What is a dry socket and how can you avoid it?

Dry socket is one of the possible complications associated with a dental extraction. The term 'socket' refers to the hole left behind as a result of the extraction. Dry socket means that a blood clot either hasn't formed over the wound, or it has dislodged before the site has properly healed. It doesn't affect everyone, but when it does occur it can be quite painful and should be looked at by a qualified professional to rule out the risk of any other issues arising.

There are a few things you can do in an attempt to avoid a dry socket in the first place, such as not smoking, practising good oral hygiene and following your dentist's instructions for recovery exactly.

What is dry socket?

Any form of tooth extraction creates a wound in the gum. As with elsewhere in the body, normally a blood clot will form as a protective layer. In the mouth, the blood clot protects the now-exposed jaw bone and nerve endings. Should a blood clot fail to form or it gets dislodged, the extraction site is unprotected. This is referred to as a dry socket (also known as alveolar osteitis) and is what causes the pain.

Dry socket can be cause for concern because the lack of a protective layer means food debris can get into the wound and there is a risk of inflammation and infection. The patient will likely feel pain around both the extraction site and into the side of the face. 

It's most commonly a problem following wisdom tooth removal (also known as the third molars) but could happen following any extraction. Dry socket is also more likely if you've had the problem before, the extraction was particularly difficult, you use birth control pills or you are a smoker.

How do you know if you have dry socket?

The pain is one of the most common and obvious signs of dry socket. Most tooth extractions result in some level of discomfort, but excessive pain that you can't control with painkillers indicates that there could be a problem. It normally starts within a few days of the extraction.

Other signs of dry socket to look out for include:

• Obvious bone visible in the wound.
• No blood clot covering the wound and therefore a definable socket shape.
• An unpleasant taste in the mouth.
• Bad breath or odour coming from the mouth.
• Slight fever.

If you have any of these symptoms following a tooth extraction, it's worth contacting your dentist for further advice.

Any level of discomfort you can't control with painkillers could be a symptom of dry socket.

5 ways to avoid dry socket

While there's no guaranteed way of avoiding dry socket, you can take steps to reduce the chances of it developing.

1) Exercise good oral hygiene

Keeping your mouth healthy following surgery is essential. While you'll need to treat the area around your wound carefully, and care for it as instructed, overall good at-home care is a key part of preventing dry socket.

2) Minimise smoking and tobacco use

Smoking and using tobacco products increase the risk of dry socket because they slow the body's ability to heal. The best scenario is to try and stop smoking before your extraction. While your wound is healing you should also avoid smoking as the sucking action can encourage the blood clot to loosen and dislodge. In any case you should talk to your dentist about your habits and what you can do to minimise ill effects. 

3) Disclose all medications to your dentist

Some medications may affect your blood's ability to clot. Before the surgery, inform your dentist of any prescribed or over-the-counter medications you're taking, including the contraceptive pill. They'll be able to advise you of any changes you need to make before the surgery or how it affects your recovery.

4) Be careful about what you eat and drink

You'll need to drink lots of water following surgery, and it's advisable to avoid alcohol, caffeine and hot beverages for as long as you can. As with smoking, using a straw can cause a blood clot to dislodge due to the sucking action. 

Stick to soft foods for the first few days so you don't have to chew too much. Soups and foods like yoghurts or smoothies are good options to begin with. Make sure to avoid very hot foods until your anaesthesia has worn off so you can feel any burning sensations. 

5) Follow your dentists instructions meticulously

While there are some common instructions that patients receive following a dental extraction, your dentist will also give you care advice specific to your own needs. As a result, it's important you do exactly as your dentist suggests. They may recommend mouthwashes, antiseptic medications or special dressings. They'll also talk to you about your lifestyle, and what you can and can't do immediately after extraction – for example if you are still able to play any sports while healing.

Should you have any concerns about a recent tooth extraction, or think you may need treatment for another condition, contact the team at City Dentists via 04 978 4964 or book an appointment online.