After having a tooth extracted, you will usually feel relief from your toothache, severe tooth decay or overcrowded jaw. However, after your dentist/ oral surgeon extracts your tooth your mouth will be in a vulnerable healing stage. Your body will begin to produce a natural blood clot to protect the area. If this doesn’t occur, or becomes dislodged or dissolve before your gums have healed, you’ll suffer from dry socket.

Dry socket is the most common complications after adult tooth extraction. Knowing the signs and taking the right steps to prevent it will ensure a quick and comfortable healing.

What is Dry Socket and Why Does It Happen?

When your dentist extracts your tooth, there will be a gap left in your jaw.

Blood Clot Formation

Your body will immediately begin to fill this gap with blood. Within a few hours the blood will start to harden into a clot. This will protect the exposed bone, nerves and blood vessels.

Healing Process

This blood clot will provide a base for new soft tissue and jawbone to grow over the next few weeks.

Causes of Dry Socket

A dry socket occurs when the blood clot becomes dislodged, washed away or dissolved. This will leave your jawbone and sensitive nerves exposed to air, liquid, food and bacteria.

Inflammation & Infection

This will cause your jawbone and surrounding gum to become severely inflamed making you heal slower and causing you severe pain.

Symptoms of Dry Socket

Dry socket will cause some unique symptoms. Unlike normal healing pain, dry socket pain will occur suddenly a few days after your appointment.

Severe Throbbing Pain

Usually, 2-3 days after your extraction you’ll experience severe throbbing pain. This will rapidly get worse.

Pain Radiating

The pain will radiate from the empty socket to your jaw and up to your ear, eye, temple or neck on the same side of your face.

Empty Socket

When looking inside your mouth you’ll notice a dark empty socket where there should be a dark red blood clot. You may also notice some white jawbone tissue at the bottom of the socket.

Bad Breath

The bacteria and food particles in the empty socket will cause a strong unpleasant odor that brushing won’t help.

Bad Taste

You’ll have a constant unpleasant taste in your mouth. This will be caused by saliva mixing with the dislodged particles and bacteria.

Slight Swelling & Redness

The gum around the empty socket will look inflamed, red and sore.

Risk Factors

Whilst dry socket can occur to anyone, the following factors will increase your chances.

Smoking

Smoking, vaping or chewing tobacco are the leading cause of dry socket. The toxins in tobacco reduce blood flow and the sucking motion will cause the blood clot to be sucked out.

Drinking Through a Straw

Drinking through a straw can cause a large amount of suction in your mouth. This can cause young, delicate blood clots to become dislodged.

Lower Wisdom Teeth Extraction

Extracting your lower wisdom teeth will put you at a much higher risk of dry socket. This is because the jawbone is much denser and has less natural blood flow.

Poor Oral Hygiene

Not brushing and rinsing your teeth can cause harmful bacteria to grow in your mouth rapidly. This can cause the blood clot to dissolve.

Previous Dry Socket

If you’ve had dry socket in the past, you’re more likely to suffer from it again.

Hormonal Contraception

Having a high level of estrogen due to taking the contraceptive pill can cause problems with your natural clotting factors. This can cause the clot to dissolve.

Active Infections

Extracting a tooth that has severe gum disease or a bone abscess will increase your chances of clot failure.

How to Prevent Dry Socket

To prevent dry socket, you need to protect the new blood clot for the first 24-72 hours. Following the below guidelines will ensure your tissues heal without any issues.

Bite On Gauze Pads

Ensure you bite firmly on the gauze pads your dentist has placed for 30-60 minutes. This will encourage the formation of a strong blood clot.

Avoid Smoking

Avoid smoking, vaping or using any tobacco products for at least 3 days. To give yourself the best protection avoid tobacco for 1 week.

Avoid Drinking Through Straws

Avoid drinking through a straw for at least 5 days.

Soft Food

Eat soft foods such as plain yogurt, smooth soups, mash, applesauce, scrambled eggs and smoothies. Avoid any crunchy, hard, chewy or spicy foods.

Chew On Opposite Side

Make sure to chew your soft food on the other side of your mouth.

Avoid Vigorous Rinsing & Spitting

Avoid rinsing, swishing or spitting for the first 24 hours. This will cause pressure in your mouth and cause the delicate clots to become dislodged.

Rest

Rest for the first 24-48 hours. Avoid heavy lifting, strenuous activity or sports as this can cause high blood pressure causing increased bleeding and throbbing.

Oral Hygiene

Keeping your mouth clean will help prevent harmful bacteria attacking your healing socket. However, be very careful when cleaning your teeth.

Don’t Brush

Avoid brushing the extraction site for the first 24 hours. However you can gently brush your other teeth with a soft bristled toothbrush.

Gentle Salt Water Rinse

After 24 hours gently rinse your mouth with warm salt water. Dissolve ½ tsp salt in a glass of warm water. Tip your head from side to side gently and let the water run out into the sink.

Avoid Alcohol Based Mouthwash

Avoid using any alcohol based mouthwashes. This can irritate your new gum tissue and cause the blood clots to dissolve.

How Dentists Can Treat Dry Socket Quickly

If you suffer from dry socket don’t suffer in pain at home. Over the counter painkillers rarely help with dry socket. Your dentist can treat dry socket quickly.

Socket Irrigation

Your dentist will gently irrigate the empty socket with warm saline or medicated solutions. This will clear out any food particles, bacteria and debris.

Medicated Dressing

Your dentist will place a special medicated paste or soothing clove oil dressing into the empty socket. This will cover the exposed bone and relieve the pain within minutes.

Pain Relief

Your dentist may prescribe specific anti-inflammatory medication or stronger painkillers.

Dressing Changes

You may need to return to the clinic every 1-2 days to have your dressing changed. This will continue until new granulation tissue has grown over the exposed bone and your pain has gone.

Patients Checklist

  • Bite firmly on the gauze pad for at least 45 minutes.

  • Avoid smoking/vaping/tobacco for at least 3-7 days.

  • Avoid drinking through a straw for at least 5 days.

  • Eat soft, cool foods such as yogurt, smooth soups and mash for the first few days.

  • Chew food carefully on the other side.

  • Avoid vigorous spitting/rinsing/swishing for the first 24 hours.

  • Gently rinse with warm salt water after meals from day 2.

  • Rest and avoid heavy activity for 48 hours to keep your blood pressure steady.

  • Contact your dentist if you suffer from severe throbbing pain 2-3 days after your appointment.

Frequently Asked Questions

How long does dry socket pain last?

Without treatment dry socket pain usually lasts between 7-10 days. This is because your body will begin to grow new soft tissue (granulation tissue) over the exposed bone. Seeing your dentist will provide instant relief within minutes using medicated dressings.

Can dry socket heal itself?

Yes, dry socket will heal itself as your body will begin to grow new tissue over the exposed bone. However, leaving it untreated will cause severe pain for over a week and increase your chances of getting a bone infection. Seeing a dentist will instantly remove the pain and help you heal quicker.

How do I know if I have dry socket?

Normal extraction pain will peak within the first 24 hours and then reduce everyday. Dry socket pain will feel fine for the first day or two and then cause severe throbbing pain on day 3/4. If your pain is rapidly getting worse after a few days you likely have dry socket.

Can I get dry socket 5 days after extraction?

Most cases of dry socket occur between day 2-4. However occasionally it can occur on day 5. After day 7 your chances of getting dry socket drop dramatically as new soft tissue will have grown over the bone.

Having dry socket after a tooth extraction can be a painful experience. However knowing the correct information will put you in complete control. Avoid smoking, drinking through a straw, eating soft foods, resting and keeping your oral hygiene gentle to protect your natural blood clot. If you suffer from severe radiating pain a few days after your extraction contact your dentist for quick and effective treatment.