Dry socket (alveolar osteitis) is a painful dental condition that sometimes happens after you have a permanent adult tooth extracted. Dry socket is when the blood clot at the site of the tooth extraction fails to develop, or it dislodges or dissolves before the wound has healed.
Normally, a blood clot forms at the site of a tooth extraction. This blood clot serves as a protective layer over the underlying bone and nerve endings in the empty tooth socket. The clot also provides the foundation for the growth of new bone and for the development of soft tissue over the clot.
Exposure of the underlying bone and nerves results in intense pain, not only in the socket but also along the nerves radiating to the side of your face. The socket becomes inflamed and may fill with food debris, adding to the pain. If you develop dry socket, the pain usually begins one to three days after your tooth is removed.
Dry socket is the most common complication following tooth extractions, such as the removal of third molars (wisdom teeth). Over-the-counter medications alone won't be enough to treat dry socket pain. Your dentist or oral surgeon can offer treatments to relieve your pain.
Products & Services
Signs and symptoms of dry socket may include:
- Severe pain within a few days after a tooth extraction
- Partial or total loss of the blood clot at the tooth extraction site, which you may notice as an empty-looking (dry) socket
- Visible bone in the socket
- Pain that radiates from the socket to your ear, eye, temple or neck on the same side of your face as the extraction
- Bad breath or a foul odor coming from your mouth
- Unpleasant taste in your mouth
When to see a doctor
A certain degree of pain and discomfort is normal after a tooth extraction. However, you should be able to manage normal pain with the pain reliever prescribed by your dentist or oral surgeon, and the pain should lessen with time.
If you develop new or worsening pain in the days after your tooth extraction, contact your dentist or oral surgeon immediately.
Request an appointment
From Mayo Clinic to your inbox
Sign up for free, and stay up to date on research advancements, health tips and current health topics, like COVID-19, plus expertise on managing health. Click here for an email preview.
To provide you with the most relevant and helpful information, and understand which information is beneficial, we may combine your email and website usage information with other information we have about you. If you are a Mayo Clinic patient, this could include protected health information. If we combine this information with your protected health information, we will treat all of that information as protected health information and will only use or disclose that information as set forth in our notice of privacy practices. You may opt-out of email communications at any time by clicking on the unsubscribe link in the e-mail.
The precise cause of dry socket remains the subject of study. Researchers suspect that certain issues may be involved, such as:
- Bacterial contamination of the socket
- Trauma at the surgical site from a difficult extraction, as with an impacted wisdom tooth
Factors that can increase your risk of developing dry socket include:
- Smoking and tobacco use. Chemicals in cigarettes or other forms of tobacco may prevent or slow healing and contaminate the wound site. The act of sucking on a cigarette may physically dislodge the blood clot prematurely.
- Oral contraceptives. High estrogen levels from oral contraceptives may disrupt normal healing processes and increase the risk of dry socket.
- Improper at-home care. Failure to follow home-care guidelines and poor oral hygiene may increase the risk of dry socket.
- Having dry socket in the past. If you've had dry socket in the past, you're more likely to develop it after another extraction.
- Tooth or gum infection. Current or previous infections around the extracted tooth increase the risk of dry socket.
Painful, dry socket rarely results in infection or serious complications. However, potential complications may include delayed healing of or infection in the socket or progression to chronic bone infection (osteomyelitis).
What you can do before surgery
You can take these steps to help prevent dry socket:
- Seek a dentist or oral surgeon with experience in tooth extractions.
- If applicable, try to stop smoking before your extraction because smoking and using other tobacco products increase your risk of dry socket. Consider talking to your doctor or dentist about a program to help you quit permanently.
- Talk to your dentist or oral surgeon about any prescription or over-the-counter medications or supplements you're taking, as they may interfere with blood clotting.
What your dentist or oral surgeon may do
Your dentist or oral surgeon will take a number of steps to ensure proper healing of the socket and to prevent dry socket. These steps may include recommending one or more of these medications, which may help prevent dry socket:
- Antibacterial mouthwashes or gels immediately before and after surgery
- Oral antibiotics, particularly if you have a compromised immune system
- Antiseptic solutions applied to the wound
- Medicated dressings applied after surgery
What you can do after surgery
You'll receive instructions about what to expect during the healing process after a tooth extraction and how to care for the wound. Proper at-home care after a tooth extraction helps promote healing and prevent damage to the wound. These instructions will likely address the following issues, which can help prevent dry socket:
- Activity. After your surgery, plan to rest for the remainder of the day. Follow your dentist's or oral surgeon's recommendations about when to resume normal activities and how long to avoid rigorous exercise and sports that might result in dislodging the blood clot in the socket.
- Pain management. Put cold packs on the outside of your face on the first day after extraction and warm packs after that, to help decrease pain and swelling. Follow your dentist's or oral surgeon's instructions on applying cold or heat to your face. Take pain medications as prescribed.
- Beverages. Drink lots of water after the surgery. Avoid alcoholic, caffeinated, carbonated or hot beverages for as long as your dentist or oral surgeon recommends. Don't drink with a straw for at least a week because the sucking action may dislodge the blood clot in the socket.
- Food. Eat only soft foods, such as yogurt or applesauce, for the first day. Be careful with hot and cold liquids or biting your cheek until the anesthesia wears off. Start eating semisoft foods when you can tolerate them. Avoid chewing on the surgery side of your mouth.
- Cleaning your mouth. After surgery, you may gently rinse your mouth and brush your teeth, but avoid the extraction site for the first 24 hours. After the first 24 hours, gently rinse your mouth with warm salt several times a day for a week after your surgery. Mix 1/2 teaspoon (2.5 milliliters) of table salt in 8 ounces (237 milliliters) of water. Follow the instructions of your dentist or oral surgeon.
- Tobacco use. If you smoke or use tobacco, don't do so for at least 48 hours after surgery and as long as you can after that. Any use of tobacco products after oral surgery can delay healing and increase the risk of complications.
By Mayo Clinic Staff
Request an appointment
Jan. 25, 2017
- Dry socket. American Dental Association. http://www.mouthhealthy.org/en/az-topics/d/dry-socket. Accessed Nov. 15, 2016.
- Akinbami BO, et al. Dry socket: Incidence, clinical features, and predisposing factors. International Journal of Dentistry. https://www.hindawi.com/journals/ijd/2014/796102/. Accessed Nov. 15, 2016.
- Postextraction problems. Merck Manual Professional Version. http://www.merckmanuals.com/en-ca/professional/dental-disorders/dental-emergencies/postextraction-problems. Accessed Nov. 15, 2016.
- Tarakji B, et al. Systematic review of dry socket: Aetiology, treatment, and prevention. Journal of Clinical and Diagnostic Research. 2015;9:ZE10.
- Hupp JR. Prevention and management of extraction complications. In: Contemporary Oral and Maxillofacial Surgery. 6th ed. St. Louis, Mo.: Elsevier; 2014. https://www.clinicalkey.com. Accessed Nov. 15, 2016.
- Sharif MO, et al. Interventions for the prevention of dry socket: An evidence-based update. British Dental Journal. 2014;217:550.
- Daly B, et al. Local interventions for the management of alveolar osteitis (dry socket) (review). Cochrane Database of Systematic Reviews. http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD006968.pub2/abstract. Accessed Nov. 17, 2016.
- Ramponi DR. Dental procedures. Advanced Emergency Nursing Journal. 2016;38:228.
- Edens MH, et al. Intraoral pain disorders. Oral and Maxillofacial Surgery Clinics of North America. 2016;28:275.
- Fenton DA, et al. Perioperative strategies for third molar surgery. Atlas of the Oral and Maxillofacial Surgery Clinics of North America. 2012;20:25.
- What to do following an extraction. Oral Health Foundation. https://www.dentalhealth.org/tell-me-about/topic/routine-treatment/what-to-do-following-an-extraction. Accessed Nov. 30, 2016.
- Salinas TJ (expert opinion). Mayo Clinic, Rochester, Minn. Dec. 4, 2016.
Products & Services
Mayo Clinic does not endorse companies or products. Advertising revenue supports our not-for-profit mission.
Advertising & Sponsorship
- Ad Choices
Mayo Clinic Press
Check out these best-sellers and special offers on books and newsletters from Mayo Clinic Press.
- Mayo Clinic on Incontinence - Mayo Clinic PressMayo Clinic on Incontinence
- NEW – Future Care - Mayo Clinic PressNEW – Future Care
- Mayo Clinic on Hearing and Balance - Mayo Clinic PressMayo Clinic on Hearing and Balance
- FREE Mayo Clinic Diet Assessment - Mayo Clinic PressFREE Mayo Clinic Diet Assessment
- Mayo Clinic Health Letter - FREE book - Mayo Clinic PressMayo Clinic Health Letter - FREE book
- Dry socket
What is the number 1 cause of dry socket? ›
Dry socket may be caused by a range of factors, such as an underlying infection in the mouth, trauma from the tooth extraction or problems with the jawbone. The condition occurs more often with wisdom teeth in the lower jaw than with other teeth. You are also more likely than others to develop dry socket if you: smoke.What causes dry socket symptoms? ›
Dry socket is a condition that can happen after tooth extraction. It occurs when a blood clot either doesn't form or is dislodged after tooth removal. Without the clot, your bone and nerves are exposed, leading to dry socket pain.What is a dry socket and what causes it? ›
Overview. Dry socket (alveolar osteitis) is a painful dental condition that sometimes happens after you have a permanent adult tooth extracted. Dry socket is when the blood clot at the site of the tooth extraction fails to develop, or it dislodges or dissolves before the wound has healed.Would I definitely know if I had dry socket? ›
The symptoms of dry socket can vary, but may include: severe pain, visible bone, bad breath, a foul taste in your mouth, and radiating pain to your ear, eye, neck or temple. The partial or complete blood clot loss at the tooth extraction site looks and feels like an empty socket.What is the highest risk day for dry socket? ›
A dry socket occurs when the blood clot breaks down or is dislodged, exposing the bone and nerves. The first five or so days after extraction are the most critical, and it is during this time that the risk for a dry socket is the highest.Is dry socket easily avoidable? ›
Thankfully, dry socket is easily avoidable. To help with any recovery, you'll need to develop healthy eating and cleaning habits. Here are a few rules you should follow: Use the oral rinse given to you after the procedure.What to do if dry socket is forming? ›
- Flushing out the socket. Flushing out the socket can remove any food particles or other debris that may contribute to pain or possible infection.
- Medicated dressings. Your dentist or oral surgeon may pack the socket with medicated gel or paste and medicated dressings. ...
- Pain medication. ...
Proper oral hygiene
Keeping your mouth clean is one of the most important ways you can prevent dry socket. Oral hygiene helps prevent germs and infection from breaking down the blood clot. Ask your dentist how to brush your teeth following surgery.
Dry socket usually occurs within 3-5 days of an extraction and more commonly in the lower jaw. Symptoms include severe pain, a throbbing sensation, an unpleasant taste, a fever, or swollen glands. It can last for up to 7 days. By following your dentist's instructions carefully, dry socket can usually be prevented.Will wet gauze prevent dry socket? ›
Gauze helps protect the wound in two ways: it prevents some of the smoke from reaching the wound and reduces pressure on the wound making the blood clot less likely to dislodge and cause a dry socket.
How can you tell the difference between dry socket and normal 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, normal healing sockets get less painful over time and do not cause any other symptoms. A dry socket can be very painful, but it is not usually serious.What if I can't get food out of extraction site? ›
Dislodge the food by gently rinsing your mouth with warm salt water (saline) solution. Avoid swishing the water around and don't spit—this can lead to painful dry sockets. If you received a syringe from your clinician, you can use warm water or salt water to gently flush the socket clean.How rare is dry socket? ›
The facts about dry socket
Dry socket can occur anywhere from 2% to 5% of the time with the extraction of a tooth. Mandibular teeth are affected by this condition more often than maxillary teeth.
A dry socket appears as an empty hole in the place of the removed tooth. The exposed bone is visible from the socket. The opening may look dry and have a creamy white color, just like a bone. Blood clotting happens on the empty socket and helps the surgery site heal by promoting the growth of new tissues.What does dry socket taste like? ›
Unpleasant Taste. Another common symptom of a dry socket is a bad or sour taste in your mouth. This can be one of the first signs of infection, so don't let that smell linger without taking swift action.Can sneezing cause dry socket? ›
Coughing, sneezing, or spitting can also cause debris to fall into the open socket, causing a dry socket. Poor oral hygiene and touching the wound area increases the risk of developing dry sockets, as well as women who take birth control medication.How many people end up with dry socket? ›
A dry socket will occur in only one to three percent of all tooth extraction cases, but it becomes much more common in the extraction of lower, or what we call mandibular, wisdom teeth. Those who undergo tooth extraction can experience dry socket.When can I stop stressing about dry socket? ›
When Can I Stop Worrying About Dry Socket? Until the full recovery of your extraction site, a dry socket can form if you fail to follow the care tips. Usually, a week (7-8 days) after wisdom tooth extraction, you can stop worrying about a dry socket as gums take this much time to close fully.Does dry socket pain start immediately? ›
Does dry socket hurt instantly? You will not feel a higher amount of pain the first two days after the extraction. However, if healing does not progress well and if the clot falls out, then you will start to feel a dull, throbbing, and radiating pain that keeps increasing to the point of becoming simply unbearable.Can I get dry socket from sleeping with my mouth open? ›
In non-smokers, dry socket is uncommon. It can still occur with negative pressure that occurs during drinking through a straw or vigorous spitting. It may also be more common in those who mouth breathe while sleeping because the mouth can dry out and the blood clot may break down.
What antibiotic is good for dry socket? ›
Prevention methods include avoiding smoking before and after surgery and a traumatic surgery, the use of antibiotics, such as, azithromycin, can be considered, chlorohexidine rinse or gel can be effective in the reduction of dry socket incidence.Can salt water rinse prevent dry socket? ›
In a study published in Evidence-Based Dentistry, researchers discovered that patients who didn't rinse their mouth with salt water after their surgery were more likely to develop dry sockets as opposed to those that did. Doing this will also help speed up your recovery.Why can't you drink coffee after tooth extraction? ›
Coffee and Dry Socket
After a tooth extraction, a blood clot should form at the site of the missing tooth. The clot is a vital part of the body's healing process. Unfortunately, drinking coffee can prevent that clot from forming or disturb a newly formed clot, leading to a painful condition known as dry socket.
The explicit throbbing pain in your jaw represents another telltale signal of dry sockets. The pain may reach your ear, eye, temple or neck from the extraction site. The soft dental extraction site usually feels on the same side.Do stitches prevent dry socket? ›
Stitches, which are usually placed after the removal of an impacted tooth, do not prevent dry sockets. Women taking birth control pills and smokers are more prone to dry sockets. The symptoms of a dry socket are easily treated with a medicated dressing.Can too much gauze cause a dry socket? ›
However, using gauze for too long can prevent clotting. You should watch for signs to stop using gauze, or you could develop complications such as dry socket, infection, or gum pain. Take it easy for a few days after surgery. An elevated heart rate can increase blood flow and bleeding at the extraction site.How do you know if a clot is dislodged? ›
How will I know if my blood clot fell out? If you develop dry sockets, the pain will let you know that your wound is no longer protected. Swelling is also an indication you have lost your blood clot, as is the taste of blood in your mouth.Can a gauze dislodge a clot? ›
You may think changing it more often will help, but actually, removing the gauze too often can dislodge a blood clot and start the bleeding up again. It's normal for most patients to use gauze for several hours following surgery, but having to use gauze the following day, is not normal.What does dry socket feel like to the touch? ›
You'll be able to feel that the tooth's socket seems empty and open. (Due to the loss of its blood clot.) You're likely to feel the sharpness of the socket's exposed bone surfaces. A picture of a dry socket.Do antibiotics prevent dry socket? ›
Antibiotics may also reduce the risk of dry socket by 34% (RR 0.66, 95% CI 0.45 to 0.97; 1882 participants; 13 studies; low‐certainty evidence), which means that 46 people (95% CI 29 to 62) need to take antibiotics to prevent one case of dry socket following extraction of impacted wisdom teeth.
What does a healthy dry socket look like? ›
A healthy socket will be a hole with a noticeable blot clot in the center. If your socket appears white in color, chances are you are seeing exposed bone and have lost the blood clot. In cases where bacteria or infection cause the clot to dissolve, you may see a socket that is black, green, or yellow in color.What can you eat with dry socket? ›
Yogurt, pudding, applesauce and Jell-O are some go-to recovery foods: no chewing involved! Stick to these post-extraction staples for the first 24 hours after your surgery before moving on to soft foods that require chewing.How do you sleep the first night after a tooth extraction? ›
Always sleep with your head elevated for the first few nights after the wisdom tooth extraction surgery. If you struggle to put yourself in that position, get support from a few pillows. Keeping your head elevated at a 45-deg angle while sleeping ensures faster recovery. It also minimizes swelling in the surgical area.What is the most common complication after extraction? ›
Dry socket – the most common complication seen from tooth extractions is dry socket. This is when the blood clot that forms in the pocket of the gums is dislodged one to three days following surgery. This exposes the bone of the jaw and the nerves and can result in intense pain and slowed healing.Does dry socket stink? ›
The condition is caused by the exposed bone in the socket being irritated and can result in a foul-smelling discharge from the mouth. Its symptoms include foul breath, severe pain, swelling, and an unpleasant taste in the mouth.
Dry Socket or alveolar osteitis is a very painful condition that sometimes follows difficult tooth extractions. To give you an idea of just how painful it can be, people who have had toothache, say it is the worst pain imaginable.How do you prevent dry socket 100%? ›
- Do Not Use A Straw For 24-48 Hours After Your Surgery. ...
- Avoid Spitting Vigorously After Rinsing For 24-48 Hours After Extraction. ...
- Don't Smoke Or Use Oral Tobacco For 48 Hours. ...
- Do Not Brush The Extraction Site Directly For 3-4 Days.
Rinse your mouth gently with warm salt water several times a day. Brush your teeth gently around the dry socket area. Use caution with eating or drinking, avoid carbonated beverages, and avoid smoking or using a straw to prevent dislodging the dressing.What is the fastest way to get rid of a dry socket? ›
Warm salt water
It can help eliminate bacteria and reduce or prevent further infection. The Mayo Clinic recommends dissolving ½ teaspoon of salt into 8 ounces of warm water. Swish this around in your mouth for a minute, or use it to flush out the dry socket with a syringe your surgeon gives you.
When Can I Stop Worrying About Dry Socket? Until the full recovery of your extraction site, a dry socket can form if you fail to follow the care tips. Usually, a week (7-8 days) after wisdom tooth extraction, you can stop worrying about a dry socket as gums take this much time to close fully.
How long is dry socket a risk? ›
After a tooth extraction, you're at risk of developing dry socket. This risk is present until you're fully healed, which may take 7 to 10 days in many cases.Can gauze cause dry socket? ›
Removing a somewhat dry gauze from over an extraction site can pull the developing clot out of the socket. This in turn can cause a dry socket--a painful infection of the tooth socket. Waiting at least 20 minutes before removing the gauze will ensure that the clot does not stick to the gauze.How easy is it to dislodge a blood clot in your mouth? ›
The drawing action of sucking in, and the force applied when spitting, can dislodge the blood clot. Sneezing and coughing can also dislodge a blood clot. Hard or crunchy foods can displace the blood clot. Sticky foods can pull the protective clot right out of the socket.How do dentists fix dry socket? ›
Your dentist will clean the tooth socket, removing any debris from the hole, and then fill the socket with a medicated dressing or a special paste to promote healing. You'll probably have to come back to the dentist's office every few days for a dressing change until the socket starts to heal and your pain lessens.How instant is dry socket pain? ›
Does dry socket hurt instantly? You will not feel a higher amount of pain the first two days after the extraction. However, if healing does not progress well and if the clot falls out, then you will start to feel a dull, throbbing, and radiating pain that keeps increasing to the point of becoming simply unbearable.Can hydrogen peroxide cause dry socket? ›
Anything containing HYDROGEN PEROXIDE WILL CAUSE A DRY SOCKET, including whitening toothpastes. Avoid whitening toothpastes for 5 days after the extractions are done.