Dry socket, or alveolar osteitis, is a common complication of tooth
extraction. It develops when the blood clot that protects the wound
disintegrates or breaks loose, leaving the nerves and bone in the socket
exposed.
Most cases of dry socket develop within 3–5 days after surgery.
In case of a dry socket, the pain will improve and then suddenly get worse,
which could be more painful than the extraction procedure.
The pain caused by a dry socket is throbbing and radiating across a large
area of the jaw or up towards the ear.
Risk factors for developing a dry socket, include:
 Chewing or biting down on the empty socket, using straws, sucking
on foods, and blowing the nose can create negative pressure inside
the mouth, increasing the risk of the blood clot detaching.
 Dry socket is more common in wisdom tooth removal and tooth
extractions from the lower jaw. It is also more prevalent if the
extraction is complicated or traumatic.
 People with bacterial infections in the mouth before undergoing tooth
extraction have a higher risk for dry socket.
 Dry socket is more common in people with a history of mouth sores,
hospitalization from a serious illness, and cancer.
 Smoking increases the chance for developing dry socket. This may be
due to the tobacco itself, or the sucking motion involved in smoking.
 Females taking birth control pills may have a two-fold increased risk
of the condition.
Treatment for a dry socket focuses on reducing pain. The patient is
advised to return to the dentist to manage symptoms. A dentist will first
flush out the socket with a medicated mouthwash or saline. Then, they
will fill in the socket with a medicated dressing to control the pain.
Depending on how long the pain lasts, people may need to change this
dressing after a couple of days. Adults can also take non-steroidal antiinflammatory drugs, such as ibuprofen.
In most cases, the pain of dry socket improves within 24–72 hours, the
pain may last up to 7 days.
Dr. Hanadi Hadi Alkhafaji