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Dry Socket


What is a Dry Socket?

Dry socket is the colloquial term used for the complication that can come as a result of the extraction of a tooth during a dental procedure. The specific medical term for the condition is known as alveolar osteitis. Dry socket is brought about by the loss of the blood clot that had previously formed or was expected to have formed over the site of extraction. The absence of a clot over the injured area exposes the underlying layers of gum tissue, bone, and sensitive nerve endings to air, food, and fluids, causing pain and discomfort and slowing down the healing of the open wound. The accumulation of food particles in the socket can also result in a foul odor. A dry socket can occur after about 2 days following the tooth extraction, and the socket can persist for around 5 days to a week.


The signs and symptoms that precede a dry socket are similar to those experienced after any routine dental procedure. This will involve a certain amount of discomfort and some pain in and around the site of the extraction. Over a day or two, the discomfort is gradually relieved as the injured tissue heals and closes up due to the formation of the clot in the hollowed out area. However, once the clot dissolves or is dislodged, the patient will notice a return of the pain and discomfort accompanied with increased intensity. The following are the specific signs and symptoms associated with a dry socket:

  • Pain that is increased after 2 – 5 days following the extraction. The pain is usually a throbbing sensation and can be localized to the site but may also radiate to the immediately surrounding regions of the mouth, as well as to the ear located on the same side of the extraction.
  • Un inspection, the tooth socket will be observably empty and hollow. Bone may also be visible at the base of the socket.
  • The socket may be covered with a grayish coating indicative of necrotized tissue and food debris may be visible inside the socket
  • Gums surrounding the site of extraction are reddened and inflamed
  • Foul odor can be observed to be originating from the site of extraction
  • Unpleasant taste in the mouth
  • Enlarged and tender lymph nodes of the jaw and neck


A dry socket results when the clot that initially formed within the hollowed-out tooth cavity is dislodged or dissolved. The blood clot, called granulation tissue, may also have failed to grow or its development may have been interrupted by certain factors. The blood clot is vital for the healing and growth of new tissue inside the socket, it is necessary for the formation of new gum tissue and bone thus its loss delays the healing process. These circumstances leave the socket unprotected and uncovered, exposing the sensitive layers of tissue, bone, and nerve endings underneath.

Certain conditions can render a person more susceptible to developing a dry socket after undergoing a dental extraction. Most of the individuals who have had dry sockets were not able to follow the physician’s postoperative advice, such as applying firm pressure over the site of the extraction to help prevent blood loss and promote clot formation. In addition, once a clot has formed, the patient is advised beforehand to refrain from engaging in any activities that could damage or disrupt the clot. For instance, dentists clearly advise against sucking on a straw or smoking after the procedure to help protect the integrity of the clot. The patient should also remember not to subject himself to physical stress and should also avoid drinking any hot beverages. Patients who are unable to follow these pieces of advice usually end up developing a dry socket.

Smoking after having a tooth extracted can cause dry sockets for a number of reasons. The presence of the carbon monoxide by-product of cigarettes in the bloodstream interferes with proper blood circulation and consequently, proper healing of injured tissue. In addition, the sucking action a smoker uses can dislodge the clot.

Women who take oral contraceptives are also more prone to developing dry sockets. The extra amount of estrogen included in birth control pills promotes the disintegration of clot formations since estrogen can trigger the fibrinolysis that dissolves blood clots.


The pain that results from alveolar osteitis can persist for about 1 to 4 days and will eventually improve and heal on its own. No specific treatment addresses the dry socket itself but certain medications help relieve the uncomfortable symptoms. The dentists can use a medicated dressing and place this onto the site of the extraction. The site is initially washed out gently to loosen or get rid of any food debris that may have gotten stuck inside the socket. Gauze coated in medication is then applied directly onto the tooth socket to provide the injury with a supply of sedative medication to ease the pain. Pain relief is usually immediate. These sedative dressings contain components that ease pain and discomfort; some of its ingredients include zinc oxide, aspirin, and oil of cloves. The patient can also take some over-the-counter analgesics to provide additional relief for intense pain.

After the dentist is able to apply the medicated dressing, the patient will be advised on self-care activities that he or she can carry out to flush the socket while at home. A plastic syringe is given to patients in order to be able to do this, the syringe is then used to administer some water or a prescribed rinsing fluid into the socket in order to promote healing and dislodge any food debris.

Home Remedies

The major problem with dry sockets is the intense pain that can be felt. Patients can take steps at home to help with the pain. Pressing cold ice packs against the face on the affected side can numb the pain as well as decrease the swelling. The patient must also ensure that he or she is properly hydrated especially if he is taking any pain medications. Gently rinsing the mouth out with warm salt water is also advised. The patient must remember to avoid any activities that could further harm the tooth socket such as smoking and drinking alcoholic beverages.

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