Dry socket (alveolar osteitis) is a painful dental condition that can occur after you have a permanent adult tooth extracted. Dry socket is the most common complication following tooth extractions, such as the removal of impacted wisdom teeth. If you develop dry socket, the pain usually begins three to four days after your tooth is removed.
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.
Dry socket occurs when the blood clot at the site of the tooth extraction has been dislodged or has dissolved before the wound has healed. 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.
Over-the-counter medications alone won't be enough to treat dry socket pain. Your dentist or oral surgeon can provide treatments to relieve your pain and promote healing.
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 several issues may be at play, including:
Severe pain following a tooth extraction is often enough for your dentist or oral surgeon to suspect dry socket. Your dentist or oral surgeon also will ask about any other symptoms and examine your mouth. He or she will check 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).
Your dentist or oral surgeon will take a number of steps to ensure proper healing of the socket and to prevent dry socket. You'll be instructed on steps you can take to prevent the complication.
Your dentist or oral surgeon may talk with you about these medications, which may help prevent dry socket:
You can take these steps to 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. These instructions will likely address the following issues, which can help prevent dry socket:
Dry socket rarely results in infection or serious complications. But getting the pain under control is a top priority. You can help promote healing and reduce symptoms during treatment of dry socket by following your dentist's instructions for self-care after your tooth extraction. You'll likely be told to:
Keep scheduled appointments with your dentist or oral surgeon for dressing changes and other care. If your pain returns or worsens before your next scheduled appointment, call your provider.
Factors that can increase your risk of developing dry socket include: