You’re at risk of developing dry socket after a tooth extraction. The clinical term for dry socket is alveolar osteitis. Dry socket can last from 7 to 10 days.

After tooth extraction, a blood clot usually forms at the site to heal and protect it. With dry socket, that clot either dislodged, dissolved too early, or it never formed in the first place. So, dry socket leaves the bone, tissue, and nerve endings exposed.

Dry socket is painful. Food particles or debris can get stuck down in the extraction site. This can delay the healing process or lead to infection.

Dry socket isn’t very common, but certain things can put you at increased risk. You’re mostly at risk of dry socket during the first week after tooth extraction.

Up to 5 percent of people get dry socket after a tooth extraction, estimates Columbia University. During normal recovery, your pain should steadily decrease over time. But instead of getting better, pain from dry socket will get worse over time.

Dry socket pain usually starts a day or a few days after surgery. If you’ve made it about a week after surgery and your mouth is mostly healed, then chances are you won’t get dry socket.

Dry socket must be treated by a dentist. This means you’ll need to make a return trip to your dentist’s office after your surgery. Your dentist will clean and medicate the site to help it heal. They’ll also likely recommend over-the-counter or prescription painkillers.

Treatment includes:

  • Cleaning the site. Sometimes food or debris get stuck down in the empty hole.
  • Medicated gauze. This should immediately relieve some pain. Your dentist will provide directions for cleaning and replacing the gauze at home.
  • Painkillers.

A possible complication of dry socket is delayed healing. Infections may occur but aren’t strictly linked to dry socket. If you have any sign of infection, call your doctor immediately.

Signs of infection include:

  • fever and chills
  • swelling
  • redness
  • pus or discharge from the extraction site

Doctors don’t yet know of a direct cause of dry socket. It can be hard to guess who might experience it. However, it’s more likely to happen to certain people and under certain conditions.

You’re most at risk of developing dry socket if you:

Every case of dry socket is different. Only your dentist or oral surgeon can tell you your personal risk factors for dry socket. Only work with a board-certified dentist to ensure that you receive top-quality dental treatments.

To prevent dry socket, it’s very important that you follow your dentist’s instructions for recovery.

After tooth extraction:

  • Don’t smoke for one week after surgery.
  • Don’t drink hot or acidic beverages that may dissolve the blood clot, such as coffee, soda, or juice.
  • Avoid injury to the mouth during recovery.
  • Avoid consuming food that may get stuck in the site, such as nuts, seeds, or gum.
  • Don’t suck on a straw or spoon for one week after surgery.
  • Avoid birth control pills if you can. Talk with your doctor and plan ahead to find a replacement birth control while you recover.

Some studies found that rinsing with a chlorhexidine gluconate rinse before and after tooth extraction decreased risk of dry socket. Using chlorhexidine gluconate gel in the socket after extraction also decreased the risk of dry socket.

The main symptoms of dry socket are increased pain and odor in the mouth. Usually, pain and swelling after a tooth extraction get better over the course of a week. With dry socket, pain begins a few days after surgery and gets significantly worse.

The pain may feel like it covers the whole side of your mouth or face. You may be extra sensitive to cold drinks since soft tissues and nerve endings are exposed.

Call your dentist if you suspect dry socket. They can determine the next steps to help you recover.

Dry socket is one of the most common complications to follow tooth extraction, though it’s still rare. Doctors don’t know exactly why it happens.

Dry socket pain feels different than the usual soreness after surgery recovery. Your dentist can help the wound heal and keep pain manageable.