Dry Socket: Symptoms, Causes & Treatment

A complication to occurs after a tooth extraction is known as dry socket or alveolar osteitis. After the tooth extraction, post-surgical pain decreases with time. However, if you experience intense throbbing pain, it can be a sign of delay in the healing process. Knowing dry socket symptoms, causes, preventions, and treatments can better prepare you for this scenario after tooth extraction.

A dry socket only occurs on the removal of a permanent tooth. Normally, after tooth extraction, a blood clot forms to stop the bleeding while decreasing the risk of infection. However, some instances can dislodge the blood clot, leaving the nerves and the jawbone underneath exposed. Using at-home treatments can help you temporarily relieve the symptoms, but for a full treatment, you need to see your dentist or oral surgeon. So, let’s learn more about dry sockets.

What Is a Dry Socket?

When the plug of a blood clot partially or completely dissolves or dislodges, the socket of the extracted tooth is left dry and empty. A complication in the extraction process, as happens in the case of impacted wisdom teeth, increases the incidence of dry socket. It can develop in both the lower and upper jawbone. However, certain teeth in the mouth are more susceptible to this condition.

One study showed that teeth in the lower jawbone (mandibular teeth) were more prone to developing this condition than teeth in the upper jawbone (maxillary teeth). Moreover, the researchers found that it was more common in the teeth found at the back of the mouth (molars). It can result from poor oral hygiene, and women tend to develop dry socket symptoms more than men.

If you’ve had more than one tooth extracted, you can develop dry socket symptoms at multiple sites. However, one study published in the Open Dentistry Journal showed that patients who had single extractions had a higher incidence of dry sockets than those with multiple teeth removed.

What Causes Dry Socket?

An empty tooth socket can result from different causes. However, it always begins with the dislodging of the blood clot. Possible causes include:

Bacterial Infection

It may develop as a result of bacterial infection, which can occur when food/liquid particles get stuck in the socket. A dry socket is especially more vulnerable to infection if you have an existing oral infection at the time of tooth extraction.


In one study, where 805 patients had undergone 1305 extractions, the incidence of dry socket was higher in smokers than non-smokers. There was a strong correlation between smoking and the occurrence of dry sockets.

It may happen because of the constriction of the blood vessels from smoking. Poor blood circulation doesn’t allow the formation of a blood clot. Another way that it can cause a dry socket is that when you suck in the cigarette smoke, the motion can also end up removing the blood clot, leaving an empty socket.

Physical Trauma

This can result from different things. If you try eating foods that are too hard, it can poke at the blood clot and displace it. In fact, according to the American Dental Association (ADA), you should chew from the opposite side of the mouth after tooth extraction. ADA also recommends not rinsing the mouth aggressively or sucking in anything through the mouth like using a straw as it can also disturb the blood clot.

Similarly, if you brush or floss the wound site, you’re risking a dry socket. Keep the toothbrush away as it might accidentally slip into the area. Also, keep your fingers and tongue away from it.

How Common is Dry Socket?

A patient is likely to get a dry socket after tooth extraction, but the likelihood of that happening is around 2-5%. The risk of developing a dry socket is more with the removal of mandibular molars. According to a study published in the International Journal of Dentistry in 2014, 1,182 patients had 1,362 extractions, of which dry socket developed only in 1.4% of cases.

What Are Dry Socket Symptoms?

While healing, the tooth extraction site will have a granulation tissue form on it, which is whitish in appearance since it’s made from white blood cells, collagen and blood vessels. Now, the dry socket also appears white, but it’s because of the exposure of the jawbone underneath. So, keep in mind, that one’s a side of healing while the other isn’t. Other dry socket symptoms will help you know if this is the problem you’re suffering from. These are as follows:

  • Throbbing, worsening pain in the socket,
  • Visible bone (white appearance),
  • Foul taste in the mouth,
  • Bad breath.

How Long After Tooth Extraction Can You Get Dry Socket?

Most people experience dry socket pain 2 days after tooth removal. Its symptoms can develop in the 3-5 days following surgery. To avoid this complication, be sure to follow your dentist’s aftercare instructions.

How To Treat Dry Socket?

If you’re unable to immediately visit your dentist, you can do some things at home to temporarily relieve the pain. First and foremost, you can rinse your mouth with salt water to make sure that food particles or debris aren’t stuck in the socket.

Usually, patients use cold compresses after the tooth extraction for pain management and swelling. However, you can also use it to reduce dry socket pain. Other than that, you can try using clove oil, which has eugenol, a natural anaesthetic for pain. Moreover, it acts as an antiseptic. You can use a cotton swab or gauze for its application.

Once at the clinic, the dentist will first clean the socket for any debris particles. Next, s/he will cover it with a medicated dressing to relieve pain. You will have to change the dressing regularly. Meanwhile, to decrease the risk of infection, you may need to use mouthwash and take antibiotics. The dentist may also prescribe you painkillers.

It is important to note that the patient should get the dry socket treated early on. That’s because the infection can also end up spreading to the jawbone. The nerves in the area radiate severe pain to the whole side of the face.

How Long Does Dry Socket Last?

Normally, it takes 7-10 days to recover from a dry socket. However, if you don’t follow the instructions of the dentist, you can delay the healing process. For instance, the dentist will advise you against smoking. If you don’t, it will take longer to heal. The age of the person and other lifestyle habits can also affect the healing time.

Who is More Likely to Have Dry Socket After Tooth Extraction?

The following instances increase the risk of dry socket after tooth extraction:

  • As mentioned above, smokers are at a greater risk of developing dry sockets. It is due to the chemicals in the smoke and fast inhalation.
  • If you don’t have good oral hygiene, you’re more likely to develop a dry socket in the week after the surgery. Make sure you keep your mouth clean.
  • A study published in the Journal of the American Dental Association in 1980 showed that the incidence of dry sockets in the third molars in the lower jaw was higher among women who took oral contraceptives. This may be a result of the high levels of estrogen, which can delay wound healing.
  • If you have gingivitis or periodontitis, the risk of bacterial contamination of the socket increases.
  • The likelihood of developing dry socket symptoms in the future is also high if you have previously experienced a dry socket.
  • More traumatic tooth extraction can also result in a dry socket. The risk is higher among patients who are older than 30 because of poor vascular ageing.

How To Prevent Dry Socket After Tooth Extraction?

To avoid developing dry socket symptoms, you can consider doing the following things:

  • Don’t eat hard, crunchy foods like nuts, carrots, apples, and hard sweets. Eat only soft foods for a few days.
  • Avoid beverages that are too hot, like coffee and tea. Moreover, you also shouldn’t drink any acidic colas.
  • Use an antiseptic mouthwash.
  • Make sure to brush and floss while avoiding the surgical site, and do not rinse vigorously.
  • Do not use straws or do anything with your mouth that involves a sucking motion.
  • Avoid smoking for at least 5 days after the tooth extraction. When you do resume, make sure you inhale the smoke very gently.


A dry socket is a painful condition that develops after the extraction of a permanent tooth. It is more common in the molars in the lower jaw. Dry socket occurs for different reasons that dislodge the blood clot in the extraction site. If you experience any dry socket symptoms, you must contact your dentist right away. After that, make sure that you do as the oral surgeon says to ensure proper healing.

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