Dry socket


 

Alternate Names

Alveolar osteitis; Alveolitis; Septic socket

Description

Dry socket is a complication of having a tooth pulled (tooth extraction). The socket is the hole in the bone where the tooth used to be. After a tooth is removed, a blood clot forms in the socket. This protects the bone and nerves underneath as it heals.

Dry socket occurs when the clot is lost or does not form well. The bone and nerves are exposed to the air. This causes pain and delays healing.

Risk Factors

You may be more at risk for dry socket if you:

  • Have poor oral health
  • Have a difficult tooth extraction
  • Use birth control pills, which may interfere with healing
  • Smoke or use tobacco, which slows healing
  • Do not take proper care of your mouth after having a tooth pulled
  • Have had dry socket in the past
  • Drink from a straw after the tooth is pulled
  • Rinse and spit a lot after the tooth is pulled

Symptoms

Symptoms of dry socket are:

  • Severe pain 1 to 3 days after the tooth is pulled
  • Pain that radiates from the socket to your ear, eye, temple, or neck on the same side that your tooth was pulled
  • An empty socket with a missing blood clot
  • Bad taste in your mouth
  • Bad breath or a terrible smell coming from your mouth
  • Slight fever

Treatment

Your dentist will treat the dry socket by:

  • Cleaning out the socket to flush out food or other materials
  • Filling the socket with a medicated dressing or paste
  • Having you come in often to have the dressing changed

Your dentist may also decide to:

  • Start you on antibiotics
  • Have you rinse with salt water or special mouthwash
  • Give you a prescription for pain medicine or irrigation solution

Self-Care for Dry Socket

To care for the dry socket at home:

  • Take pain medicine and antibiotics as directed
  • Apply a cold pack to the outside of your jaw
  • Carefully rinse the dry socket as directed by your dentist
  • If taking antibiotics, avoid smoking or using tobacco and alcohol

How to Prevent Dry Socket

Following your dentist's instructions for mouth care after having a tooth pulled may help prevent dry socket.

When to Call the Doctor

Call your dentist if you think you have:

  • Symptoms of dry socket
  • Increased pain or pain that does not respond to pain relievers
  • Worse breath or taste in your mouth (could be a sign of infection)

References

Buttaravoli P, Leffler SM. Dental pain, postextraction alveolar osteitis. In: Buttaravoli P, Leffler SM, eds. Minor Emergencies. 3rd ed. Philadelphia, PA: Elsevier Saunders; 2012:chap 47.

Daly B, Sharif MO, Newton T, Jones K, Worthington HV. Local interventions for the management of alveolar osteitis (dry socket). Cochrane Database Syst Rev. 2012 Dec 12;12:CD006968. PMID: 23235637.1. Available at: http://www.ncbi.nlm.nih.gov/pubmed/23235637.1.

Kolokythas, A., Olech, E., Miloro, M. Alveolar Osteitis: A comprehensive review of concepts and controversies. International Journal of Dentistry. 2010:1-10:PMCID: PMC2905714. Available at: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2905714/.

Review Date: 11/21/2014
Reviewed By: Ilona Fotek, DMD, MS, private practice in Palm Beach Gardens, FL. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.

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