Dry socket: A common—and painful—complication of wisdom teeth surgery

Having wisdom teeth surgery can be a real pain, but if your healing regimen goes awry, you can find yourself in a world of hurt. An expert from the Texas A&M College of Dentistry explains this uncomfortable complication and how to avoid it.

What is dry socket?

 When a tooth is extracted, a blood clot forms and fills the extraction site to help protect the area as it heals. However, once in a while, if you’re not careful, that blood clot can be displaced, which leaves the bone and nerve high and dry.

“The blood clot is there to protect the wound,” said Michael Ellis, DDM, clinical associate professor with the Texas A&M College of Dentistry. “If the clot is broken down prematurely, then the bone is exposed and the area becomes a ‘dry socket.’”

The blood clot has its own “life cycle,” which can last for about a day or two. It forms naturally, then the body breaks it down once the socket starts filling with soft tissue to help the healing process.

“We typically see dry socket after the removal of lower impacted third molars, or wisdom teeth,” Ellis said. “The pain can last anywhere from a few days to a week.”

Symptoms and treatment

 There are not many symptoms of dry socket, but there is one that stands out above the rest, and that’s pain.

“When someone has a dry socket, the first thing they’ll notice is a moderate to severe amount of pain,” Ellis said. “The exposed bone is sensitive, and that is the source of pain, which can be dull or throbbing and even radiate up to the patient’s ear.”

A dry socket can also have a foul odor, and this can lead to the patient experiencing a bad taste in the mouth.

While many people may think that their dry socket is infected or that having one increases the chances of infection, that may not be the case. “There’s not a lot of swelling or fever with a dry socket,” Ellis said. “An infection can happen, but it’d be unrelated to the dry socket.”

The treatment for dry socket is pretty straightforward, and is almost the same as cleaning out any other painful wound. “You want to clean the wound, irrigate it with saline and then dress the wound with medicated gauze,” Ellis said. “Treating the wound doesn’t speed up the healing process: It just deals with the amount of discomfort that the patient is in—whether you treat it or not, it will get better.”

Risk factors and how to prevent a dry socket

After surgery, a surgeon will provide directions to help decrease the odds of developing dry socket. Some of the instructions include avoiding carbonated or warm beverages, keeping the mouth relaxed and avoid messing with the area. Also avoid using a straw, as the suction can dislodge the blood clot.

Clots break down naturally, but some people may have factors that causes them to break down prematurely, a condition called secondary fibrinolysis. This process can be induced by medication, stress or an underlying medical condition.

People who smoke can also see an increase risk of dry socket, especially if they smoke within three to five days after surgery. Women who take birth control also see a slight increase in risk for dry socket.

If you begin to notice an unpleasant discharge, severe pain or fever, call your surgeon right away. Also, if your swelling gets worse instead of better, or if your bleeding doesn’t subside with pressure, contact your health care provider. Complications after surgery are rare, but they are real.