When you have a tooth removed, you develop a blood clot over the removal site to protect and heal your underlying bone and nerve endings. This clot should stay in place until your gums have healed and your mouth is back to normal.
Sometimes the clot can become dislodged. If that happens, you’ll experience the painful complication known as a dry socket, or alveolar osteitis. Dry socket is uncomfortable and delays healing. It’s important to try and avoid it.
The blood clot that forms after a tooth removal protects bone and nerve tissue. It also helps your gums heal, so you want it to stay in place until you’ve healed after surgery.
Dry socket usually occurs because something moves or dissolves the blood clot from the socket. Sometimes dry socket occurs when you never develop the blood clot to begin with.
Here are a few ways you can prevent dry socket:
1. Avoid straws
The suction movement of air and cheek muscles when you use a straw may dislodge your blood clot. You should avoid using straws for one week after your extraction.
2. Avoid smoking and tobacco
People who smoke and use tobacco are at a much higher risk of developing dry socket after tooth extraction. One study found that dry socket occurred in 12 percent of people who smoked after a tooth extraction. By comparison, only 4 percent of those who don’t smoke developed dry socket.
The fast inhalation of smoking can dislodge your blood clot. This applies to smoking anything at all, not just cigarettes. That’s because chemicals in other tobacco products may prevent healing and cause an infection.
Reduce your tobacco intake for a couple weeks leading up to a planned surgery. If you need help avoiding tobacco while you recover, or if you’d like to use your dental surgery as a way to kick-start a smoking cessation program, an app may help. Your dentist may also be able to provide resources or help you develop a plan to quit smoking.
If you’re not interested in quitting tobacco use, the following tips may help reduce your risk of dry socket:
- Switch to a nicotine patch.
- Wait at least 48 hours after your surgery before smoking. When you resume smoking, inhale very gently.
- Ask your dentist for stitches on your surgery site.
- Keep gauze in place over your socket while smoking.
- Avoid nicotine gum or chewing tobacco.
- When you’d normally smoke, distract yourself with a new habit.
If you plan to resume tobacco use after your surgery, ask your dentist or oral surgeon when you’re allowed to start.
3. Soft food
The first day after your surgery, eat only soft foods like applesauce, yogurt, and mashed potatoes. On the second day you can attempt slightly heartier foods but you should return to soft foods if you experience any pain.
Avoid soup, which might cause sucking that may dislodge the blood clot. Also avoid nuts, seeds, crunchy foods such as chips, and sticky foods which might get stuck in your socket.
4. Ask about medication interactions
Some studies show a link between dry socket and oral contraceptives. Ask your dentist if you’re at risk. Other medications may prevent a proper blood clot from forming.
5. Proper oral hygiene
Keeping your mouth clean is one of the most important ways you can prevent dry socket. Oral hygiene helps prevent germs and infection from breaking down the blood clot.
Ask your dentist how to brush your teeth following surgery. They might suggest you simply rinse your mouth the first day and then brush very gently the second day.
It’s possible you may be prescribed an antibacterial mouthwash to use after surgery. Use gauze pads only as directed by your doctor.
Follow your doctor’s instructions on proper oral care after surgery in order to improve your recovery. Most people feel a lot better three days after surgery and totally healed within a week.
Tips for tooth extraction aftercare include:
- Keep your mouth clean with a saltwater rinse a few times a day.
- Brush teeth very gently.
- Drink plenty of fluids.
- Avoid food, beverages, and activities that threaten your blood clot.
- Rest from strenuous work as long as possible.
- Treat swelling externally by holding an ice pack to your cheek.
Normal discomfort following tooth removal surgery can include swelling and soreness. It should be manageable with over-the-counter painkillers and be totally gone three days after surgery.
If your pain gets worse, you might have dry socket. Since dry socket exposes bone and nerve tissue, the pain may be searing or cold-like nerve pain.
Symptoms of dry socket include:
- intense pain a few days after surgery
- visibly empty socket with missing or partially missing blood clot
- pain that radiates from the socket into the rest of your face and head
- bad breath or foul odor in your mouth
- visible bone in the socket
If you suspect you have dry socket or experience intense pain after oral surgery, call your dentist immediately. Even after office hours, many doctors have a service that will page an on-call dentist.
Dry socket is treatable. Your doctor may rinse out the socket, apply medication, and prescribe painkillers. After seeing your doctor, you should feel better almost right away and continue to improve over the next few days.
You can resume normal activities once your mouth and dry socket have completely healed. Healing times vary greatly but most people feel recovered after one week.