Now you know all about what a dry socket looks and feels like. But what is it like when your socket heals normally after the extraction?
An Overview of Dry Socket
You probably think having a tooth pulled is not a particularly enjoyable experience. And you no doubt expect to have some discomfort afterward. But that’s OK, you say. You can endure it when you need to. But if the pain becomes intense and perhaps even worsen after a few days, it may be a symptom of a condition called dry socket, or alveolar osteitis.
Only a very small percentage — about 2% to 5% of people — develop dry socket after a tooth extraction. In those who have it, though, dry socket can be uncomfortable. Fortunately, it’s easily treatable.
The socket is the hole in the bone where the tooth has been removed. After a tooth is pulled, a blood clot forms in the socket to protect the bone and nerves underneath. Sometimes that clot can become dislodged or dissolve a couple of days after the extraction. That leaves the bone and nerve exposed to air, food, fluid, and anything else that enters the mouth. This can lead to infection and severe pain that can last for 5 or 6 days.
Who Is Likely to Get Dry Socket?
Some people may be more likely to get dry socket after having a tooth pulled. That includes people who:
- smoke
- have poor oral hygiene
- have wisdom teeth pulled
- have greater-than-usual trauma during the tooth extraction surgery
- use birth control pills
- have a history of dry socket after having teeth pulled
Rinsing and spitting a lot or drinking through a straw after having a tooth extracted also can raise your risk of getting dry socket.
What Are the Symptoms of Dry Socket?
If you look into the site where the tooth was pulled, you’ll probably see a dry-looking opening. Instead of a dark blood clot, there will just be whitish bone. The pain typically starts about 2 days after the tooth was pulled. Over time it becomes more severe and can radiate to your ear.
Other symptoms of dry socket include bad breath and an unpleasant smell and taste in your mouth.
How Is Dry Socket Treated?
You can take a nonsteroidal anti-inflammatory drug (NSAID), such as aspirin or ibuprofen, to ease the discomfort. Sometimes these over-the-counter medications aren’t enough to relieve the pain. When that’s the case, your doctor may prescribe a stronger drug or will anesthetize the area.
Your dentist will clean the tooth socket, removing any debris from the hole, and then fill the socket with a medicated dressing or a special paste to promote healing. You’ll probably have to come back to the dentist’s office every few days for a dressing change until the socket starts to heal and your pain lessens.
Your dentist may prescribe antibiotics to prevent the socket from becoming infected. To care for the dry socket at home, your dentist may recommend that you rinse with salt water or a special mouthwash every day.
What Can I Do to Prevent Dry Socket?
Because smoking is a big risk factor for dry socket, avoid cigarettes, cigars, and any other tobacco products for a day or so after your surgery. If you take birth control pills, ask your dentist about performing the extraction on a day when you are getting the lowest dose of estrogen. The hormone can affect the ability of the blood to clot. Also, check with your dentist about other medications you are taking that can interfere with normal blood clotting.
After surgery, avoid drinking through a straw and spitting for the first few days. Also don’t rinse your mouth more than your dentist recommends. If you do rinse, do so gently. Be sure to visit your dentist for all scheduled follow-up visits.
Show Sources
American Dental Association: “Dry Socket.”
Reekie, D, Downes, P, Devlin, CV, Nixon, GM, Devlin, H. British Dental Journal, 2006; vol. 200: pp. 210-213.
Roberts J, Custalow C, Hedges, J. Roberts: Clinical Procedures in Emergency Medicine, 4 th ed, Elsevier, 2004.
Dry Socket vs Normal: Do I have dry socket?
If one of your teeth was extracted, you’ve been warned about the dreaded dry socket. Read up on what it is and how to know if you have it.
Did you have a tooth extraction? Maybe you have one coming up. You likely heard the nerve-wracking advice, “Whatever you do, don’t get dry socket.” Okay, sounds like great advice. But what the heck is “dry socket?” Is this color normal? Should my socket look like that? How the heck am I supposed to know if this is healing normally?
Each year Americans spend $3B per year to have 10 million wisdom teeth extracted. That’s quite a chunk of change for the tooth fairy to redistribute to the kids losing their baby teeth. With all that cash being spent on extractions nobody wants to spend more money to deal with dry socket.
What is dry socket
After a tooth extraction, dry socket can happen if the blood clot either fails to develop or dislodges before the wound heals. It’s a painful situation because the underlying bone and nerve ending, normally protected by the blood clot, are exposed. The clot is important for the healing process as it allows your bone to regrow and for soft tissue to re-develop over the empty space.
When the bone and nerve are exposed, it causes crazy pain. Not just in the site of the extraction but also along the jaw and the side of your face where the tooth was removed. The open space (the socket) will get irritated and may fill with food particles, which just worsens the pain.
If you get it, you’re not alone. It’s the most common complication people get after a tooth extraction. And if you think you have a dry socket, don’t fight through the pain. Call your dentist right away as they’ll be able to help you address and overcome the problem.
How do I know if I have dry socket?
Of the millions of extractions that happen, 2-5% of those people will have to deal with dry socket. So how do you know if you’re one of the unlucky few?
Feeling pain and discomfort is totally normal the first few days after an extraction. Come on, you just yanked something out of your jaw, of course it’s not gonna feel great once the anesthetics wear off! This pain should be manageable with the pain reliever prescribed by your dentist, and it will go down after 2-3 days.
If you’re paranoid (hey, it’s cool to be worried!), here are the typical symptoms of dry socket:
- Pain of 5 out of 10 or higher within a few days of the extraction
- Pain that worsens in the days after the extraction
- An “empty-looking” socket where the tooth was removed
- Visible bone in the socket
- Pain that radiates from the extraction site out to your ear, eye, forehead, or neck on the same side of your face
- Bad breath or a foul odor
- Unpleasant taste in your mouth
Normal sockets after tooth extraction
Now you know all about what a dry socket looks and feels like. But what is it like when your socket heals normally after the extraction?
- Pain that continues to improve (aka decrease in intensity)
- A visible blood clot in the area of the socket
- No visible bone in the area
- No change in the taste of your mouth or how your breath smells
It will still take you a few days to start to feel like yourself again (minus a tooth or two) but each day you should feel like singing “I have to admit it’s getting better” when you wake up.
Dry socket with stitches
Unfortunately dry socket is still possible with stitches. Dry socket can happen when the stitches fall out too early, which means the wound doesn’t have time to heal.
Most dentists use dissolvable stitches to close the wound after a tooth removal. Dissolvable stitches usually disintegrate within a few weeks after the extraction. If your dentist used regular stitches they will schedule a follow up appointment in 7-10 days to remove the stitches.
Being gentle with those stitches helps keep the stitches intact, allowing your extraction to heal normally. “While it’s important to be gentle with those stitches, it doesn’t let you off the hook for keeping up your oral hygiene routine at home,” shares Sarah Clark, RDH. “In fact, keeping your mouth clean is critical after an extraction to minimize the chance that food particles or bacteria get into your wound. That can cause irritation and even infections, leading to more serious complications.”
TL;DR Yes it sucks to get a tooth extracted so you CAN eat ice cream for breakfast, but you CANNOT shrug off brushing your teeth.
Dry socket with bone graft
Dry socket can also happen with a bone graft. However, it’s less likely than with a regular extraction because the wound is well-covered after the graft to ensure the bone has time to integrate into your jaw.
Your jaw will start to feel more normal after a few weeks of your bone grafting, but that doesn’t mean your jaw is ready for an implant. It takes several months for the bone to integrate into your jaw and become strong enough to support implants.
Worried about dry socket?
Then let’s talk about what you can do in the short- and long-run to help your socket heal well and stay healthy for the long run. Learn what you can do to help your socket heal whether things are going well or you have dry socket, and how you can prevent future issues that are complex, and expensive.
Check out “Dry Socket: The ultimate guide” for everything you need to know to avoid or deal with dry socket.
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