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Dry Socket: Identification, Treatment, and More

Is dry socket common?

If you’ve recently had a tooth removed, you’re at risk for dry socket. Although dry socket is the most common complication of tooth removal, it’s still relatively rare.

For example, researchers in one 2016 study found that about 40 people out of the 2,218 observed experienced some degree of dry socket. This puts the incidence rate at 1.8 percent.

The type of tooth extraction determines how likely you are to experience dry socket. While still rare, dry socket is more likely to develop after your wisdom teeth are removed.

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

A dry socket can leave the nerves and bones in your gums exposed, so it’s important to seek dental care. If left untreated, this can lead to infection and other complications.

Read on to learn how to recognize dry socket, how to help prevent this from occurring, and when you should call your dentist or oral surgeon for help.

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Symptoms

How to identify dry socket

If you’re able to look into your open mouth in a mirror and see bone where your tooth used to be, you’re probably experiencing dry socket.

Another tell-tale sign of dry socket is an unexplained throbbing pain in your jaw. This pain may spread from the extraction site up to your ear, eye, temple, or neck. It’s typically felt on the same side as the tooth extraction site.

This pain typically develops within three days of tooth extraction, but can occur at any time.

Other symptoms include bad breath and an unpleasant taste that lingers in your mouth.

If you’re experiencing any of these symptoms, you should see your dentist right away.

Causes

What causes dry socket

A dry socket can develop if, after tooth extraction, a protective blood clot doesn’t form in the vacated space. Dry socket can also develop if this blood clot becomes dislodged from your gums.

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

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.

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Risk factors

Who gets dry socket

If you’ve had a dry socket before, you may be more likely to experience it again. Make sure your dentist or oral surgeon is aware of your history with dry socket ahead of your planned tooth extraction.

Although your dentist can’t do anything to prevent it from occurring, keeping them in the loop will speed up the treatment process if a dry socket develops.

You’re also 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, the act of inhaling can 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. Ignoring your dentist’s instructions for at-home care or failing to practice good oral hygiene can cause a dry socket.

Diagnosis

How dry socket is diagnosed

If you experience extreme pain after having your tooth removed, it’s important to contact your dentist or surgeon right away. 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 other conditions. This includes bone infection (osteomyelitis) or the possibility that bone or roots are still present in the extraction site.

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Complications

Possible complications

Dry socket itself rarely results in complications, but if the condition is left untreated, complications are possible.

This includes:

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

How to treat dry socket

If you have a 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 from forming.

Your dentist may also pack the socket with gauze and a medicated gel to help numb the pain. They’ll provide you with instructions on how and when to remove it at home.

After removing your dressing, you’ll need to clean the socket again. Your dentist will likely recommend a salt water or prescription rinse.

If your dry socket is more severe, they’ll provide instructions on how and when to add a new dressing at home.

Over-the-counter pain medication can help relieve any discomfort. Your dentist will probably recommend a nonsteroidal anti-inflammatory pain reliever, such as ibuprofen (Motrin IB, Advil) or aspirin (Bufferin). A cold compress may also provide relief.

If your pain is more severe, they 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.

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Outlook

Outlook

You should start to experience symptom relief 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 five days, you should see 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 for developing dry socket again, so keep your dentist in the know. Letting them know that dry socket is a possibility with any tooth extraction can speed along potential treatment.

Prevention

How to prevent dry socket

You can reduce your risk for 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 their Yelp reviews, ask around about them — whatever you need to do to know that you’re in good hands.
  • After selecting a care provider, talk to 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.
  • Limit or avoid smoking before — and after — your extraction. This can increase your risk of dry socket. Talk to your dentist about management options, like the patch during this time. They may even be able to provide guidance about cessation.

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 solutions
  • medicated gauze
  • medicated gel

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

Keep reading: 5 Oral health warning signs »

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