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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 should ask after getting a tooth extracted. The pain of dry socket can be excruciating, so you should follow your dentist’s advice after your tooth extraction. But is there anything that you can do to avoid developing this complication altogether?

In addition to the conventional pharmacological treatment, there are several remedies you can use to prevent dry socket. Some of these measures are as simple as only eating soft foods and avoiding smoking and using 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 calm 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 dry socket?

Dry socket, or alveolar osteitis, occurs when the blood clot at the site of a tooth extraction dissolves or becomes dislodged. Without this clot, the sensitive area beneath is exposed. This makes the socket vulnerable to further trauma and bacteria. This blood clot protects the nerves and bone tissue at the extraction site.

How common is dry socket?

Fortunately, only 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.

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 1–5% of people develop dry socket after tooth removal.

What is the main cause of dry socket?

dry socket
Dry socket can be excruciating

The main cause of dry socket is a partial or a complete loss of a blood clot in the tooth socket after extraction. This clot protects the exposed socket and jawbone. 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 other factors that can contribute to dry socket complications:

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, and some research studies suggest that extractions resulting from poor oral health are more likely to lead to dry socket.

Some other factors that can increase your chances of suffering from this painful condition include:

  • Undergoing a difficult extraction
  • Taking oral contraceptives
  • Using tobacco or nicotine within 48 hours of surgery
  • Not taking care of your oral health after tooth extraction
  • Having a history of dry socket
  • Frequent spitting after tooth extraction

What are the symptoms of a dry socket?

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, eyes, jaws, or neck
  • A headache

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 will 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 such as 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.

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

Even with regular brushing and flossing you may need to have a tooth pulled and occasionally when a tooth is removed, dry socket may occur. Dry Socket results from the lost of the bloodclot from the extraction site. If you have dry socket, your dentist will recommend various treatments to promote healing and ease discomfort. Hear more about the causes of dry socket and prevent measures you can take to have a healthy and beautiful smile.

How to treat dry socket

If you have dry socket and the pain isn't showing any signs of easing up, you should see your dentist as soon as you can. 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 try to flush 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.

Medicated dressings

After making sure the socket is clean, your dentist may then pack 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.

Pain medication

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

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 saltwater 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 clean.

Once the treatment begins, you will soon notice some pain relief. The 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.

Will dry socket heal on its own?

Dry socket can heal on its own but you should always see a dentist to get their advice on what to do. If you get dry socket you should see a dentist as soon as possible. They may advise you on things you can do at home to help the healing process.

Why? The blood clot not only protects you from pain; it also stops bacteria and food getting into the socket and causing infection. So, without a blood clot, the chance of infection and further complications increases. It will also take longer for the dry socket tooth to heal if you don't get it treated.

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?

dry socket treatment
Your dentist may apply a medicated dressing

Your dentist can take several steps to make sure that your mouth heals properly 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

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.

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?

How to prevent dry socket: Homecare

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

Absolutely! There are some simple steps that you can take in order to reduce your chances of suffering from a dry socket. Remember, this condition most commonly occurs when some exterior force dissolves or dislodges the protective blood clot from the socket, so your aim should be to keep the clot in place until your mouth has completely healed post-surgery.

You should always follow your dentist's advice to prevent dry socket after tooth extraction, but perhaps you don't remember that clearly what they told you or you want some more tips for avoiding a dry tooth socket. In that case, here's what you should do:

Rest and recuperate

After surgery, make sure to rest for the remainder of the day. Consider taking the following day off work (or scheduling your surgery for a Friday) so you have that extra day to recover. Your dentist will tell you how long to stay away from sports and other strenuous activities to prevent the blood clot from dislodging.

Manage the pain

To relieve pain and swelling from the extraction, you can alternate placing ice packs (wrapped in a tea towel) and warm compresses on your cheek. Of course, you should also take any pain medication you have been prescribed.

For some home remedies for dry socket pain, including clove oil, our tooth pain home remedies article is a good resource.

Ask a dentist: How can I avoid dry socket?

After an extraction, I recommend to my patients the following dry socket prevention tips:

  • One of the main reasons people develop dry sockets following extractions is frequent spitting after the procedure to get rid of the taste of blood. I advise my patients to try to swallow their saliva including the blood, instead of spitting it out, as this disturbs the formation of the blood clot at the bottom of the socket.
  • If the patient is a heavy smoker and absolutely must smoke within the first 48 hours after surgery, I advise them put a gauze over the extraction site to cover and protect the socket and its blood clot.
  • In case there is excessive bleeding following the extraction, patients should place a wet tea bag over the extraction site to both reduce the bleeding and protect the blood clot.

I also recommend that patients eat pineapple or drink pineapple juice before any surgeries and after it, because the bromelain in pineapple helps to reduce the inflammation, pain, swelling and bruising that could develop following any surgical procedures including extractions. 

Dr. Joseph Salim, Sutton Place Dental Associates

Stay away from straws

When you use a straw to drink, the sucking action creates a vacuum in your mouth. This vacuum can pull the blood clot out of place, so you should completely avoid the use of straws for at least one week following dental extraction.

Also stay away from carbonated, caffeinated, hot, and alcoholic beverages for as long as advised by your dentist.

Eat soft food

For a day or two after surgery, stick to soft foods like smoothies, soups, mashed potato and yoghurt. Avoid very hot or cold food, and be careful about biting your cheek until the anesthesia wears off.

Switch to semi-soft foods when you feel like you can easily tolerate them, but chew on the side of the mouth away from the extraction. Stay away from sticky, chewy and crunchy foods for at least a few more days to avoid damage to the site.

Adopt proper oral hygiene

Maintaining good oral hygiene is among the most important ways to prevent dry socket.

Ask your dentist about how to brush your teeth after surgery. In most cases, you will be advised to just gently 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.

When using a mouth rinse, be very careful not to swish it around too vigorously, especially for the first 24 hours. Instead, put some in your mouth and move your head around so it covers the extraction site.

Once you are past the first 24 hours, you can use warm salt water to rinse your mouth a few times a day following surgery. To make this rinse, mix 1/2 teaspoon of table salt in a small glass of warm water and mix until dissolved.

Say ‘no' to tobacco

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

Inhaling cigarette smoke after tooth removal can dislodge the blood clot for the same reasons as sucking a straw can. 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 days prior to dental surgery as well as in the days following it.

quit smoking to prevent dry socket
Help prevent dry socket by avoiding tobacco

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

  • Switch to a nicotine patch for the time being
  • Wait for at least 48 hours post-surgery before resuming smoking
  • Ask about getting stitches on the surgical site
  • Avoid chewing tobacco or nicotine gums

If you do want to 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. Please do seek help to quit smoking—the benefits to your health are numerous, plus you can get to whitening those smokers' teeth.

The dry socket statistics above also apply to those who smoked e-cigarettes after tooth extraction as well. If you'd like to know more about vaping and oral health, check out our article ‘is vaping bad for your teeth?

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 your tooth extraction. Follow your dentist's advice and take some extra precautions using the tips in this article. If you do notice any dry socket symptoms developing in the days after your treatment, speak to your dentist straight away.

FAQs

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 dry socket healing process?

The clot serves as a barrier of protection against bacteria and other types of irritants that may lead to infection. It also plays a crucial role in generating new tissue and bone at the extraction site.

What complications can develop from dry socket?

The most common dry socket complication is delayed healing. Infection may occur but might not be strictly associated with dry socket. If you develop signs 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:
Joseph Salim DMD is a NYC cosmetic and sleep apnea dentist, as well as a botox specialist. In 1996 he founded Sutton Place Dental Associates, a multi-specialty dental practice. Dr. Salim completed his General Practice Residency at the Lutheran Medical Center in New York in 1993. He has received numerous awards, and in 1989 was the recipient of a grant for outstanding academic achievement.
Dr. Junaid Tariq is a medical doctor and professional content creator and copywriter. In addition to working as a part-time 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 simplifies complex scientific concepts into basic terms to create something easily accessible to the majority. His medical knowledge includes general medicine, dentistry, medical manufacturing, pharmacy, nursing, optometry, chiropractic, plastic surgery, and emergency care, among others.
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.