Dry socket is a condition that can occur after tooth removal. It usually happens 3–5 days after surgery. Dry socket causes intense pain because it exposes the nerves and bones in the gum.

Dry socket, or alveolar osteitis, can last for up to 7 days. It is a common complication of wisdom tooth extraction. If food particles enter the socket, they can exacerbate the pain, increase the risk of infection, and slow down the healing.

Following a tooth extraction, a blood clot usually develops over the extraction site to protect the bones and nerves underneath. In cases of dry socket, this blood clot fails to form, or it falls off before the wound heals.

In this article, we list treatments for dry socket and possible methods of prevention.

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Dry socket pain can last 24–72 hours.

According to the Canadian Dental Association, dry socket typically occurs within 3–5 days of the extraction and lasts for up to 7 days.

The pain is severe and can persist for 24–72 hours. The research recommends that further investigation takes place if pain continues beyond this timeframe.

Dry socket is not very common. Columbia University College of Dental Medicine estimate that it occurs in approximately 2–5% of cases of tooth removal.

If symptoms do not appear within a few days of the extraction, it is unlikely that a person will develop a dry socket. A review in the International Journal of Dentistry indicates that people report 95–100% of all cases within a week.

Over-the-counter (OTC) or home remedies are not often enough to treat the pain of dry socket. People with the condition must usually see their dentist for treatment.

Sometimes multiple dental visits are necessary. Research into the condition suggests that approximately 45% of people with dry socket need to see their dentist several times to manage the condition.

The pain should begin to reduce following treatment and should go away within a few days. If not, a dentist may do further investigations to rule out complications.

Treatments for dry socket include:

Flushing the socket

The dentist will flush out the socket with a saline solution or other fluid that helps clean wounds. This will remove food particles or germs that may be causing pain or infection.

Gauze application

Packing the socket with a medicated gauze dressing can provide fast pain relief.

Depending on the severity of the symptoms, it may be necessary to change the dressing several times.

Medication

It is essential to manage the pain until the dry socket heals. Many people will require prescription medication to provide enough pain relief. If symptoms are mild, OTC painkillers may work.

People should discuss the available pain relief options with their dentist.

Antibiotic medication may be necessary if an infection develops in the socket and begins to spread to other areas of the mouth.

Signs of an infection include:

  • discharge from the socket
  • swelling and redness around the extraction site
  • fever and chills
  • malaise, or generally feeling unwell

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Brushing gently around the dry socket can help prevent irritation.

In addition to dental treatment, home remedies can provide further relief. Self-care and home remedies include:

  • Flushing the socket: It may be helpful to regularly flush the socket with a saltwater solution until it heals. A dentist can provide a plastic syringe and instructions on how to do this.
  • Brushing gently: People can carefully clean the teeth around the dry socket to avoid irritation to the gums.
  • Avoiding smoking or tobacco use: Smoking slows down healing following a tooth extraction or other dental surgery.
  • Choosing foods and beverages carefully: People should avoid anything that will irritate the dry socket, including spicy or acidic foods and carbonated drinks.
  • Applying a hot or cold compress. People can place a hot or cold pack against their face to reduce swelling and pain in the area. For the first 24 hours after surgery, they should use a cold compress to bring down inflammation. After this time, heat may provide better pain relief.

Certain steps can help people to reduce their risk of developing a dry socket. Tips for prevention include:

Quitting smoking or avoiding tobacco use

Dentists recommend this before as well as after the extraction. Some research found that a dry socket occurred in 12% of smokers but only 4% of nonsmokers.

Discussing medication use with a dentist

Some OTC or prescription medications may reduce blood clotting. Others, such as oral contraceptives, can affect the healing process and increase the risk of dry socket.

Choosing food and beverages carefully after surgery

It can be helpful to drink plenty of water after a tooth extraction. Eating soft foods for the first 24 hours can also reduce the risk of irritating the extraction site.

People should avoid alcohol, caffeine, or carbonated drinks. They should also avoid using a straw, as these can dislodge a blood clot in the socket.

Resting after surgery

People should follow the dentist's instructions on when to rest and when to resume normal activities and exercises.

Following home care guidelines carefully

Poor oral hygiene or failure to look after the wound after having an extraction can increase dry socket risk.

Similarly, the development of a gum infection can increase the chances. Proper dental hygiene reduces the likelihood of a gum infection.

How a dentist can help prevent dry socket

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A dentist can prescribe antibiotics to help prevent dry socket.

A dentist can also take steps to prevent dry socket. Examples include:

Prescribing oral antibiotics before the procedure

Some research suggests that antibiotics significantly reduce the risk of a dry socket in molar extractions. However, the use of antibiotics as a preventive measure is controversial.

Nonetheless, they may be necessary for some people, such as those with a compromised immune system.

Using antibacterial agents

Using an antibacterial mouthwash or gel before and after surgery can reduce the risk of dry socket.

Similarly, applying an antiseptic solution or dressing after surgery may help.

A dry socket is a relatively uncommon complication of tooth extraction. When it does occur, it can be extremely painful. However, a dentist can treat the condition to reduce pain and prevent complications, such as infection.

With treatment, dry socket typically only lasts a few days. During this time, home care strategies can help people to alleviate discomfort and encourage healing.