How to Prevent Dry Socket: Tips to Follow After Tooth Extraction

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“How to prevent dry socket” is one of the most important questions you could have after getting a tooth extracted. This dreadful condition can be your worst nightmare because of all the pain and discomfort it brings. But is there anything that you can do to avoid developing this complication altogether?

Painful Dry socket
Dry socket can be extremely painful

In addition to the conventional pharmacological treatment, there are several remedies you can use to prevent developing this condition. Some of these measures are as simple as avoiding smoking, eating soft food only, and avoiding the use of straws to drink any beverages. Others include maintaining proper oral hygiene by using antibacterial mouthwashes, using antiseptic measures on the wound and drinking lots of fluid to aid the process of recovery without complications.

The mere mention of a problem as painful as a dry socket can make a dentist cringe, for it is among the most dreaded complications that can affect patients following a dental extraction.

This article will explore all the relevant details needed to quell your fears regarding this agonizing condition prior to extraction. Furthermore, it will also provide answers to some of the most commonly asked questions, like how to cure dry socket, and what you can do to prevent it in the first place for better oral health.

What is a dry socket?

Dry socket, or alveolar osteitis, occurs due to the dissolution of a blood clot present at the site of tooth extraction following the extraction surgery. This blood clot is usually responsible for protecting the nerve and bone tissue present at the extraction site during the entire healing process. The dissolution of this blood clot exposes the sensitive area beneath it, making the socket vulnerable to further trauma and bacteria.

A small number of people undergoing tooth extraction develop problems like alveolar osteitis. The problem hits teeth in the lower jaw more than teeth in the upper jaw. The symptoms of dry socket also occur more commonly following molar extractions, especially when the dentist or oral surgeon is dealing with a wisdom tooth.

What is the main cause of dry socket?

As mentioned before, the main cause of dry socket is a partial or a complete loss of a blood clot in the tooth socket following extraction. This blood clot forms in order to protect the exposed socket and the jawbone present beneath the teeth. If this blood clot gets lost or does not form at all, the underlying jawbone is exposed and healing is delayed.

Now let's have a look at some of the main causes of dry socket.

Bacteria

Any pre-existing infection of the oral cavity prior to tooth extraction, for instance, periodontal disease, may cause an improper formation of the blood clot. Even if the blood clot is somehow formed, the oral bacteria present in the mouth may cause its breakdown.

Chemicals

Nicotine is among the most common chemicals that severely and negatively affect oral health. Abundantly present in cigarettes, this chemical can reduce the blood supply in the oral cavity which hinders the formation of the blood clot at the site of tooth extraction.

Abrupt movements

Performing certain activities such as aggressive rinsing, sucking through a straw, and forceful spitting after a recent wisdom tooth extraction can dislodge the blood clot leading to alveolar osteitis.

Biological factors

Certain factors, like having a dense jawbone, hormonal imbalances, and a poor blood supply can prevent the formation of the blood clot. This drastically increases the chances of acquiring a dry socket following tooth removal.

How do you get a dry socket?

Dry socket begins with a tooth extraction, so it follows logic that the causes of the need for tooth extraction are also the causes that ultimately lead to a dry socket. According to research, the most common causes of tooth extraction and dry sockets in patients are shown in the table below.

Reason for tooth extraction Prevalence of dry socket (%)
Dental caries 20
Periodontal disease 10
Prosthetic reasons 5
Impaction 5
Orthodontic reasons 4
Pericoronitis 1

What are the symptoms of a dry socket?

What does a dry socket feel like? There are a lot of symptoms that characterize this tooth problem.

Among the most common dry socket symptoms is the presence of persistent throbbing pain that begins a few days following tooth removal. The pain normally radiates to surrounding areas of the face. Drinking cold beverages or merely breathing may cause extreme pain and discomfort in the mouth.

Some other dry socket symptoms include:

  • A visible bone in the socket   
  • Bad breath
  • An unpleasant taste in the mouth
  • Pain in ears
  • Pain in eyes
  • Pain in jaw
  • Headache
  • Severe pain in the neck

Diagnosis

The presence of pain and other symptoms of dry socket is usually enough for the dentist or oral surgeon to make a diagnosis. The dentist may also examine your oral cavity to check if there is a blood clot in your tooth socket or if there is an exposed bone.

You may also be required to go through certain tests like x-rays in order to rule out other conditions like bone infections or the presence of small bone fragments embedded in the wound following tooth removal.

What are the risk factors of dry socket?

According to most dentists, you are more likely to suffer from dry socket during the first seven days following tooth removal. While more research is needed, most dental experts believe that less than 1 to 5 percent of people develop dry socket after tooth removal.

Other risk factors that predispose people to develop dry socket include:

  • Having poor oral health
  • Undergoing a difficult tooth extraction
  • Taking oral contraceptives or birth control pills which can also interfere with the healing process
  • Using tobacco or nicotine products within 48 hours of surgery
  • Not taking care of your oral health after extraction of the tooth
  • Having a history of dry socket
  • Frequent spitting after extraction of the tooth, which dislodges the clot

Have a look at the video below from the American Dental Association (ADA) for a summary on treating and preventing dry socket.

How to treat dry socket?

Wondering how to treat dry socket? The primary aim of the treatment is to decrease the intensity of symptoms, especially dry socket pain. The main things done to treat dry socket include:

Flushing out the socket

Your dentist may suggest flushing out the socket in order to get rid of any food particles and other things embedded at the site of extraction. This helps relieve dry socket pain and heal the underlying infection.

Using medicated dressings

Your dentist may suggest packing the affected socket using a medicated paste or gel as well as medicated dressings. This can help provide immediate dry socket relief. They will also assess certain factors such as the severity of pain in order to determine how often dressings should be changed.

Taking pain medications

You can seek medical advice from your dentist about the most suitable pain medication to reduce the discomfort associated with dry socket.

Focusing on self-care

Once the dentist removes the dressing, you may need to flush the socket by yourself in order to get rid of debris and promote healing. For this purpose, you will need some salt water and a plastic syringe with a curved tip for squirting water. Using the syringe, insert the water into the socket and continue rinsing until your socket is free of debris.

Once the treatment begins, you will soon notice some pain relief. Pain, along with other symptoms, will continue to improve and go away completely within a few days. However, it is important to keep in touch with your dentist for regular dressing changes and oral care.

How to prevent dry socket: Homecare

Is there a home remedy for dry socket? Can taking simple measures at home prevent this problem from developing in the first place?

Absolutely! There are some simple measures that you can take in order to make sure you do not suffer from a dry socket. The main aim of these measures is to prevent the blood clot at the site of extraction from dislodging. This blood clot not only protects your bone and nerve tissue but also aids in the recovery of gums and teeth. So it is important that you keep it in place until your tooth has completely healed post-surgery.

Dry socket most commonly occurs when some exterior force dissolves or dislodges the blood clot from the socket. Here are a few ways to prevent this from happening.

Stay away from straws

When you use a straw to drink a beverage, it creates a suction movement of air as well as with your cheek muscles. This, in turn, may move the blood clot from its original spot and make way for dry socket. Therefore, you should completely avoid the use of straws for at least one week following dental extraction.

Say no to tobacco

People who routinely use tobacco are at a greater risk for dry socket following dental extraction. One of the studies found that this problem occurred in approximately 12% of the individuals who smoked after a dental extraction. In comparison to this, only 4% of the non-smokers who underwent dental treatment developed a dry socket.

Inhaling cigarette smoke after tooth removal can dislodge the blood clot. Furthermore, the chemicals present in tobacco products can also interfere with healing and may lead to the development of a secondary infection.

Hence, most dentists advise reducing your tobacco intake for at least a few weeks prior to dental surgery as well as after it.

quit smoking to prevent dry socket
Not using tobacco is very essential in preventing a dry socket

If you find you experience withdrawal symptoms, the following tips can significantly decrease your risk of acquiring a dry socket:

  • Switching to a nicotine patch for the time being
  • Waiting for at least 48 hours post-surgery before resuming smoking
  • Asking about getting stitches on the surgical site from the dentist
  • Avoiding activities like chewing tobacco or using nicotine gums

If you do resume using tobacco after the treatment, as your dentist about when you can safely start. As a general rule of thumb, you must wait for at least 48 hours; however, this may vary from person to person.

Eat soft food

During the initial 24 hours following your dental surgery, take care to consume soft foods only. Some examples include yogurt, applesauce and mashed potatoes. As the second day approaches, you may switch to slightly heartier foods but you should resort back to softer foods if you feel any kind of discomfort.

Avoid eating soup as it involves sucking, which may ultimately dislodge the blood clot. Also, stay away from sticky foods, seeds, nuts, and crunchy foods like chips as they may aggravate the condition.

Inquire about medication interactions

Research has proven a strong association between using oral contraceptives and the development of dry socket. If you are already taking birth control, discuss it with your dentist. In case you are using any other medications, seek medical advice from your dentist about any possible interactions.

Adopt proper oral hygiene

Maintaining good oral hygiene is among the most important ways to prevent dry socket. Practicing good dental measures can also destroy germs and stop the infection from dislodging the blood clot.

Ask your dentist about how to brush your teeth after surgery. In most cases, you will be advised to simply rinse your mouth on the first day following surgery, and switch to gentle tooth brushing on the second day. You may also be asked to use an antibacterial mouthwash and gauze pads a few times a day.

How to prevent dry socket: Surgical care

Are you about to undergo tooth removal? Are you worried about dry socket and want to know how to prevent this problem? The following are some of the things you and your dentist can do before and after the surgical procedure.

What you can do before surgery?

The following measures can be taken before surgery in order to prevent a dry socket.

  • Go to a dentist who has experience in dental extractions.
  • If you are a smoker, try to avoid smoking a few days before the surgery as the use of tobacco products can increase the risk of dry socket.
  • Discuss with your dentist any over-the-counter or prescription drugs that you are already taking as they may interfere with the clotting of blood.

What can your dentist do?

Your dentist can take several steps to make sure that your tooth properly heals following the surgery in order to prevent dry socket. This includes recommending certain medications such as:

  • Antibacterial gels or mouthwashes both before and after surgery
  • Antiseptic solutions to apply to the wound
  • Oral antibiotics, especially if you are immune-deficient
  • Medicated dressings to apply to the wound after surgery
dry socket and tooth extraction
The dentist may apply a medicated dressing to treat dry socket.

What you can do after surgery?

After the surgical treatment, the dentist will instruct you about what to expect during the recovery process and how to take care of the wound. Following a proper plan for home care after extraction can significantly promote healing and prevent complications.

The tips mentioned below will also help prevent dry socket:

Activity

After surgery, make sure to rest for the remainder of the day. Follow all the recommendations provided by your dentist about how long to stay away from sports and other activities to prevent the blood clot from dislodging, and when you can resume a normal life.

Pain management

Place icepacks on your cheek on the first day after surgery. Then, replace these with warm compresses in order to reduce swelling and pain. Make sure to follow the instructions given by your dentist regarding the application of heat or cold to your face. Take appropriate medications to fight dry socket pain.

Beverage consumption

Consume lots of water after surgery. Stay away from carbonated, caffeinated, hot, and alcoholic beverages for as long as advised by the dentist. Do not drink using a straw for at least seven days.

Food consumption

Only eat soft foods like applesauce or yogurt, especially on the first day of surgery. Take care while consuming cold or hot liquids and try your best to avoid biting your cheek until the effects of anesthesia wear off. Switch to semi-soft foods when you feel like you can easily tolerate them. Try to prevent chewing on the affected side of the mouth.         

Oral hygiene

After surgery, you might be asked to brush your teeth and rinse your mouth with medicated mouthwashes. However, once you are past the first 24 hours, use warm salt water to rinse your mouth a few times a week following surgery. To make saltwater, mix 1/2 teaspoon of table salt in 8 ounces of water.

Use mouthwash to prevent dry socket
Use medicated mouthwash to prevent the growth of harmful bacteria

Tobacco use

If you are a regular smoker or use any other tobacco-containing products, avoid them for at least 2 days before the treatment and as long as you can following its completion.

Conclusion

Dry socket is an extremely painful condition that can happen following a tooth extraction. However, the condition usually improves after beginning treatment, especially if you properly follow the instructions of your dentist.

There are also plenty of ways to prevent dry socket even before it starts bothering you. For this purpose, keep in touch with your dentist both before and after tooth extraction.

FAQs

Will dry socket heal on its own?

Most patients suffering from dry socket prefer to manage their issues at home. In most cases, dry socket tends to heal on its own; however, patients are likely to experience discomfort during this process.

How long does dry socket last?

Dry socket normally occurs within 3 to 5 days following the extraction. The usual dry socket healing time is 7 days, of which the first 3 days are the most painful. If the condition persists beyond this time, further investigation is warranted.

Why is the blood clot needed for the healing process?

The blood clot serves as a barrier of protection against food debris, bacteria, and other types of irritants that may give rise to infection. It also plays a crucial role in the generation of new tissue and bone at the site of extraction.

What questions can I ask my dentist during my appointment?

Some questions to ask the dentist during your appointment include:

  • What are the underlying causes of my pain?
  • What can I use for this pain?
  • Will I need to undergo any tests?
  • What type of treatment regimens will I need in order to recover?
  • Is there a generic version of the medication prescribed to me?
  • How long will it take to feel better?
  • Are there any restrictions?
  • How long should I wait before eating or drinking?

If you have any additional questions in mind, do not hesitate to ask them during the appointment.

What questions can my dentist ask me?

Your dentist may ask one or more of the following questions:

  • When did the pain begin?
  • When did it get severe?
  • Does the pain occur spontaneously or is it triggered by any activity such as touching the affected area?
  • Where is the pain located? Does it radiate?
  • On a scale of 1 to 10, how would you rate the severity of your pain?
  • Have you already taken any painkillers? If yes, what is the dosage and frequency of these medications?
  • Does using painkillers reduce the pain?
  • Are there any other symptoms not related to this pain?

What complications can develop from dry socket?

The most common complication of dry socket is delayed healing. Infections may also occur but these might not be strictly associated with dry socket. If you develop any sign of infection, contact the dentist immediately. The most common symptoms include:

  • Fever
  • Rigors and chills
  • Redness
  • Discharge from the extraction site
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Contributors:
Dr. Junaid Tariq
Dr. Junaid Tariq
Dr. Junaid Tariq is a professional content creator and copywriter. The meticulous nature of his MBBS degree proved invaluable in sculpting his research skills and honing his writing efficiency. In addition to working as a content creator, Dr. Tariq continues to fulfill his duties as a medical doctor at a local hospital and has acquired hands-on experience in both acute and chronic patient care. From white papers to blogs, Dr. Tariq writes everything, simplifying complex scientific concepts into basic terms to create something easily accessible and readable for the majority.
You can follow him on his blog: https://themedchronicles.com/
Sources
Oral Health Dent Manag: Prevalence and association of dry socket in oral health and dental management. Consulted 10 Feburary, 2020. International journal of dentistry: Alveolar osteitis: a comprehensive review of concepts and controversies. Consulted 10 Feburary, 2020. The open dentistry journal: Dry socket: frequency, clinical picture, and risk factors in a palestinian dental teaching center. Consulted 10 Feburary, 2020. Journal of clinical and diagnostic research (JCDR): Systemic review of dry socket: aetiology, treatment, and prevention. Consulted 10 Feburary, 2020.  
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