Dry socket is a complication of having a tooth pulled (tooth extraction). The socket is the hole in the bone where the tooth used to be. After a tooth is removed, a blood clot forms in the socket. This protects the bone and nerves underneath as it heals.

Dry socket occurs when the clot is lost or does not form well. The bone and nerves are exposed to the air. This causes pain and delays healing.

Alveolar osteitis; Alveolitis; Septic socket

You may be more at risk for dry socket if you:

• Have poor oral health
• Have a difficult tooth extraction
• Use birth control pills, which may interfere with healing
• Smoke or use tobacco, which slows healing
• Do not take proper care of your mouth after having a tooth pulled
• Have had dry socket in the past
• Drink from a straw after the tooth is pulled, which can dislodge the clot
• Rinse and spit a lot after the tooth is pulled, which can dislodge the clot

Symptoms of dry socket are:

• Severe pain 1 to 3 days after the tooth is pulled
• Pain that radiates from the socket to your ear, eye, temple, or neck on the same side that your tooth was pulled
• An empty socket with a missing blood clot
• Bad taste in your mouth
• Bad breath or a terrible smell coming from your mouth
• Slight fever

Your dentist will treat the dry socket by:

• Cleaning out the socket to flush out food or other materials
• Filling the socket with a medicated dressing or paste
• Having you come in often to have the dressing changed

Your dentist may also decide to:

• Start you on antibiotics
• Have you rinse with salt water or special mouthwash
• Give you a prescription for pain medicine or irrigation solution

To care for the dry socket at home:

• Take pain medicine and antibiotics as directed
• Apply a cold pack to the outside of your jaw
• Carefully rinse the dry socket as directed by your dentist
• Take antibiotics as instructed
• Do not smoke, use tobacco, or drink alcohol

To prevent dry socket, follow your dentist's instructions for mouth care after you have a tooth pulled.

Contact your dentist if you think you have:

• Symptoms of dry socket
• Increased pain or pain that does not respond to pain relievers
• Worse breath or taste in your mouth (could be a sign of infection)

American Dental Association website. Dry socket. www.mouthhealthy.org/all-topics-a-z/dry-socket/. Published 2023. Accessed February 3, 2023.

Hupp JR. Postextraction patient management. In: Hupp JR, Ellis E, Tucker MR, eds. Contemporary Oral and Maxillofacial Surgery. 7th ed. Philadelphia, PA: Elsevier; 2019:chap 11.