Dry Socket Causes, Symptoms and Treatment

When a tooth is extracted, for example, when wisdom teeth are removed – a painful dental condition called dry socket can occur. In todays article, you’ll learn what dry socket is, its symptoms, causes, and how it’s treated.

What is Dry Socket?

Dry socket (also called alveolar osteitis) is an inflammatory condition that affects the jawbone following tooth extraction. Compared to other complications arising from such procedures, dry socket is relatively rare, with an incidence of roughly two percent. However, that incidence goes up considerably – to twenty percent – when impacted mandibular third molars (lower wisdom teeth) are removed.

Dry Socket Symptoms

Dry socket hurts, it can cause severe pain within a few days of a tooth extraction. The pain can radiate from the socket (the site of the extraction) toward your neck, ear, temple, eye, or the side of your face, and be accompanied by halitosis or a foul taste in your mouth. Lymph nodes close to the jaw or around the neck may become swollen, and fever is possible. The blood clot which normally forms where a tooth was extracted may partially or completely vanish, and you might see visible bone in the empty socket.

What Causes Dry Socket?

When a tooth is extracted, a blood clot forms, protecting the bone and sensitive nerves in the socket left behind by the tooth. Aside from acting as a protective barrier, the clot stimulates the growth of new bone and soft tissue. When a blood clot gets dislodged, or dissolves prematurely, dry socket occurs, resulting in intense pain and other unpleasant symptoms.

A blood clot can be loosened, dislodged or dissolved by eating hard, spicy or hot foods too soon after a tooth extraction, or drinking carbonated beverages. Such foods and drinks can break apart the relatively delicate blood clot, get stuck in the empty socket, irritate the nerves, and if not flushed away, fester and cause an infection.

Swishing water and spitting (which may be tempting to do after a tooth extraction), as well as sucking too hard through a straw, can also dislodge a blood clot. Other possible causes include unhealthy teeth, gum disease, certain medications, such as blood thinners (which can make it difficult for a clot to form), and hormonal changes. Research shows that women are likelier to develop a dry socket, possibly because estrogen may dissolve blood clots. Even vigorous exercise may loosen a clot—it’s best to rest after having a tooth removed.

Dry socket may also be caused by smoking, bacterial contamination, tiny bone or root fragments that weren’t removed post-surgically, and major bone or soft tissue trauma caused by a difficult extraction.

Treatment of Dry Socket

Dry socket is most commonly treated by rinsing the socket free of debris, and applying medicated dressings or dry socket paste. Doing so forms a new protective layer over the exposed bone and nerves, reducing pain and allowing the healing process to continue.

Dressings may be changed up to several times a day for the first few days of treatment, dependent upon pain and other symptoms. Most patients are prescribed pain medication to lessen their discomfort, as well as an antibiotic to treat or prevent infection. With regularly changed dressings, and proper at-home care (flushing the socket with a syringe, and avoiding irritating foods and beverages), most cases of dry socket resolve in seven to ten days.

A dry socket isn’t life-threatening, but can be extremely unpleasant. Fortunately, barring certain unavoidable predisposing factors, dry sockets are largely preventable, and easily treated with good results. Always speak to your dental professional if you develop excessive pain, discomfort, swelling or signs of infection after having a tooth extracted.