©2018 WebMD, Inc. All rights reserved. eMedicineHealth does not provide medical advice, diagnosis or treatment. See Additional Information.

Dry Socket

  • Medical Author:
    Steven B. Horne, DDS

    Dr. Steve Horne began his career at Brigham Young University obtaining his BA in English. He earned his doctorate of dental surgery in 2007 from the University of Southern California where his pursuit for academic excellence landed him on the dean's list. He was recognized for his superior clinical skills and invited to help teach other dental students in courses on restorative dentistry, prosthodontics, and tooth anatomy. During dental school, he provided dental care for underserved populations of Los Angeles and Orange County, Mexico, and Costa Rica with the international volunteer organization AYUDA. After graduation from USC, Dr. Horne entered active duty with the U.S. Army and practiced dentistry at Fort Knox, Kentucky, for four years. During this time, in 2010, he was deployed as part of a medical unit to Baghdad, Iraq, to provide dental and triage support to military and civilian workers who were involved in the effort there. During his military service, he received multiple Army Achievement Medals, the Army Commendation Medal, and served as company commander. After leaving the Army in 2011, Dr. Horne joined a private practice in La Jolla, Calif., and became credentialed with Scripps Memorial Hospital La Jolla as a dental consultant. Health and education are of paramount importance to Dr. Horne, and since 2012, he has been writing dental articles for MedicineNet and WebMD to provide accurate information about oral health to the public. He is a member of the American Dental Association (ADA), Academy of General Dentistry (AGD), California Dental Association (CDA), and the San Diego County Dental Society and American Academy of Cosmetic Dentistry (AACD). He is a preferred provider with Invisalign and spends countless hours each year pursuing continuing education in order to maintain a standard of excellence in dentistry. Dr. Horne has been married for 15 years to his wife, Christy. They have 3-year-old twins, Camille and Trent, and very recently welcomed their third child, Colette Elise, on July 6! The heart and soul of the family is Roscoe, their chocolate Labrador.

  • Medical Editor: William C. Shiel Jr., MD, FACP, FACR
    William C. Shiel Jr., MD, FACP, FACR

    William C. Shiel Jr., MD, FACP, FACR

    Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.

Dry Socket Related Articles

Dry Socket Facts

  • A dry socket is a fairly common complication of tooth extraction characterized by severe pain.
  • It occurs when the tooth socket loses the blood clot that forms after a tooth is extracted and the bone inside the socket becomes exposed.
  • It is one of the most painful dental problems one can experience. A dry socket is also referred to as alveolar osteitis.

What Causes Dry Socket?

The blood clot that forms after tooth extraction is essential for optimal healing of the underlying tissue. Destruction or loss of the blood clot prevents normal healing and causes alveolar osteitis. There are a variety of reasons why the initial blood clot could be lost or destroyed prematurely. The body reacts to local infection and inflammation, trauma, bacteria, and estrogen to destroy the blood clot, leaving an exposed socket. So it is important to minimize these risk factors as much as possible.

How Often Does Dry Socket Happen?

A dry socket will occur in only a small percentage of tooth extractions, but it becomes much more common in the extraction of lower (mandibular) wisdom teeth.

What Are Dry Socket Symptoms and Signs?

A patient may first notice signs of a dry socket 3 to 4 days after extraction of the tooth by feeling moderate-to-severe pain that could last anywhere from 10 to 40 days. The exposed bone of a dry socket is very sensitive and leads to an intense dull aching pain that throbs and radiates around the affected side of the jaw often to the patient's ear. Frequently, the patient affected by a dry socket will also complain of a bad odor or bad taste in their mouth.

What Is the Treatment for Dry Socket?

Treatment for dry socket is intended to make a patient more comfortable by reducing dental pain but it generally won't accelerate the healing process. It is very important to diagnose the dry socket correctly and not confuse it with something equally as painful like a root canal problem. It is diagnosed by visualizing or probing the exposed bone of an extraction site and noting the patient's symptoms of pain and foul odor or taste.

The dry socket is treated by flushing the extraction site with warm salt water solution and packing the socket with gauze or a gelatin sponge coated with an antiseptic dressing. Clove oil when mixed into a paste has been used effectively in treating dry sockets due to its soothing properties. The dressing is replaced every 1 to 3 days, depending on the severity of pain, until the pain goes away. As soon as the pain is gone, the socket must be allowed to heal on its own.

QUESTION

What causes tooth decay? See Answer

What Are Home Remedies for Dry Socket?

To ease the pain and mild swelling, the patient can take a nonsteroidal anti-inflammatory drug (NSAID), such as ibuprofen. Also, a small drop of clove oil can be applied to a cotton ball and placed over the socket until the patient can see a doctor for a proper dressing. A rinse with warm salt water will help promote healing as well.

How Do You Prevent Dry Socket?

There are some things that can be done to lessen the probability of a tooth extraction resulting in a dry socket. The most important thing a patient can do to prevent a dry socket is follow the post operative instructions given at the time of extraction. These include avoiding the use of tobacco products and activities where the extraction site could be traumatized in any way. Also, avoid things like sucking forcefully through a straw or spitting as these actions could dislodge the blood clot.

Having the wisdom teeth removed as soon as it is determined necessary by a dentist or oral surgeon is also very important. Since the presence of bacteria and infection tends to contribute to the premature destruction of the blood clot, removing impacted wisdom teeth before they get infected, inflamed, or painful will help avoid a dry socket. Waiting until they are painful or infected puts the patient at increased risk.

There is also a link to oral contraceptive use and the incidence of dry socket. The estrogen dose in birth control pills is what contributes to the destruction of the clot, so planning an extraction during days 23 through 28 of the tablet cycle will help avoid this contributing factor to a dry socket.

Health Solutions From Our Sponsors

QUIZ: Learn about good dental health

The best way to prevent dry socket is to avoid needing a pulled tooth. The best way to keep your teeth healthy it to practice good oral hygiene.

Tooth decay occurs when foods containing carbohydrates (sugars and starches) are left on the teeth. Bacteria that live in the mouth digest these foods, turning them into acids. The bacteria, acid, food debris, and saliva combine to form plaque, which clings to the teeth. The acids in plaque dissolve the enamel surface of the teeth, creating holes in the teeth called cavities, or dental caries.

Reviewed on 1/15/2019
References
Medically reviewed by Kenneth Rotskoff, MD, DDS; Board Certified Dentistry, Oral/Maxillofacial Surgery

REFERENCES:

Little, James W., et al. Dental Management of the Medically Compromised Patient 6th ed. Mosby, 2002.

McArdle, Barry F. "Preventing the negative sequelae of tooth extraction." Journal of the American Dental Association 133.6 (2002): 742-743.

Neville, Brad W., et al. Oral & Maxillofacial Pathology 2nd ed., Saunders Company, 2002.

Peterson, Larry J., et al. Contemporary Oral and Maxillofacial Surgery 4th ed., Mosby, 2003.

Patient Comments & Reviews

  • Dry Socket - Experience

    Please describe your experience with dry socket.

    Post
  • Dry Socket - Symptoms and Signs

    What were the symptoms and signs of your dry socket?

    Post
  • Dry Socket - Treatment

    What was the treatment for your dry socket?

    Post
  • Dry Socket - Prevention

    In what ways have you tried to prevent dry socket?

    Post
CONTINUE SCROLLING FOR RELATED SLIDESHOW