Dry Socket: How to Tell, Pain Symptoms, Healing (2024)

Dental Health

Dental Conditions

ByKathi Valeii

Updated on May 01, 2024

Medically reviewed byEdmund Khoo, DDS

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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.

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

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 PainExtraction Pain
SevereMild to moderate
Radiates outwardIsolated to mouth
Not responsive to pain medsPain meds help
May be accompanied by bad breath and tasteNot associated with bad breath or taste
Pain gets worse each dayPain 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.

  1. MedlinePlus. Dry socket.

  2. 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

  3. 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

  4. 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

  5. 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

  6. 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

  7. 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

  8. 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

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.

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Dry Socket: How to Tell, Pain Symptoms, Healing (2024)

FAQs

Dry Socket: How to Tell, Pain Symptoms, Healing? ›

Dry sockets become increasingly painful in the days after a tooth extraction. They may also have exposed bone or tissue, or an unpleasant smell. By comparison, typical healing sockets become less painful over time and do not cause any other symptoms. A dry socket can be very painful but is not usually serious.

How do you know the difference between dry socket pain and healing pain? ›

Dry sockets become increasingly painful in the days after a tooth extraction. They may also have exposed bone or tissue, or an unpleasant smell. By comparison, typical healing sockets become less painful over time and do not cause any other symptoms. A dry socket can be very painful but is not usually serious.

How do I know if my socket is healing? ›

About 3 days after your tooth extraction, your gums will begin to heal and close around the removal site. And finally, 7-10 days after your procedure, the opening left by your extracted tooth should be closed (or almost closed), and your gums should no longer be tender or swollen.

When does dry socket pain go away? ›

This condition can be extremely painful, so it's important to see your dentist at the first sign of trouble. The good news is that a dry socket usually heals in about one week. In the meantime, ask your dentist how to manage your symptoms.

Can you tell right away if you have dry socket? ›

Dry socket normally occurs two to three days after you've had a tooth extracted. If you have dry socket, you will know immediately (there will be no guessing). Your body will send signals to your brain that something is wrong. You may experience intense pain and have a foul taste in your mouth.

Should I still have pain 5 days after tooth extraction? ›

In most cases, the pain or discomfort should have subsided after 7 to 10 days. Even though people's pain threshold and healing are different, the pain and the discomfort should decrease each day. There should be little to no pain by the time you get to five days.

What color is a healing dry socket? ›

Because there is no blood clot formed, the area appears dry, empty and with a seemingly white or bone-like color. If food and bacteria have gotten into the socket, it can display different colors: yellow, green, or black. It is also possible for some patients not to see a clear dry socket. They will only see a hole.

Does throbbing mean healing tooth extraction? ›

Throbbing pain during the first 24 hours post-extraction is a sign that your body is healing. Headaches, pain around the temples, neck or jaw and a sore throat may result from swelling and should subside within 1-3 days. Some temporary side effects of tooth extraction include: Bleeding.

What are the stages of socket healing? ›

The socket-healing process may be divided into three sequential, and frequently overlapping, phases: inflammatory; proliferative; and modeling/remodeling.

How do you know when to stop worrying about dry socket? ›

A dry socket is only a concern for as long as it takes for your mouth to heal after an extraction. For most patients who've had a tooth extracted, that healing should take between seven and ten days.

Is dry socket pain bearable? ›

Yes, a dry socket can be extremely painful! Unfortunately, when nerve endings and bone are left unprotected by a proper blood clot barrier, they are exposed to the gnawing of the jaw and any food particles that may become lodged. This process can cause severe pain in a patient's mouth and delay healing.

How do you get rid of dry socket pain fast? ›

Lifestyle and home remedies
  1. Take pain medicines as prescribed.
  2. Do not smoke or use tobacco products.
  3. Drink plenty of clear liquids. ...
  4. Rinse your mouth gently with warm salt water several times a day.
  5. Brush your teeth gently around the dry socket area.
  6. Be careful with eating or drinking.
Jul 18, 2023

How long should dry socket packing stay in? ›

Dressings are “packed” lightly into the socket and provide immediate pain relief. They typically remain in place for three to five days. Some will slowly break up in a few days, but gauze may require another trip to the dentist to be removed.

How can you tell the difference between dry socket and normal pain? ›

However, the main difference between a dry socket vs normal is that your pain level will begin to escalate as time goes on. You may experience throbbing that spreads across your jaw, all the way up to your ear.

What does mild dry socket feel like? ›

Pain occurs in the socket and along the nerves to the side of the face. The socket becomes swollen and irritated. It may fill with bits of food, making the pain worse. If you get a dry socket, the pain usually begins 1 to 3 days after the tooth removal.

Why is my dry socket not healing? ›

Dry socket is painful. Food particles or debris can get stuck down in the extraction site. This can delay the healing process or lead to infection.

Does dry socket feel like throbbing? ›

Dry socket

The empty socket causes an ache or throbbing pain in your gum or jaw, which can be intense like a toothache.

What should a tooth extraction look like when healing? ›

This empty socket will look deep red and a blood clot will form that reaches to about the level of the gumline. The tissue around the socket might appear whitish in color due to trauma. After two to three days, the hole will look smaller and you'll notice new gum tissue has started to form around the edges.

What are the warning signs of a dry socket? ›

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.
Nov 7, 2022

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