Like any minor surgical procedure, a tooth extraction leaves a small wound that needs to heal. Most extraction sites improve without complications and a blood clot forms at the site of the extraction, protecting the underlying bone and nerve endings. Occasionally, a blood clot fails to develop, resulting in a dry socket.1 Learning how to prevent a dry socket can make a significant difference in recovery after tooth removal.
What Is dry socket?
The hole left behind after tooth removal begins immediately healing. At first, blood flows into the tooth socket. This process is similar to a scab forming over a skin wound. The clot covers the bone and nerve endings and provides building blocks for new bone formation. But in some cases, the clot dissolves, falls out or fails to form completely. The exposed bone results in a painful condition called alveolar osteitis, commonly known as dry socket.2
Dry socket is the most common complication following tooth extractions and occurs in 0.5 – 5.6% of most tooth extractions. However, dry socket rates are up to 30% following extraction of third molars.3
How do I know if it’s dry socket?
Most patients experience some discomfort after tooth removal, but pain medication usually controls the symptoms. Clues that a dry socket has occurred include:4
- Increasing pain three to four days after surgery, sometimes severe
- Bad odor or taste
- Bare, visible bone in the site that’s greyish or white
- Pain that doesn’t adequately respond to pain medications
Swelling into the neck, face, floor of the mouth, or below the eye generally doesn’t indicate a dry socket. Instead, it may be evidence of a bacterial infection. Swelling, especially from lower molars, presents a risk requiring immediate medical attention. Also, puffiness underneath the eyes related to a mouth infection needs evaluation due to the proximity to the brain.5
If a tooth extraction site becomes more uncomfortable after a few days, it’s probably a dry socket. If there’s swelling, fever, or difficulty breathing, don’t wait for evaluation and treatment. Return to the dentist who performed the procedure, or find a dentist nearby who can help.
How do I prevent dry socket?
No one fully understands what causes dry socket, but researchers do know certain factors affect the risk of developing this problem. Some of the ways to control aggravating the risk include:
Set tobacco aside
Avoid smoking after having a tooth removed for at least the first 48 hours. One study showed that smoking triples the risk of dry socket.6 In addition, higher levels of use seem to lead to higher incidences of this painful condition.
Go easy on your mouth
Be careful with anything that loosens or dislodges a new clot. Don’t spit, drink through a straw, or rinse during the first 24 hours to avoid dislodging the blood clot. Choose soft foods, chew away from the area and let hot foods and drinks cool down.7
Birth control pills? Consider timing
Estrogen may influence dry socket formation, and women on birth control pills face double the risk than non-users. Women on birth control should try to schedule tooth extractions in days 23 through 28 of their menstrual cycle. Studies show lower risk of dry socket during this last phase.8
Choose good nutrition and sleep
While there’s limited research on the effect of nutrition on dry socket incidence, good eating affects the healing of oral wounds. Vitamins and minerals provide building blocks for repair and new bone growth. While soup and yogurt are great choices, salmon also offers a healthy protein source that’s rich in omega-6 fatty acids. Omega-6 fats lower general inflammation in the body, including in the mouth.9
Practice good oral hygiene
While the direct causes of dry socket remain a mystery, studies have shown that bacteria may play a role.10 Before tooth removal, spend extra time cleaning your teeth, gums, and tongue.
How do I treat dry socket?
If a dry socket develops, contact your dentist, who may apply a soothing dressing into the area to diminish the pain. This application may need to be repeated several times, depending on the severity of the symptoms.
If the pain persists, your dentist may need to x-ray the area to ensure nothing is interfering with normal healing. Your dentist may need to prescribe antibiotics and a stronger pain medication to assist the healing process.11
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Brought to you by The Guardian Life Insurance Company of America (Guardian), New York, NY. Material discussed is meant for general illustration and/or informational purposes only and it is not to be construed as tax, legal, investment or medical advice. It is not dental care advice and should not be substituted for regular consultation with your dentist. If you have any concerns about your dental health, please contact your dentist's office.