Dry socket (alveolar osteitis) is a dental complication that sometimes occurs after a tooth extraction. It’s one of the more common side effects of getting a tooth pulled. However, it still only affects an estimated five out of 100 patients. The bad news is that this condition can be quite painful and cause lingering infection, discomfort and sensitivity. The good news is that it is usually preventable. When it does occur, it is readily treatable.

How Does Dry Socket Occur?

Your jawbone has a series of sockets or holes in which teeth sit. The tooth is not fused to the bone. Instead, it is held in the socket by a periodontal ligament (a specialized piece of gum tissue). When a tooth is extracted along with the connective tissue, the underlying bone is temporarily exposed. A blood clot quickly forms (within the first 24 hours) to cover up the bone and nerve endings. This clot keeps out infection and maintains a moist environment in the socket to aid healing. If the clot is dissolved or dislodged, the bone is exposed to the air again, resulting in dry socket. Anything you eat or drink can come into contact with the socket (along with oral bacteria). This causes irritation and inflammation in the socket.

Why Does Dry Socket Happen?

Alveolar osteitis has the highest rate of occurrence after complicated and extensive extractions (like impacted wisdom teeth). The most common cause of dry socket is improper post-procedure care. The blood clot in the extraction site can be easily damaged by actions such as drinking through a straw or repeated, vigorous rinsing of the extraction site. Other factors that can increase your risk of this complication include:

  • Smoking
  • Birth control pills that contain estrogen
  • Prior history of alveolar osteitis

What Are Dry Socket Symptoms?

Pain is the No. 1 indication that something is wrong. Unlike immediate post-procedure soreness, dry socket pain usually begins two or three days after oral surgery. It can be very intense and radiate into your jaw or up to your ear. You may be able to see the hole with the missing blood clot and exposed bone. Dry socket can also lead to a serious case of bad breath due to bacterial infection and rotting food stuck in the socket. If you have any of these symptoms, contact your dentist immediately. The sooner you get treatment, the sooner you can feel relief.

How Is Dry Socket Treated?

The first step of treatment is cleaning out the socket to get rid of any food or infectious debris. This is followed by medicated dressing to ease pain and keep the socket covered. Next, you may need pain medications (over the counter or prescription depending on the severity of your symptoms). You will receive detailed instructions on how to keep the socket clean until it is fully healed. This process may take a week or two depending on the severity of the infection. However, dry socket usually does heal completely with bone growing in to fill the socket and gum tissue covering the bone.