What Is a Dry Socket?

Dry socket is a condition that can occur after a tooth is pulled. It happens when the blood clot that forms over a socket—the hole in the bone where the tooth used to be—is lost or not properly formed in the first place. This leaves the bone and nerves exposed to the air, which can be very painful and slow down the healing process.

Causes of Dry Socket

Dry socket—also known as alveolar osteitis, alveolitis, and septic socket—is an oral condition that can happen to adults after they've had a tooth extracted. Following an extraction, a dentist typically:

• Cleans out the gum socket and smooths out the bone that is left
• Closes the gum with one or more stitches (also called sutures) if necessary
• Asks the patient to bite down on a damp piece of gauze to stop the bleeding

The hole in the bone where the tooth used to be is called a "socket," and typically, after a tooth is pulled, a blood clot forms in the socket to protect the bone and nerves underneath as it heals. But sometimes, the blood clot either becomes displaced or doesn't fully form at all, leaving the bone and nerves exposed in the socket. This is referred to as "dry socket," and is not only painful but also means that it will take longer for the socket to heal.

Dry socket typically occurs more often in the lower teeth, and is slightly more common in women than men, likely because of estrogen. Generally speaking, dentists don't know what causes someone to experience dry socket, though it is associated with the following risk factors:

• An especially difficult tooth extraction
• Poor oral hygiene
• Not following mouth care instructions after the tooth is removed
• Using tobacco products
• Taking oral contraceptives
• Drinking through a straw after the tooth is removed
• Smoking or using tobacco
• Having a dry socket in the past
• Rinsing and spitting too much after a tooth is removed

Symptoms of Dry Socket

Dry socket can cause more than pain. Here are some of the other potential symptoms of dry socket, as well as more information on the type of pain involved:

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

Diagnosis of Dry Socket

If a person is still experiencing severe pain three days after having a tooth removed, their dentist may require them to return to the office for a follow-up appointment. In most cases, when a person has dry socket, their dentist can tell simply by looking at the spot where their tooth used to be. Rarely, the dentist will take an X-ray of the socket to determine whether any tooth fragments were left behind following the extraction.

Treatment of Dry Socket

Once a dentist has confirmed that a patient has dry socket, they will likely do something immediately to help treat the condition, including:

• Cleaning out the socket to flush out food or other materials
• Filling the socket with a medicated dressing or paste
• Prescribing antibiotics if they suspect the socket is infected
• Prescribing pain medicine or an irrigation solution
• Having the patient come in regularly to have their dressing changed

The dentist will also recommend an at-home care regimen, including:

• Taking pain medicine and antibiotics as directed
• Applying a cold pack to the outside of the jaw
• Carefully rinsing the dry socket (typically with saltwater)
• Taking antibiotics as instructed
• Refraining from smoking and drinking alcohol
• Putting medicated gauze in the socket to help manage pain

In most cases and with proper care—including regular brushing and flossing—a dry socket typically heals within seven to 10 days. During that period, new issue forms and covers the exposed socket.

How to Prevent Dry Socket

Although there are a variety of factors that can make a person more prone to dry socket than others, there are a few ways to decrease some of the risk factors associated with the condition, including:

• Not smoking for at least three days following a tooth extraction
• Avoiding drinking carbonated or warm beverages following a tooth extraction
• Refraining from drinking through a straw following a tooth extraction
• Following all the instructions from a dentist after a tooth is removed

A Word From Verywell

Getting a tooth pulled is never pleasant, and ending up with dry socket makes it even worse. Following through on all the instructions from the dentist may seem tedious or overly cautious, but it's your best defense against dry socket and potential infections. Sure, everyone wants to get back to eating and drinking normally again, but that process will take much longer if you ignore the dentist's recommendations.