What is dry socket?

Dry socket, also called alveolar osteitis, is a painful condition that can happen when you have a tooth removed (extracted).

When your tooth is removed, a blood clot usually forms in the socket. The socket is the hole in the jawbone where the tooth used to be. When a blood clot forms, it protects the bone and nerves underneath. Dry socket usually occurs in the bone of the upper or lower jaw.

If the blood clot is removed or does not form well, the bone and nerve are exposed. This causes extreme pain and can lead to infection.

Dry socket is common and occurs in about 1 in 20 tooth extractions. If you have dry socket, you need to contact your dentist or oral surgeon.

What are the symptoms of dry socket?

It is normal to feel sore or uncomfortable after having a tooth removed. But if you have dry socket, the pain can be intense. It may start a few days after the extraction.

If you have dry socket, you may experience:

• severe, ongoing throbbing pain within 1 to 3 days of the tooth extraction — the pain may extend to your ear or eye on the same side of the face
• bad breath
• a slight fever
• an unpleasant taste in your mouth
• swelling around the socket

You may be able to see the dry socket — there will be exposed bone instead of a dark blood clot. There may be greyish tissue covering the socket.

What causes dry socket?

The breakdown of a blood clot that leads to dry socket may be caused by a range of factors, such as:

• an underlying infection in the mouth
• trauma from the tooth extraction
• problems with the jawbone

The condition occurs more often with wisdom tooth extraction in the lower jaw than with other teeth.

Some factors make it harder for a blood clot to form and stay in place. You are more likely to develop dry socket if you:

• smoke
• previously had dry socket
• had a difficult tooth extraction (trauma)
• use oral contraceptives (birth control pills)
• don't have good dental hygiene
• have had a tooth extracted from the lower jaw, especially a wisdom or molar tooth

When should I see my dentist or doctor?

If you have ongoing intense pain a few days after your tooth removal, or you think you may have dry socket, contact your dental clinic or dentist. They can help you ease your pain.

If you have facial swelling, contact your dentist or see your doctor.

How is dry socket diagnosed?

Your doctor or dentist can diagnose dry socket with a physical examination. If you have severe pain after a tooth extraction, see your dentist or oral surgeon. They will talk to you and examine you. They will ask you about your pain and when it started. They may be able to see that the blood clot is missing from your socket. You may need other tests to rule out conditions such as osteomyelitis (a bone infection).

How is dry socket treated?

Dry socket can heal by itself after a few weeks. However, pain during this time can be intense. If you develop dry socket, your dentist or oral surgeon may flush out any food particles or debris stuck in the socket, or put a medicated dressing in the socket.

To help treat your pain, your dentist will ask you to rinse your mouth with mouthwash or salt water at home, and may prescribe pain relief medicines.

The condition should improve quickly after treatment. If you still feel pain after 3 weeks, return to your doctor or dentist.

What are the complications of dry socket?

The main complication of dry socket is that it may take longer for the wound to heal fully.

You might be in pain and experience inflammation until you get treatment. During this time, it may be harder to eat and go about your daily activities.

Can dry socket be prevented?

Tips to prevent dry socket after a tooth extraction include:

• rinse and spit gently
• avoid smoking
• always follow your dentist's instructions, including how to clean your mouth

Your dentist may also take some steps during the extraction itself. They can help prevent dry socket by:

• giving you a medicated mouth rinse before and after the extraction
• applying a special gel on the socket after surgery

Resources and support

To find out more about mouth health, visit Teeth.org.au — a website created by the Australian Dental Association.

The Queensland Government web page on tooth removal includes information on dry socket and how to prevent complications.

Call healthdirect on 1800 022 222 at any time to speak to a registered nurse (known as NURSE-ON-CALL in Victoria) for more information and advice.

You can speak with your dental practitioner if you need help to quit smoking. You can also call Quitline on 13 7848 or find information on the Queensland Government website.

Languages other than English

You can find translated information on how to care for your mouth after an extraction on the Health Translations website.

The Queensland Government website has translated information on caring for yourself after dental surgery.

Oral Health Victoria has translated oral health advice.