Dry socket (alveolar osteitis) is a painful dental condition that sometimes happens after you have a permanent adult tooth extracted. Dry socket is when the blood clot at the site of the tooth extraction fails to develop, or it dislodges or dissolves before the wound has healed.
Normally, a blood clot forms at the site of a tooth extraction. This blood clot serves as a protective layer over the underlying bone and nerve endings in the empty tooth socket. The clot also provides the foundation for the growth of new bone and for the development of soft tissue over the clot.
Exposure of the underlying bone and nerves results in intense pain, not only in the socket but also along the nerves radiating to the side of your face. The socket becomes inflamed and may fill with food debris, adding to the pain. If you develop dry socket, the pain usually begins one to three days after your tooth is removed.
Dry socket is the most common complication following tooth extractions, such as the removal of third molars (wisdom teeth). Over-the-counter medications alone won't be enough to treat dry socket pain. Your dentist or oral surgeon can offer treatments to relieve your pain.
Signs and symptoms of dry socket may include:
A certain degree of pain and discomfort is normal after a tooth extraction. However, you should be able to manage normal pain with the pain reliever prescribed by your dentist or oral surgeon, and the pain should lessen with time.
If you develop new or worsening pain in the days after your tooth extraction, contact your dentist or oral surgeon immediately.
The precise cause of dry socket remains the subject of study. Researchers suspect that certain issues may be involved, such as:
Severe pain following a tooth extraction is often enough for your dentist or oral surgeon to suspect dry socket. He or she will also ask about any other symptoms and examine your mouth to see if you have a blood clot in your tooth socket and whether you have exposed bone.
You may need to have X-rays taken of your mouth and teeth to rule out other conditions, such as a bone infection (osteomyelitis) or small fragments of root or bone remaining in the wound after surgery.
Painful, dry socket rarely results in infection or serious complications. However, potential complications may include delayed healing of or infection in the socket or progression to chronic bone infection (osteomyelitis).
You can take these steps to help prevent dry socket:
Your dentist or oral surgeon will take a number of steps to ensure proper healing of the socket and to prevent dry socket. These steps may include recommending one or more of these medications, which may help prevent dry socket:
You'll receive instructions about what to expect during the healing process after a tooth extraction and how to care for the wound. Proper at-home care after a tooth extraction helps promote healing and prevent damage to the wound. These instructions will likely address the following issues, which can help prevent dry socket:
You can help promote healing and reduce symptoms during treatment of dry socket by following your dentist's or oral surgeon's instructions for self-care. You'll likely be told to:
Factors that can increase your risk of developing dry socket include: