry socket may resolve quickly. You may feel significant pain relief within just a few minutes of starting treatment. The pain may continue to get better over the next few days. 

Who Is Likely to Get Dry Socket?

You may have a higher risk of developing dry socket after a tooth extraction if:

• You smoke cigarettes or use other tobacco products. How does smoking cause dry socket? It can decrease your body’s ability to heal wounds. That’s because the nicotine in tobacco restricts your blood vessels. After a tooth extraction, this reduced blood flow to your gum tissue could prevent or slow the healing process.
• You had a wisdom tooth removed. While dry socket could develop after any tooth extraction, this complication is much more common in wisdom teeth. Dry socket may occur after as many as 30% of wisdom tooth extractions. 
• You don’t practice good oral hygiene. Bacterial contamination may play a role in developing dry socket, so it’s important to keep the wound clean as it heals. Follow your dentist’s instructions on cleaning your mouth and brushing your teeth after the extraction.
• You take oral contraceptives. The high levels of the hormone estrogen in these medications may interfere with the normal healing process after a tooth extraction. In fact, women who take oral contraceptives may get dry socket about twice as often as those who don’t.

If you’re concerned that you’re more likely to get dry socket, talk to your dentist.

Dry socket causes haven’t been precisely identified, but researchers think bacterial contamination may play a role. To help reduce the risk of dry socket, dentists and oral surgeons may take extra steps to keep your extraction site clean. For instance, they may ask you to use a mouthwash that kills bacteria before the procedure. 

Trauma to the extraction site is another potential cause of dry socket. The complication is more common after difficult tooth extractions, such as the removal of wisdom teeth that are trapped beneath the gums (impacted).

It’s normal to have some discomfort or pain after a tooth extraction. Your dentist may recommend managing this discomfort with over-the-counter pain medications. As the wound heals in the days after the extraction, the discomfort should get better.

Severe pain that starts within a few days of the extraction, or pain that gets worse over time rather than better, could be a sign of dry socket. In some cases, the pain may radiate from the extraction site to other parts of your head and neck. For example, you could feel pain in your ear or eye on the same side of your face as the tooth extraction.

If you have dry socket, you may also notice bad breath or a bad taste in your mouth. And if you examine the extraction site, you may notice the tooth socket looks empty. 

Contact your dentist or oral surgeon right away if you notice any signs or symptoms of dry socket.

After removing your tooth, your dentist or oral surgeon may provide instructions about caring for the wound. Carefully follow these directions since proper at-home care may help promote the healing process and prevent dry socket. Your dentist may advise:

• Sticking to soft foods. For the first few days after your tooth extraction, eat soft foods, such as applesauce, yogurt, and mashed potatoes. To avoid disturbing the clot, try to chew on the opposite side of your mouth from where the tooth was extracted. 
• Steering clear of straws. Drinking through a straw may create suction, which could loosen or dislodge the clot in your tooth socket. For at least a week after having a tooth pulled, avoid drinking with straws.
• Avoiding tobacco products. Smoking after a tooth extraction is a risk factor for developing a dry socket. Your dentist may recommend avoiding tobacco for at least 48 hours after your extraction. 
• Avoiding rigorous exercise. Working out is good for your health, but in the first few days after a tooth extraction, your dentist may recommend taking it easy. Rigorous exercise could dislodge the clot in your tooth socket, resulting in a dry socket.
• Rinsing your mouth. For the first few days after the extraction, your dentist may recommend gently rinsing your mouth with warm saltwater. To avoid disturbing the clot, try to avoid swishing vigorously or spitting. 
• Brushing and flossing carefully. Regular brushing and flossing help keep your teeth healthy, but your routine may look a little bit different in the days after your extraction. Your dentist may recommend not cleaning the teeth next to the wound to avoid disturbing the clot. 

Dentists and oral surgeons may offer many treatments to help relieve the painful symptoms of dry socket. These treatments may include:

• Cleaning the socket. Food particles or other debris may irritate the sensitive wound. Your dentist may flush out the socket to help reduce pain and encourage healing. 
• Applying medicated dressings. To help your wound heal, your dentist may fill the socket with medicated paste or medicated gauze. Some dressings dissolve on their own, while others need to be removed by your dentist after two or three days.
• Recommending pain medication. Your dentist may recommend taking over-the-counter pain medication. If necessary, they may prescribe stronger pain medication. 

Your dentist may recommend dry socket treatment at home. This could include flushing out your socket with saltwater to remove debris. If you need to flush the socket, your dentist may provide a special plastic syringe with a curved tip. 

If you develop symptoms of dry socket after a tooth extraction, let your dentist or oral surgeon know right away. They may provide treatments to help control the pain as your wound heals. 

Complications of dry sockets are rare, but they may occur. Left untreated, a dry socket may become infected, and this infection could spread to the surrounding bone tissue. 

Dry socket occurs when the protective clot is dislodged before the wound heals, so it’s no longer a risk once the extraction site is healed. The healing time may vary depending on the tooth that was pulled. Typically, it takes about seven to 10 days for the extraction site to heal. If you had a wisdom tooth removed, it might take a bit longer: up to two weeks. 

Dry socket is a painful complication that may follow tooth extractions, but fortunately, it can be treated. If you’re experiencing dry socket symptoms and are asking where you can find a trusted dentist near me, you can use our Find a Dentist tool to search for Smile Generation-trusted dental offices in your area. You can browse staff bios and read reviews left by verified patients, and when you find the right dentist, you can request an appointment online.