What is dry socket? And how to treat it
Tooth extractions are a relatively common surgery, and most people find they have no complications at all while healing.
That said, one complication that may occur is alveolar osteitis, also known as dry socket. Let’s talk about what dry socket would mean for you, symptoms, risk factors, and how to manage it at home.
In this guide:
What is dry socket?
When you go through tooth extraction surgery, it will temporarily leave your bone and nerves exposed. This is a bit of a risk, so to help protect the socket and heal the wound the body produces a blood clot in the hole. This covers the sensitive area, and stops the bleeding.
Alveolar osteitis, commonly known as dry socket, is when a blood clot fails to form over this tooth extraction site, falls out of the hole, or dissolves before the wound has a chance to heal.
What does dry socket look like?
A healthy tooth extraction site will likely have a noticeable blood clot at the bottom of it (assuming you can see into the socket – which may be difficult if it’s quite far back in the mouth!).
If the blood clot is missing, or especially if you notice something white at the bottom of the socket, you may be developing dry socket. That white colour could be exposed bone, which is cause for concern.
Other signs you may have complications due to dry socket include black, green or yellow discoloration – seeing these in or around the socket could mean you have an infection that must be taken care of as soon as possible.
How long does dry socket last?
Dry socket can last up to a week or two, causing pain, swelling, and putting your mouth at risk of infection. It usually develops within three or so days of having a tooth extracted and is more common in the lower jaw.
That said, normally you wouldn’t leave dry socket alone without visiting your dentist for a check-in. If you experience pain in the extraction site for more than a few days in a row, it’s probably safest to pop back in for a consultation and let us take a look.
Dry socket risk factors – who is likely to get it?
Dry socket can happen to anyone. However, these risk factors may increase the chance that it occurs:
Improper tooth extraction care at home: The guidelines you’ll receive for managing tooth extraction pain and dry socket are vital for ensuring the healthy formation of the blood clot.
Smoking: Cigarettes and other tobacco products can inhibit healing at the wound site. Additionally, the act of sucking may dislodge a newly formed blood clot.
Poor oral hygiene: Gum disease, infection and other complications from poor oral hygiene may increase the risk of dry socket.
Birth control: Oral contraceptives such as birth control have been known to contribute to disrupting the regular healing process.
History of dry socket: Those who have had dry socket after a tooth extraction before may be at a higher risk of developing it again.
Symptoms of dry socket
Pain and sensitivity is most common, radiating from the socket to your ear, eye, temple or neck.
Swelling around the socket
Unpleasant taste in the mouth
Slight fever
Bone and nerves visible.
10 tips for preventing dry socket
1. Talk to your dentist about your medications
Some common medications (such as birth control pills) can affect the body’s ability to form blood clots.
We highly recommend that, before you have any teeth extracted, you talk to your dentist about any prescriptions you’re taking so we can factor that into your treatment plan.
2. Try to limit smoking before and after the procedure
As described earlier, smoking is a major risk factor of dry socket – and gum disease in general. The chemicals can contaminate your exposed tooth extraction site and increase the risk of infection, in addition to slowing the healing process. The act of sucking may also dislodge your blood clot.
Consider avoiding smoking as much as possible before and after your surgery, or quit entirely.
Note: While chemicals differ between products, this advice applies to any kind of smoking – be it tobacco, marijuana, vaping, hookah, and so on.
For help quitting smoking, visit health.govt.nz
3. Don’t drink anything through a straw
Sucking increases your risk of dislodging the blood clot; the pressure that sucking puts on the mouth can pull the clot right out of the socket.
Avoid using a straw, or any other product requiring a sucking action, for about a week
4. Try not to spit
Spitting can put some of the same pressure on the mouth as sucking, again potentially dislodging your blood clot.
If you must spit, try to do so as gently as possible in those first few days, up to a week. To remove toothpaste from your mouth during this time period, try to gently push it out and let it drool rather than spit it.
Learn more: How to brush your teeth after wisdom tooth removal
5. Rinse based on your dentist’s advice
Your dentist will give you individualised advice on what mouthwash or rinse to try, and how often to use it. Generally speaking, you’ll be rinsing very gently for the first few days and will probably be asked to avoid rinsing near the extraction site in the first 24 hours.
6. Consider using warm salt water to rinse
Salt water is well-known in the dental community to help with inflammation and reduce the risk of infection. As a part of treating your extraction site at home, you can try rinsing gently with a warm salt water solution about twice a day – to promote healing and keep the site clean.
But how much salt to use? Half a teaspoon per cup of water is relatively common – you don’t want it to be too salty or it may be more irritating to the mouth than helpful!
7. Switch to soft foods for a few days
Hard foods can cause damage to the tooth extraction site and dislodge your blood clot, so for a few days you may wish to avoid them (imagine what a spikey nacho crisp might do to a sensitive hole in your mouth).
In the first 24 hours after surgery, try to consume only very soft foods – like soup and yoghurt. In the few days following you can diversify a bit, but still stay away from particularly hard or crunchy items like crisps and crackers, or granular food such as grains and nuts.
8. Avoid chewing near the extraction site
Chewing in the area of a fresh tooth extraction can also increase the risk of dry socket – food debris could bump a newly formed blood cut right out of the hole.
This may be particularly tricky if you’ve had a few teeth extracted at once. Try your best to avoid chewing in the area of each site as best you can, for at least a few days.
9. Feeling sore? Try a cold or hot pack
On your first day after surgery you may experience pain and swelling in the area of the extraction. Holding a cold press (for swelling) or hot press (for pain relief) to the outside of your face can help with some of these symptoms, although we would recommend asking your dentist about pain management tips before or after your surgery – they may also recommend anti-inflammatory pain medications like ibuprofen.
10. Avoid strenuous exercise for a few days
Rigorous sport and exercise is an activity that could put you at risk of developing dry socket by increasing the chance your blood clot will become dislodged.
Plan to rest for the remainder of your surgery day, to give your body a head start on healing. Then, in the few days that follow, avoid strenuous physical activities.
Thereafter you can start to wind back up again, although your dentist will be able to recommend an individual plan if sports and exercise are important to your daily life.
How to treat dry socket
What to do if you develop dry socket
While you can help prevent dry socket at home, if you believe you have developed the condition then it’s time to come back for a check-in with your dentist.
The site will need to be checked, cleaned, medicated and dressed. Call Kowhai Dental on 09 430 0707 or book an appointment online so we can help you.
What will my dentist do to treat dry socket?
Examine the socket to determine what’s happening, what’s causing your symptoms, and what needs to happen to fix it.
Clean the socket by irrigating it, either with sterile water or an antiseptic mouthwash.
Dress the open socket to protect the exposed bone and nerves while the body heals your gums.
6 tips for caring for dry socket at home
1. Take your medication
If your dentist prescribes any medication – for example, ibuprofen as mentioned earlier – make sure you read any instructions given to you and follow them closely.
2. Try a salt water rinse
Just as salt water can help with the prevention of dry socket, it can also help with the treatment. This is generally considered a good way to fight bacteria in the mouth and promote that healing we need.
Note: It’s also possible that your dentist will recommend a specific irrigation plan for your unique needs. This might include a salt water rinse, an antiseptic mouthwash, or perhaps just sterile water. They may even give you a special syringe to help you. In any of these cases, you would follow their advice over the advice of this article.
3. Use a cold or hot compress
As mentioned, cold can help with issues of swelling, while heat is useful for soothing pain.
You might start with a cold compress on the day of your dry socket treatment and then switch to heat after the first day or so.
4. Keep the area (and your mouth) clean
Keeping your mouth clean is vital to ensuring the safe healing of dry socket. Beyond rinsing with salt water or an antiseptic, brushing your teeth, tongue and gums properly, as well as flossing regularly, will help keep bacteria at bay.
Read more: How to clean your gums and keep them healthy
5. Stay hydrated
Drinking lots of water is very important when you’re trying to heal, as it can promote the healing process.
It’s also vital for someone on pain medications. Nausea is a common side effect of certain pain meds and anti-inflammatories, and one of the worst things that can happen to your mouth right now is vomiting.
Staying hydrated is a powerful way to mitigate the risk that you’ll feel nauseous from your meds.
Need to book a dentist appointment?
It pays to be safe when it comes to your oral health. If you’re ever unsure about your tooth extraction surgery, preventing dry socket or treating dry socket, we would highly recommend that you talk to a professional.
To book your appointment, call us on 09 430 0707, book online, or pop into our office at the heart of Whangarei.