Dry Socket

Dry socket is the most common complication of an extraction. It develops in about 5% of tooth extractions. It is very painful condition that is easily treated.

What is a dry socket?

Any socket in which a patient is having pain due to the loss of the blood clot thus exposing the bone to air, food, and fluids along with an offensive odor. This often occurs two or more days after an extraction and can last about 5-6 days. It is normal to have soreness and discomfort following an extraction. However, pain should be lessening by the second day.

This condition exist when a blood clot is dislodged from the surgery site thus exposing the bone and fine nerve endings. The blood clot helps in the stopping of bleeding and lays the foundation or framework for new tissue and bone to develop over a two-month healing process. This condition is more common in the mandibular area and in back teeth due to poorer circulation in this area, with wisdom teeth being the most common site. Dry socket delays the healing process.

It usually takes gum tissue about 3-4 weeks to heal where as the bone can take up to six months to heal.

This condition is most often found:

  1. In individuals who smoke too soon! before adequate healing occurs. Smoking: decreases healing, decrease blood supply to the protective blood clot, brings toxic products to the area, injuries the gum tissue and the negative pressure of sucking removes the blood clot from the surgery site.
  2. If you do not care for your extraction site as instructed by staff.
  3. Not following your home care instruction.
  4. Sucking action from smoking, sneezing, coughing, spitting or sucking, within the first 24 hours.
  5. Women taking oral contraceptives are more susceptible.

Prevention of dry socket:

  • Women who use birth control pills or have their teeth removed in the first 22 days of the menstrual cycle are twice as likely to develop dry socket after an extraction. Schedule extractions during the last week of your menstrual cycle (days 23 through 28) ** when estrogen levels are low or inactive.
  • Avoid drinking through a straw
  • Avoid smoking, it contaminates the extraction sit
  • Avoid excessive mouth rinsing, it interferes with blood clotting
  • Keeping food from impacting in this area.  Chew on the other side of your mouth and gently rinse your mouth with warm salt water after the first 24 hours.

A "socket" is the area where the tooth was removed.

If you have a dry socket contact us immediately.


Treatment could include the following:

  • Medication applied to the site.
  • Clove oil technique.
  • Gauze with medication.

Additional home care instructions.

  • Applying topical anesthetic.
  • Alvogyl by Septodont

Patients usually notice pain relief in about 5-10 minutes after the dressing is applied.

We have experienced fewer cases of dry socket since every patient is asked to rinse with an antimicrobial mouthwash and each patient is instructed on how to care for their extraction site through our patient education, verbal instruction and home care instruction handouts. We highly recommend patients use Peridex their daily oral hygiene routine to help control oral bacterial

Continue these instructions for the next 3-4 days:

  • Good oral health care.
  • Avoid food with any residuals...popcorn, peanuts and pasta
  • Eat soft foods...mashed potatoes, clear or cream soups that don't contain any residue, puddings.

News Updates on Dry Socket

Oral contraceptive may increase pain after wisdom tooth extraction

That tests on 267 women showed that those on the birth control pill were more susceptible than non-users to both postoperative pain and a condition known as "dry socket". In this condition, normal healing of the vacant tooth socket is delayed by the failure of a blood clot to form. Infection instead causes the socket to remain empty. In the study, pain on the day after the operation was experienced by 30 percent of pill takers compared to just 11 percent of non-users. Five days after the operation the difference was 14 percent compared to 5 percent. The researchers said these results suggest that the pill may reduce the pain threshold. The differential was similar when the development of dry socket was compared. Here, 11 percent of pill users were affected compared to 4 percent of non-pill users.

SOURCE: British Dental Journal 2003;194:453-455.
** Academy of General Dentistry.

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