Dry Socket: How to Tell, Pain Symptoms, Healing (2024)

Dental Health

Dental Conditions

ByKathi Valeii

Updated on May 01, 2024

Medically reviewed byEdmund Khoo, DDS

Dry socket, clinically called alveolar osteitis, is a healing complication that occurs after tooth extraction, often with wisdom teeth removal. Poor oral hygiene can place you at greater risk of dry socket. Food particles that get stuck in your extraction site and not cleaned out can dislodge the blood clot that protects the site.

Lots of other things contribute to developing the condition, including drinking through a straw, smoking, and rinsing and spitting too much after your dental procedure. Those activities can dislodge the blood clot over your extraction site.

This article explains how to differentiate dry socket pain from expected oral pain after tooth extraction, how to find pain relief, and expected healing time.

Dry Socket: How to Tell, Pain Symptoms, Healing (1)

Dry Socket and Mouth Pain: Understanding Symptoms

Dry socket is a distinct kind of pain that follows dental extraction. Early stage dry socket usually begins one to three days after your tooth has been pulled.

Dry socket symptoms include:

  • Severe pain in the first few days after an extraction
  • Pain that radiates from the extraction site outward toward your ear, eye, or neck
  • A visibly missing blood clot
  • A bad taste in your mouth
  • Bad breath
  • Low fever

When the blood clot over your extraction site is no longer there, it exposes bone and nerves and causes pain.

A Word From Verywell

Dry socket can be a very painful and unpleasant experience. Fortunately, it is predictably treatable, and further complications are rare.

EDMUND KHOO, DDS, MEDICAL REVIEW BOARD

Dry Socket: How to Tell, Pain Symptoms, Healing (2)

How Much Pain After a Tooth Pull Is Normal?

Dry socket is common in about 1% to 5% of all extractions and up to 38% of wisdom tooth extractions. So, it is important to understand how to identify the pain.

Some pain is expected and normal after a tooth extraction. Since pain is expected, it can sometimes be difficult to differentiate normal extraction from dry socket pain. Normal healing pain is not severe, responds to pain meds, and improves with time.

Dry Socket PainExtraction Pain
SevereMild to moderate
Radiates outwardIsolated to mouth
Not responsive to pain medsPain meds help
May be accompanied by bad breath and tasteNot associated with bad breath or taste
Pain gets worse each dayPain improves over time

As long as you have an open wound, you are at risk of developing a dry socket. Once the site is healed, dry sockets are no longer a risk. Extraction sites usually take a week to 10 days to fully close.

Risks of Dry Socket After a Dental Procedure

Dry socket after wisdom teethor other dental extraction is caused by a dislodged blood clot. Not everyone loses a blood clot, leading to dry socket, but some things may increase the risk of developing dry socket.

Risk factors include:

  • Smoking
  • Traumatic extraction
  • Using vasoconstrictor (epinephrine, often used in local anesthetics)
  • The amount of anesthesia administered
  • Pre-existing infections
  • Not following post-surgical instructions
  • Poor oral hygiene
  • Diabetes
  • Chemotherapy
  • Anti-inflammatory drugs
  • Age (older studies have found a peak incidence at 18 to 33 years)
  • Sex (higher in females than males)
  • Use of oral contraceptives (birth control pills)

A Note on Gender and Sex Terminology

Verywell Health acknowledges thatsex and genderare related concepts, but they are not the same. To accurately reflect our sources, this article uses terms like “female,” “male,” “woman,” and “man” as the sources use them.

Dry Socket Pain Relief

Managing dry socket pain includes dental care and at-home care measures.

Dental Care

Your dentist will treat dry socket in the following ways:

  • Flushing food or other materials out of the socket
  • Packing the socket with a medicated dressing
  • Repacking the dressing at multiple visits

They may also prescribe a more powerful pain medicine. However, often, once the site is packed with a medicated dressing, your pain will reduce significantly. They may also prescribe antibiotics if they feel you could be at risk of developing a bacterial infection.

At-Home Measures

Your dentist will also advise you to care for dry socket at home, which usually includes the following:

  • Applying a cold pack to your jaw
  • Rinsing the dry socket with a saltwater solution
  • Avoiding smoking, tobacco, and alcohol

It is critical to follow your dentist's instructions to the letter. Doing so will help prevent complications and help you heal more quickly.

An Overview of Pain Management

Dry Socket Healing Time

Fortunately, dry socket pain doesn't last long. Once treatment begins, dry socket pain usually resolves within a few days. However, the speed at which you heal may vary depending on some factors.

For example, one small study found that 73% of those who received the antibiotic Cipro (ciprofloxacin) were completely relieved of symptoms within 24 hours without the need for additional painkillers or non-steroidal anti-inflammatory drugs (NSAIDs).

Dry socket can heal on its own. However, since the pain is severe, it's important to see a dentist for help managing pain. That's the fastest way to heal dry socket and find pain relief.

Dental Hygiene Tips With Dry Socket

If you develop a dry socket, oral hygiene is extra important. You need to keep the open wound clean and irrigated to remove food and other debris. Excellent oral hygiene may help prevent infection and limit the pain you experience.

Here are some tips for oral hygiene practices if you have dry socket:

  • Brush gently around the extraction site
  • Rinse your mouth with warm saltwater a few times a day
  • If your dentist instructed you to rinse your wound, follow their instructions in doing so
  • Avoid smoking
  • Avoid straw use
  • Avoid chewy, hard, or sticky foods

Oral and Maxillofacial Surgery: Everything You Need to Know

Is Dry Socket Preventable?

After a tooth extraction, an oral surgeon will send you home with a list of instructions. These instructions will reduce your likelihood of developing an infection and dry socket, so it's essential to follow them exactly.

Researchers have found that the greatest risk of developing dry socket is having had it before. It is also more common in the mandible (teeth extracted from the lower jaw), with the highest incidence following lower wisdom teeth extraction.

Oral surgery recovery guidelines aimed at preventing dry socket include:

  • Avoiding straws
  • Sticking to soft foods and steering clear of hard, crunchy, and sticky foods
  • Maintaining good oral hygiene, including carefully brushing your teeth around the extraction site
  • Rinsing your mouth with a saltwater solution, carefully avoiding excessive spitting
  • Avoiding smoking and tobacco
  • Avoiding alcohol and carbonated beverages
  • Getting enough rest

Dry socket isn't always preventable. Some people are more prone to developing dry socket. However, following prevention strategies can reduce the risk.

Summary

Dry socket is common after teeth extraction, especially after wisdom teeth removal in the lower jaw. Good oral hygiene before and after your procedure can reduce your risk of developing this painful condition.

If you do develop dry socket, seeing your oral surgeon right away can help. They will pack your wound with medicated gauze, which usually results in immediate relief. Follow your oral surgeon's instructions to speed healing and experience less pain.

8 Sources

Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.

  1. MedlinePlus. Dry socket.

  2. Mamoun J. Dry socket etiology, diagnosis, and clinical treatment techniques.J Korean Assoc Oral Maxillofac Surg. 2018;44(2):52-58. doi:10.5125/jkaoms.2018.44.2.52

  3. Khalil W. A new approach for explaining and treating dry sockets: a pilot retrospective study.Cureus. 2023;15(7):e41347. doi:10.7759/cureus.41347

  4. Tanaka K, Kudo K, Ambe K, Kawaai H, Yamazaki S. A histological study of vasoconstriction by local anesthetics in mandible.Anesth Prog. 2018;65(4):244-248. doi:10.2344/anpr-65-03-15

  5. Abu Younis MH, Abu Hantash RO. Dry socket: frequency, clinical picture, and risk factors in a Palestinian dental teaching center.Open Dent J. 2011;5:7-12. doi:10.2174/1874210601105010007

  6. Bienek DR, Filliben JJ. Risk assessment and sensitivity meta-analysis of alveolar osteitis occurrence in oral contraceptive users. J Am Dent Assoc. 2016;147(6):394-404. doi:10.1016/j.adaj.2016.01.011

  7. Khalil W. A new approach for explaining and treating dry sockets: a pilot retrospective study.Cureus. 2023;15(7):e41347. doi:10.7759/cureus.41347

  8. Taberner-Vallverdú M, Camps-Font O, Gay-Escoda C, Sánchez-Garcés MA. Previous dry socket as a risk factor for alveolar osteitis: a nested case-control study in primary healthcare services.J Clin Exp Dent. 2022;14(6):e479-e485. doi:10.4317/jced.59586

Dry Socket: How to Tell, Pain Symptoms, Healing (3)

By Kathi Valeii
Valeii is a Michigan-based freelance writer with a bachelor's degree in communication from Purdue Global.

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