Dental Dry Socket

ExitCare ImageAfter a tooth is pulled (extracted), blood fills up the hole (socket) where the tooth once was. This blood hardens (clots) and protects the bone and nerves underneath. Normally, gums completely grow over the top of the bones and nerves and close an open socket in about a week. After several months, the clot is replaced by bone that grows into the socket.

However, when blood does not fill up the extraction socket, or the blood clot is lost for some reason, a dry socket may form. This condition leaves the bone and nerves exposed to air, food, liquid, or anything else that enters the mouth. The gums cannot grow over the extraction socket because there is nothing to grow over, and the dry socket remains open.

CAUSES

  • Blood not filling up the extraction socket properly.

  • Anything that can dislodge a forming blood clot. Forceful spitting or sucking through a straw can pull a blood clot completely out of the socket and cause a dry socket.

  • Having a difficult extraction. The forceful pushing against the wall of the socket when the tooth is extracted causes the walls of the tooth socket to become crushed. This prevents bleeding into the socket because the blood vessels have been crushed closed.

  • Alcoholic drinks may dry out the blood clot and cause a dry socket.

  • Smoking can disturb blood clot formation and cause a dry socket.

Factors that put you at an increased risk for a dry socket include:

  • Having lower teeth extracted.

  • Being female.

  • Poor oral hygiene.

  • Taking birth control pills.

  • Having your wisdom teeth extracted.

SYMPTOMS

  • Severe, constant, dull throbbing pain. The pain generally begins 2 to 3 days after the tooth extraction. The pain may last about a week after it begins.

  • Bad smelling breath and bad taste in your mouth.

  • Ear pain.

HOME CARE INSTRUCTIONS

  • Follow your dentist's instructions.

  • Only take over-the-counter or prescription medicines for pain, discomfort, or fever as directed by your caregiver. If pain medication does not relieve the pain, you may need to see your dentist who can clean the socket and place a medicated dressing on the extraction to promote healing.

  • Take your antibiotics as told, if prescribed. Finish them even if you start to feel better.

  • Wait at least a day before rinsing with warm salt water to avoid possibly dissolving the new blood clot. When salt water rinsing, spit gently to avoid pressure on the clot.

  • Avoid carbonated beverages.

  • Avoid alcohol.

  • Avoid smoking for a few days after surgery.

Patients who have recently had oral surgery should avoid anything that may irritate the extraction socket or anything that may cause the blood clot inside the extraction socket from being dislodged. Carefully follow your instructions for after surgery care.

SEEK IMMEDIATE DENTAL CARE IF:

  • Your medicine does not relieve pain.

  • You have uncontrolled bleeding, marked swelling, or severe pain.

  • You develop a fever above 102° F (38.9° C), not controlled by medication.

  • You have difficulty swallowing or cannot open your mouth.

  • You have other severe symptoms.