Dry Socket

Dry socket is treatable by a doctor and you will likely feel immediate relief after treatment. Call your doctor right away if you experience any complications after a tooth extraction.

How Long After Tooth Extraction Can You Get Dry Socket?

Dry socket is the most common complication following a tooth extraction. Tooth extraction involves removing your tooth from its socket in your jawbone. After a tooth extraction, you’re at risk of developing dry socket. This risk is present until you’re fully healed, which may take 7 to 10 days in many cases.

Dry socket occurs when the blood clot that should have formed in the socket after your extraction is either accidentally removed or never formed in the first place.

Dry socket is no longer a risk once the site is healed. Ask your dentist when they expect you to be fully healed. Based on your health history and how your surgery went, they can give you the best timeframe for reference.

These tips may improve your recovery and reduce your risk of dry socket:

Follow your body’s signs and doctor’s orders on recovery. You may need to wait until you’re fully recovered before resuming normal activities.
Plan to take the whole day off from work or school following your extraction.
As your pain decreases, try slowly getting back into your routine. Stop any activity if you suddenly have more pain.

Pain, swelling, and bleeding should all decrease steadily in the first week. Read on to learn more about dry socket signs, prevention, and treatment.

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Normally, a blood clot forms over your empty socket. This clot protects the wound while it heals and promote new tissue growth.

Without a blood clot over your socket, raw tissue, nerve endings, and bone are exposed. This can be painful and over-the-counter pain relievers are sometimes not enough to help.

Symptoms of dry socket include:

severe pain that can’t be controlled by over-the-counter medications
pain extending across the side of your face from where your tooth was pulled
lack of blood clot over your socket
visible bone in your socket
bad taste, smell, or the presence of pus in your mouth, which may be possible signs of infection

It’s normal for you to feel sore and swollen the first day after surgery. You may also see small amounts of blood on your gauze dressing. If your pain increases, doesn’t improve, or you notice any of the symptoms noted above, see your dentist right away.

The American Dental Association recommends you keep gauze over your extraction site for 30 to 45 minutes after surgery. This encourages a blood clot to form and can help prevent dry socket. If you smoke, you may ask for a special oxidized cellulose dental dressing to help prevent dry socket.

You should be very gentle with your mouth until the site is totally healed. Eat soft foods and chew on the opposite side of your mouth from your extraction. You may not be able to tell when you’re completely healed, so err on the side of caution.

For 24 hours after surgery, avoid:

smoking
eating nuts, seeds, and crunchy foods which can get stuck in the socket
drinking very hot or acidic beverages, such as coffee, soda, or orange juice, which can disintegrate your blood clot
sucking motions such as slurping soup or using a straw
vigorous mouth rinsing
alcohol and mouthwash containing alcohol
brushing or flossing your teeth surrounding the socket

Ask your dentist if you should stop taking oral contraceptives if you have a tooth extraction. Some studies show these medications may increase your chance of developing dry socket.

Dry socket pain usually starts a few days after surgery. Call your doctor immediately if:

your pain suddenly increases
you develop fever, nausea, or vomiting

Most dentists have an answering service even after office hours are closed.

Dry sockets require a return trip to your doctor for diagnosis and treatment.

Your dentist will clean the wound and apply medication for immediate pain relief. They’ll replace the gauze and give you detailed instructions for keeping the site clean and safe. You may be given a special mouthwash, antibiotics, or prescription pain medication.

Treating dry socket starts your healing process all over again, so it will take a few days for it to heal. Closely follow your doctor’s instructions for at-home recovery to help dry socket heal properly.

Dry socket is the most common complication following a tooth extraction. Trauma to the blood clot and extraction site can cause severe pain. Certain factors such as smoking may increase your risk.

Dry socket is treatable by a doctor and you will likely feel immediate relief after treatment. Call your doctor right away if you experience any complications after a tooth extraction.

Last medically reviewed on April 20, 2018

How we reviewed this article:

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Dry socket. (n.d.).
mouthhealthy.org/en/az-topics/d/dry-socket
Johnson J. (2013). Tooth extraction.
ada.org/en/~/media/ADA/Publications/Files/ADA_PatientSmart-Extraction
Mayo Clinic Staff. (2017). Dry socket.
mayoclinic.org/diseases-conditions/dry-socket/symptoms-causes/syc-20354376
Murph JT Jr, et al. (2015). A retrospective study on the use of a dental dressing to reduce dry socket incidence in smokers.
ncbi.nlm.nih.gov/pubmed/25945758
Tarakji B, et al. (2015). Systemic review of dry sockets: Aetiology, treatment, and prevention. DOI:
10.7860/JCDR/2015/12422.5840

Dry Socket

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When a tooth is removed from the bone and gums, a blood clot forms to protect the hole in your gums as it heals. If it does not form properly or becomes dislodged, it can create a dry socket.

Dry socket is also called alveolar osteitis.

Dry socket can leave the nerves and bone in your gums exposed, so it’s important to seek dental care. It can be incredibly painful, and if left untreated, it can lead to complications, including:

delayed healing
infection in the socket
infection that spreads to the bone

What does it feel like?

Dry socket typically causes steady, throbbing pain. The pain can be severe and is often not fully helped by over-the-counter or prescription pain medications. It may lead to being unable to work or focus on other things.

Pain from dry socket may radiate from the extraction site to your:

If you have dry socket, you may also feel pain when you drink something cold or breathe in cold air.

Diagnosis

If you’re experiencing symptoms of dry socket, your dentist will want to see you to look at the empty socket and to discuss next steps.

In some cases, your dentist may suggest X-rays to rule out conditions other than dry socket. This includes bone infection (osteomyelitis) or the possibility that bone or root fragments are still present in the extraction site.

Dry socket can develop if after a tooth is removed, a protective blood clot doesn’t form in the open space.

Dry socket can also develop if this blood clot becomes dislodged from your gums.

Researchers aren’t sure what prevents this blood clot from forming. It’s thought that bacterial contamination, whether from food, liquid, or other things that enter the mouth, can cause dry socket.

Trauma to the area may also lead to dry socket. This can occur during a complicated tooth extraction or during aftercare. For example, accidentally poking the area with your toothbrush may disrupt the socket’s healing.

Risk factors

You’re more likely to develop dry socket if:

You smoke cigarettes or use other tobacco products. Not only can the chemicals slow healing and contaminate the wound, but the act of inhaling can also dislodge the blood clot.
You take oral contraceptives. Some birth control pills contain high levels of estrogen, which may disrupt the healing process.
You don’t care for the wound properly. Not following your dentist’s instructions for at-home care or not practicing good oral hygiene can cause dry socket.

Cleaning and dressing the area

If you have dry socket, your dentist will clean the socket to make sure it’s free of food and other particles. This may alleviate any pain and can help prevent infection.

Your dentist may also pack the socket with a medicated dressing or paste to help numb the pain.

If the dressing needs to be removed, you’ll have to return to your dentist after a few days. The dressing may need to be replaced if the pain is still severe. Otherwise, you may be instructed to remove it at home and clean the socket again afterward.

Your dentist will likely recommend a saltwater or prescription rinse. They may also prescribe antibiotics to prevent infection in the area.

Managing pain

Over-the-counter pain medication may help relieve any discomfort. Your dentist will probably recommend a specific nonsteroidal anti-inflammatory drug (NSAID), such as ibuprofen (Motrin IB, Advil), or acetaminophen (Tylenol).

It’s best to avoid taking aspirin, as it’s an NSAID that may cause more bleeding in the area.

A cold compress may also provide relief.

If your pain is more severe, your dentist may recommend a prescription pain reliever.

You’ll likely have a follow-up appointment about a week after your extraction. Your dentist will look over the affected area and discuss any next steps.

Buy ibuprofen to help relieve discomfort.

You can reduce your risk of dry socket by taking the following steps before surgery:

Ensure that your dentist or oral surgeon is experienced with this type of procedure. You should check out their credentials, read online reviews, and ask around about them — whatever you need to do to know that you’re in good hands.
After selecting a care professional, talk with them about any over-the-counter or prescription medications that you’re currently using. Some medications can prevent your blood from clotting, which can cause dry socket.
If you smoke, limit or avoid smoking before and after your extraction. Smoking can increase your risk of dry socket. Talk with your dentist about using nicotine management options, such as the patch, during the healing process. They may even be able to provide guidance about quitting.

After the procedure, your dentist will provide you with information about recovery and general guidelines for care. It’s important that you follow these directions. If you have any questions, call your dentist’s office. They can clear up any concerns that you may have.

Your dentist may recommend one or more of the following during recovery:

antibacterial mouthwashes
antiseptic rinses
medicated gauze
medicated gel
pain medication

Your dentist may also suggest an antibiotic, especially if your immune system has been compromised.

While it can be very painful, dry socket is a highly treatable condition. You should start to feel better shortly after treatment begins, and your symptoms should be gone entirely within a few days.

If you’re still dealing with pain or swelling after about 5 days, call your dentist. You may still have debris caught in the area or another underlying condition.

Having had dry socket once does put you at risk of developing dry socket again, so be sure to tell your dentist about your dental history if you ever need to have another tooth removed.

Last medically reviewed on December 22, 2021

Dry Socket