Dry socket (DS) is a painful condition that occurs after a tooth extraction. It happens when the blood clot in the socket is dislodged or fails to form properly. This exposes the underlying bone and nerve endings, leading to significant discomfort and delayed healing. It is one of the most common complications following a tooth extraction. DS particularly occurs in cases of molar or wisdom tooth removal. It has higher occurrence in people aged 30–40 and in women, possibly due to hormonal factors.

Causes:

The blood clot that forms in the tooth socket after extraction acts as a protective layer over the bone and nerves. Loss of this clot can lead to dry socket.

Using a straw to drink creates strong suction. This can disturb the blood clot in the socket.

Forceful spitting or aggressive rinsing also disturb the clot.

Bacterial infection of the extraction site can interfere with clot formation and stabilization. As a result, patient suffer from aute pain.

Smoking creates suction that can dislodge the clot. Nicotine reduces blood flow and delays healing.

Women taking oral contraceptives or undergoing hormonal changes are more prone to dry socket.

Neglecting post-operative instructions after extraction increases the risk of infection and clot loss.

Symptoms

• Severe, throbbing pain that begins 1–3 days after extraction and radiates to the ear, temple, or neck.
• A visible empty socket with exposed bone.
• Foul odor or unpleasant taste in the mouth.
• Delayed healing compared to the expected recovery timeline.

Treatment

If dry socket occurs, prompt treatment can alleviate pain and promote healing:

1. Cleaning the Socket: The dentist will irrigate the socket to remove debris and bacteria.
2. Packing the Socket: A medicated dressing or paste containing eugenol or anesthetics, is placed in the socket to soothe pain and encourage healing.
3. Pain Management: Over-the-counter pain relievers like ibuprofen or prescribed medications can help manage discomfort.
4. Oral Rinse: Hot salt water mouth rinsing is recommended.
5. Follow-Up Visits: Regular check-ups ensure proper healing and dressing changes, if necessary.

With appropriate care and treatment, the symptoms of dry socket generally subside within 7–10 days. Healing may take longer in severe cases, but most patients recover without long-term complications.