After your dentist extracts a tooth, a blood clot forms to fill the empty area left behind by the removed tooth. This blood clot provides a protective barrier between the mouth and the exposed nerves and bone underneath, until the gum tissue heals and closes over the extraction site. But in some cases, the blood clot becomes dislodged before the gum tissue heals – a painful condition called alveolar osteitis, or dry socket.
In the absence of a blood clot, the extraction site can easily become exposed to air and harmful oral bacteria, and food can become lodged in the site as well. Dry socket is painful, delays healing, and raises the risk of infection and further complications. Dry socket only occurs in about 2-5% of all tooth extraction cases, but is much more common in wisdom tooth extractions, occurring nearly 20% of the time after impacted wisdom teeth extractions.
Causes of Dry Socket
Using straws - the suction from drinking through a straw can dislodge a blood clot and cause
dry socket.
Smoking and using oral tobacco. Tobacco users are 3x more likely to develop dry socket.
The suction action of smoking a cigarette (or pipe, vape) or chewing on tobacco can dislodge a healing clot and cause dry socket.
Spitting vigorously, repetitive sneezing or coughing, vomiting - these are all violent
mouth motions that can dislodge a blood clot.
Eating hard, sticky or crunchy foods
Drinking acidic drinks - Acid can prevent the blood clot from forming, and/or dissolve the clot.
Acidic drinks include sodas, alcohol, juices.
Certain medications - Some studies indicate that taking oral contraceptives with estrogen
doubles the likelihood of developing dry socket after tooth extraction, while other medications may prevent a blood clot from forming.
Having a history of dry socket
Poor oral hygiene
Tips for Preventing Dry Socket
If you are sick, reschedule your appointment. Sneezing, coughing, and vomiting are violent
mouth motions that can dislodge a blood clot. If you are sick or have severe allergies and cannot reschedule, ask your dentist about any precautions you should take.
Do not use straws for 48 hours after tooth extraction.
Do not spit vigorously for 24 hours after extraction.
Don’t smoke or use any oral tobacco for at least 48 hours.
Eat soft foods, and Avoid acidic drinks as well as hard, sticky and crunchy foods for
about a week post-surgery.
Don’t brush directly on the extraction site for 2-3 days. We recommend not
brushing at all for 24 hours after extraction; instead, rinse your mouth gently with warm salt water a few times a day. When you do begin brushing your entire mouth again, brush very gently on the extraction site until it is fully healed (about 7 days after surgery).
Ask about medication interactions. Some medications may increase the risk of dry socket,
while others may prevent a blood clot from forming. Ask your dentist if you are at risk, and if so what measures you should take.
Keep your mouth clean. Good oral hygiene is always important, but especially so following
oral surgery. Keeping your mouth clean will help you heal faster, by helping to prevent bacteria from entering the wound, harming the clot, or causing infection.
How to Treat Dry Socket
If you suspect you may have dry socket, or are experiencing intense pain in the jaw or in the area around the extraction site after getting a tooth removed, contact your dentist. We treat dry socket by 1) flushing the area to remove any accumulated debris within the extraction site, 2) applying medicated dressing and/or packing it with a medicated gel or paste, and 3) prescribing painkillers. Your pain should be relieved nearly immediately after treatment, and with good oral hygiene and care, the site should heal within 7-10 days.
Have any questions or concerns? Don’t hesitate to contact us, we will be happy to help!