Dry Socket

Symptoms and signs of dry socket include severe pain following tooth extraction, gray-colored tissue around the site of extraction, or lack of a blood clot at the site of extraction.

Dry socket symptoms generally occur within a few days of tooth extraction and are usually limited to the oral cavity. Oral symptoms of dry socket may come and go or may be continuous. These symptoms include:

• Bad breath or foul odor in the mouth

• Bleeding from the site of extraction

• Bone visible inside the site of extraction

• Dental abscess

• Gray or dead-looking tissue surrounding the extraction site

• Pain at the extraction site

• Unpleasant taste in the mouth

Left untreated, dry socket can result in more serious symptoms outside of the mouth. These symptoms include:

• Earache

• Pain in other parts of your head and face on the same side as the tooth extraction

• Swollen lymph nodes in the neck

Left untreated, dry socket can lead to a serious or life-threatening infection. Seek immediate medical care (call 911) if you, or someone you are with, have any of these serious symptoms including:

• Difficulty breathing

• Dizziness or vertigo

• Fever and chills

• Nausea, which may be described as feelings of wooziness, queasiness, retching, sea-sickness, car-sickness, or an upset stomach

• Severe swelling of the jaw

• Vomiting

After a tooth is extracted, a blood clot fills the hole left by the tooth. The normal healing process takes place underneath this clot. In the normal healing process, tissue regrowth replaces the blood clot. In some cases, the clot may come loose or dissolve, which exposes the tooth socket to the environment. In addition to causing severe pain, this exposure can slow down or reverse normal healing and lead to severe infections.

A number of factors increase the risk of developing dry socket. Not all people with risk factors will get dry socket. Risk factors for dry socket include:

• Diabetes
• Poor dental hygiene
• Smoking
• Tooth extraction
• Use of oral contraceptives

If you have a tooth extracted, it is important to follow the directions provided by your dentist or oral surgeon. Eating certain foods, including hard or sticky foods, can dislodge the protective clot.

You may be able to lower your risk of dry socket by:

• Avoiding hard or sticky foods after a tooth extraction
• Following your dentist’s recommendations after tooth extraction
• Maintaining good dental hygiene
• Not drinking from a straw or spitting excessively after a tooth extraction
• Rinsing with chlorhexidine solution following tooth extraction
  
• Stopping smoking prior to and for two weeks after tooth extraction

The treatment of dry socket begins with seeking care from your dentist. Dry socket can be diagnosed by a simple examination by your dentist, who will determine a treatment plan specifically for you.

Dry socket is typically treated with prescription pain-relieving medication, often in the form of medicated dressings that are applied to the teeth. Antibiotics may also be prescribed if an infection is present.

Examples of medical treatments for dry socket include:

• Antibiotics, such as penicillin or erythromycin

• Over-the-counter pain-relieving and fever-reducing medications, such as ibuprofen (Advil, Motrin) or acetaminophen (Tylenol)

• Prescription pain relievers or medicated dressings. These dressings may need to be changed every day for several days, either at home or by your dentist.

In addition to medical treatment, your dentist will inspect and clean the dry socket. If you are experiencing severe pain, a local anesthetic may be used. Getting prompt treatment and completing all the medication prescribed by your dentist are important in preventing complications or recurrence.

You should contact your dentist if you had a tooth extraction and think you may have a dry socket. Before seeing your health care provider, you may be able to reduce the discomfort associated with your dry socket by:

• Rinsing your mouth with warm salt water

• Taking over-the-counter pain relievers or pain relievers prescribed by your dentist or oral surgeon following extraction

• Using ice packs on the cheek next to the dry socket to decrease pain and swelling

Dry socket is usually not life threatening. However, left untreated, dry socket may lead to an abscess, potentially resulting in serious complications, including bone, heart or lung infections. Because of the potential for complications, it is important that you see your dentist or oral surgeon if you suspect dry socket after a tooth extraction.

You can help minimize your risk of serious complications by following the treatment plan you and your health care professional design specifically for you. Complications of dry socket are very rare but may include:

• Cellulitis (infection of the skin)

• Dental abscess

• Endocarditis (infection of the heart chambers or valves)

• Mediastinitis (infection of the area around the lungs and heart)

• Meningitis (infection or inflammation of the sac around the brain and spinal cord)

• Osteomyelitis (bone infection)

• Pneumonia

• Sepsis (life-threatening bacterial blood infection)

• Tooth loss