Dental Health
Dental Conditions
ByKathi Valeii
Updated on May 01, 2024
Medically reviewed byEdmund Khoo, DDS
Table of Contents
View All
Table of Contents
Symptoms
How Much Pain Is Normal?
Risk Factors
Pain Relief
Healing Time
Dry socket, clinically called alveolar osteitis, is a healing complication that occurs after tooth extraction, often with wisdom teeth removal. Poor oral hygiene can place you at greater risk of dry socket. Food particles that get stuck in your extraction site and not cleaned out can dislodge the blood clot that protects the site.
Lots of other things contribute to developing the condition, including drinking through a straw, smoking, and rinsing and spitting too much after your dental procedure. Those activities can dislodge the blood clot over your extraction site.
This article explains how to differentiate dry socket pain from expected oral pain after tooth extraction, how to find pain relief, and expected healing time.
:max_bytes(150000):strip_icc()/what-is-a-dry-socket-5092288_final-8cc02f167b0741c998fd1ee2832d31f6.jpg "Dry Socket: How to Tell, Pain Symptoms, Healing (1)")
Dry Socket and Mouth Pain: Understanding Symptoms
Dry socket is a distinct kind of pain that follows dental extraction. Early stage dry socket usually begins one to three days after your tooth has been pulled.
Dry socket symptoms include:
- Severe pain in the first few days after an extraction
- Pain that radiates from the extraction site outward toward your ear, eye, or neck
- A visibly missing blood clot
- A bad taste in your mouth
- Bad breath
- Low fever
When the blood clot over your extraction site is no longer there, it exposes bone and nerves and causes pain.
A Word From Verywell
Dry socket can be a very painful and unpleasant experience. Fortunately, it is predictably treatable, and further complications are rare.
— EDMUND KHOO, DDS, MEDICAL REVIEW BOARD
:max_bytes(150000):strip_icc()/EdmundKhoo-8dcd86634a0f42bab8f3320b0b0bd8c4.png "Dry Socket: How to Tell, Pain Symptoms, Healing (2)")
How Much Pain After a Tooth Pull Is Normal?
Dry socket is common in about 1% to 5% of all extractions and up to 38% of wisdom tooth extractions. So, it is important to understand how to identify the pain.
Some pain is expected and normal after a tooth extraction. Since pain is expected, it can sometimes be difficult to differentiate normal extraction from dry socket pain. Normal healing pain is not severe, responds to pain meds, and improves with time.
| Dry Socket Pain | Extraction Pain |
| Severe | Mild to moderate |
| Radiates outward | Isolated to mouth |
| Not responsive to pain meds | Pain meds help |
| May be accompanied by bad breath and taste | Not associated with bad breath or taste |
| Pain gets worse each day | Pain improves over time |
As long as you have an open wound, you are at risk of developing a dry socket. Once the site is healed, dry sockets are no longer a risk. Extraction sites usually take a week to 10 days to fully close.
Risks of Dry Socket After a Dental Procedure
Dry socket after wisdom teethor other dental extraction is caused by a dislodged blood clot. Not everyone loses a blood clot, leading to dry socket, but some things may increase the risk of developing dry socket.
Risk factors include:
- Smoking
- Traumatic extraction
- Using vasoconstrictor (epinephrine, often used in local anesthetics)
- The amount of anesthesia administered
- Pre-existing infections
- Not following post-surgical instructions
- Poor oral hygiene
- Diabetes
- Chemotherapy
- Anti-inflammatory drugs
- Age (older studies have found a peak incidence at 18 to 33 years)
- Sex (higher in females than males)
- Use of oral contraceptives (birth control pills)
A Note on Gender and Sex Terminology
Verywell Health acknowledges thatsex and genderare related concepts, but they are not the same. To accurately reflect our sources, this article uses terms like “female,” “male,” “woman,” and “man” as the sources use them.
Dry Socket Pain Relief
Managing dry socket pain includes dental care and at-home care measures.
Dental Care
Your dentist will treat dry socket in the following ways:
- Flushing food or other materials out of the socket
- Packing the socket with a medicated dressing
- Repacking the dressing at multiple visits
They may also prescribe a more powerful pain medicine. However, often, once the site is packed with a medicated dressing, your pain will reduce significantly. They may also prescribe antibiotics if they feel you could be at risk of developing a bacterial infection.
At-Home Measures
Your dentist will also advise you to care for dry socket at home, which usually includes the following:
- Applying a cold pack to your jaw
- Rinsing the dry socket with a saltwater solution
- Avoiding smoking, tobacco, and alcohol
It is critical to follow your dentist's instructions to the letter. Doing so will help prevent complications and help you heal more quickly.
An Overview of Pain Management
Dry Socket Healing Time
Fortunately, dry socket pain doesn't last long. Once treatment begins, dry socket pain usually resolves within a few days. However, the speed at which you heal may vary depending on some factors.
For example, one small study found that 73% of those who received the antibiotic Cipro (ciprofloxacin) were completely relieved of symptoms within 24 hours without the need for additional painkillers or non-steroidal anti-inflammatory drugs (NSAIDs).
Dry socket can heal on its own. However, since the pain is severe, it's important to see a dentist for help managing pain. That's the fastest way to heal dry socket and find pain relief.
Dental Hygiene Tips With Dry Socket
If you develop a dry socket, oral hygiene is extra important. You need to keep the open wound clean and irrigated to remove food and other debris. Excellent oral hygiene may help prevent infection and limit the pain you experience.
Here are some tips for oral hygiene practices if you have dry socket:
- Brush gently around the extraction site
- Rinse your mouth with warm saltwater a few times a day
- If your dentist instructed you to rinse your wound, follow their instructions in doing so
- Avoid smoking
- Avoid straw use
- Avoid chewy, hard, or sticky foods
Oral and Maxillofacial Surgery: Everything You Need to Know
Is Dry Socket Preventable?
After a tooth extraction, an oral surgeon will send you home with a list of instructions. These instructions will reduce your likelihood of developing an infection and dry socket, so it's essential to follow them exactly.
Researchers have found that the greatest risk of developing dry socket is having had it before. It is also more common in the mandible (teeth extracted from the lower jaw), with the highest incidence following lower wisdom teeth extraction.
Oral surgery recovery guidelines aimed at preventing dry socket include:
- Avoiding straws
- Sticking to soft foods and steering clear of hard, crunchy, and sticky foods
- Maintaining good oral hygiene, including carefully brushing your teeth around the extraction site
- Rinsing your mouth with a saltwater solution, carefully avoiding excessive spitting
- Avoiding smoking and tobacco
- Avoiding alcohol and carbonated beverages
- Getting enough rest
Dry socket isn't always preventable. Some people are more prone to developing dry socket. However, following prevention strategies can reduce the risk.
Summary
Dry socket is common after teeth extraction, especially after wisdom teeth removal in the lower jaw. Good oral hygiene before and after your procedure can reduce your risk of developing this painful condition.
If you do develop dry socket, seeing your oral surgeon right away can help. They will pack your wound with medicated gauze, which usually results in immediate relief. Follow your oral surgeon's instructions to speed healing and experience less pain.
8 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
MedlinePlus. Dry socket.
Mamoun J. Dry socket etiology, diagnosis, and clinical treatment techniques.J Korean Assoc Oral Maxillofac Surg. 2018;44(2):52-58. doi:10.5125/jkaoms.2018.44.2.52
Khalil W. A new approach for explaining and treating dry sockets: a pilot retrospective study.Cureus. 2023;15(7):e41347. doi:10.7759/cureus.41347
Tanaka K, Kudo K, Ambe K, Kawaai H, Yamazaki S. A histological study of vasoconstriction by local anesthetics in mandible.Anesth Prog. 2018;65(4):244-248. doi:10.2344/anpr-65-03-15
Abu Younis MH, Abu Hantash RO. Dry socket: frequency, clinical picture, and risk factors in a Palestinian dental teaching center.Open Dent J. 2011;5:7-12. doi:10.2174/1874210601105010007
Bienek DR, Filliben JJ. Risk assessment and sensitivity meta-analysis of alveolar osteitis occurrence in oral contraceptive users. J Am Dent Assoc. 2016;147(6):394-404. doi:10.1016/j.adaj.2016.01.011
Khalil W. A new approach for explaining and treating dry sockets: a pilot retrospective study.Cureus. 2023;15(7):e41347. doi:10.7759/cureus.41347
Taberner-Vallverdú M, Camps-Font O, Gay-Escoda C, Sánchez-Garcés MA. Previous dry socket as a risk factor for alveolar osteitis: a nested case-control study in primary healthcare services.J Clin Exp Dent. 2022;14(6):e479-e485. doi:10.4317/jced.59586
:max_bytes(150000):strip_icc()/Valeiiheadshot2-832258dfafd64123820042937456110e.jpg "Dry Socket: How to Tell, Pain Symptoms, Healing (3)")
By Kathi Valeii
Valeii is a Michigan-based freelance writer with a bachelor's degree in communication from Purdue Global.
See Our Editorial Process
Meet Our Medical Expert Board
Was this page helpful?
Thanks for your feedback!
What is your feedback?
Related Articles
By clicking “Accept All Cookies”, you agree to the storing of cookies on your device to enhance site navigation, analyze site usage, and assist in our marketing efforts.
