How To Avoid Dry Socket After a Tooth Extraction

What is dry socket, and can you avoid it?

Dry socket is a painful problem that can happen after a tooth is removed. After an extraction, a blood clot forms in the empty socket. The clot protects the bone and nerves while the site heals. Dry socket happens when the clot does not form or comes out too soon. Cleveland Clinic says you cannot always prevent it, but you can lower your risk.

The medical name is dry socket (alveolar osteitis). It affects about 2% to 5% of all extractions, per Cleveland Clinic, and it is more common after wisdom tooth removal. Our tooth extraction page explains what the visit involves.

What does the blood clot do?

The blood clot is the first stage of healing. Cleveland Clinic says it looks like a dark scab and covers the bone and nerves. If you see it, leave it alone. Do not poke at it with your tongue, a finger, or a brush. Mayo Clinic adds that the clot also holds cells that are needed for proper healing of the site.

What can you do to lower your risk?

Follow the steps your dentist gives you, plus these tips from Cleveland Clinic and Mayo Clinic:

1. Skip straws. Suction can dislodge the clot. Both clinics say to avoid straws for at least a week.
2. Do not smoke or use tobacco. Mayo Clinic says to avoid tobacco for at least 48 hours after surgery and as long as you can after that. See our post on smoking and vaping after tooth extraction.
3. Rinse gently. Cleveland Clinic says to use gentle motions when rinsing or spitting, because hard rinsing can dislodge the clot or stitches. Mayo Clinic says to avoid the extraction site for the first 24 hours, then rinse gently with warm salt water several times a day for a week.
4. Eat soft foods. Choose soft items such as yogurt or applesauce, and steer clear of hard, crunchy, or chewy food.
5. Skip hot and fizzy drinks. Cleveland Clinic says to skip warm or fizzy drinks while you heal. Mayo Clinic says to avoid alcoholic, caffeinated, carbonated, or hot drinks for as long as your dentist recommends.
6. Rest and avoid hard exercise. Cleveland Clinic says a raised heart rate can cause more pain and bleeding, and advises skipping strenuous activity for 48 to 72 hours.
7. Keep your mouth clean. Brush and floss the rest of your mouth as usual, and brush around the site only when your dentist says it is fine.

What does the first week look like?

Healing follows a rough path. Your dentist’s written steps come first, but this outline can help you plan.

1. Day of the extraction. Cleveland Clinic says to bite on folded gauze for 15 minutes if the site oozes, and repeat if needed. Mayo Clinic says to plan to rest for that day.
2. First 24 hours. Avoid the extraction site when you rinse or brush, per Mayo Clinic. Cold packs on the outside of the face can ease pain and swelling.
3. Days one to three. This is the window when dry socket most often starts. Cleveland Clinic says day three is usually the worst day of pain after an extraction, so rest and take it easy.
4. Day five. If you have had no dry socket symptoms by day five, Cleveland Clinic says you are likely in the clear.
5. Through day seven. Keep using gentle salt water rinses and skip straws.

See post-operative instructions for how to read the sheet your dentist gives you.

Who has a higher risk?

If you take birth control or any other medicine, tell your dentist before the extraction. Do not stop or change a medicine on your own. Your dentist and your doctor can decide together if anything needs to be adjusted.

What are the signs of dry socket?

Cleveland Clinic lists these symptoms:

• Pain in the mouth or face, including pain that radiates from your jaw toward your head and neck
• An empty-looking hole with a whitish layer at the bottom, which is exposed bone
• A bad taste or bad breath
• Tooth or gum infection

Mayo Clinic says the pain usually begins one to three days after the extraction and that over-the-counter medicine usually will not be enough to treat dry socket pain. If you have new pain or pain that gets worse in the days after your tooth removal, call your dentist right away.

How is dry socket treated?

Your dentist may flush the socket with salt water or an antibacterial rinse, place a medicated dressing, and suggest pain medicine. Antibiotics may be added if infection is suspected. Cleveland Clinic says dry socket usually heals within seven to 10 days with proper care.

If you cannot reach the dentist who did the extraction, Cleveland Clinic says to go to the nearest urgent care or emergency room. Our tooth extraction aftercare guide has more detail on the first week.

Next step

Learn more about tooth extraction at Town Center Dental, then call (636) 273-5866 or request an appointment if you have questions about aftercare or think you have dry socket. The office is closed Friday through Sunday, so call early in the week and plan ahead.