What Does Dry Socket Look Like?

What is a Dry Socket?

A dry socket (alveolar osteitis) is a painful inflammation that can develop in the jawbone's open tooth socket after a tooth has been removed. Dry sockets often develop after extraction and are more common after extraction of the third molars, or wisdom teeth removal.

A socket appears as a hole in the jawbone where a tooth was previously. After a tooth is removed during oral surgery, a blood clot forms in the socket. A blood clot protects the bone and nerves underneath as it heals.

A dry socket occurs when the blood clot is lost or prevented from forming. When the blood clot cannot form properly, the bone and nerves are exposed to the air, which causes severe pain and delays healing.

Dry socket occurs in approximately 1 to 5% of all extractions and up to 38% of wisdom tooth extractions. Dry sockets are more frequent in the lower jaw, in patients older than thirty years, in female patients, and in teeth that were infected before surgery.

What Causes a Dry Socket?

A dry socket forms when the blood clot at the site of surgery dissolves or is dislodged.

Common factors that cause dry socket include:

• Bacteria in the area dissolve the clot pre-maturely and may hinder the reformation of a dislodged blood clot.
• Food particles that collect inside the socket and dislodge a blood clot.
• Mechanical motions such as sucking through a straw or cigarette or aggressive rinsing and spitting can cause loss of a blood clot.
• Smoking nicotine, which impairs healing and decreases new blood vessel formation.
• Oral contraceptive pills and menstrual hormones, which increase the risk for dry sockets. 
• Alcohol and carbonated drinks can also dissolve a blood clot.

Symptoms of a Dry Socket

Symptoms of dry socket are:

• Severe pain 3 to 5 days after tooth extraction
• Throbbing pain that radiates from the socket and can extend up to the ear, eye, temple, or neck on the same side of tooth extraction
• Unpleasant taste in the mouth
• Bad breath or a smell coming from the mouth
• Slight fever

Factors that increase the risk for a dry socket include:

• Poor oral hygiene
• A problematic tooth extraction
• Taking birth control pills, which may interfere with healing and prevent blood clotting
• Smoking or tobacco use, which slows healing
• Drinking alcohol, which slows healing
• Previous history of dry sockets
• Drinking from a straw after the tooth is removed, which can dislodge the clot
• Rinsing and spitting a lot after tooth extraction, which can dislodge the blood clot

What Does a Dry Socket Look Like?

A dry socket looks like a hole left after tooth extraction, where exposed bone within the socket or around the perimeter is visible. The opening where the tooth was pulled may appear empty, dry, or have a whitish, bone-like color.

Typically, a blood clot forms over your empty socket. This clot protects the wound while it heals and promotes new tissue growth. Without a blood clot over the socket, raw tissue, nerve endings, and bone are exposed.

The socket bone can be exposed entirely or can be covered by food debris or clumped bacterial material. When surrounded by food debris or bacteria, the socket can appear in various colors, including black, yellow, and green.

On the other hand, some patients sometimes may not be able to visibly notice a dry socket, just a hole after tooth extraction.

Dry Socket Pictures

Dry Socket Treatment

A dry socket is treated by a dentist or an oral surgeon, and typically consists of the following steps:

1. Clean the socket to flush out food and debris.
2. Fill the socket with medical dressings. This helps prevent any new food particles and debris from entering the tooth socket.
3. After the dressing is placed, you must visit your dentist regularly to have it changed out during the healing process. 
4. Your dentist may prescribe you antibiotics, pain medications, a special mouthwash, and/or irrigation solutions to assist in healing. You can also take over-the-counter pain relievers.
5. Rinse your mouth with salt water a few times each day to flush out bacteria and food particles. Most mouthwashes are too harsh. Many of them also contain alcohol, which can increase the risk of a dry socket.

Home Remedies for Dry Sockets

To prevent dry socket, patients should follow their dentist's instructions, which may include:

• No smoking
• No rinsing or disturbing the socket area for at least 24 hours
• Changing cotton gauzes over the socket as they become soaked with blood

To care for a dry socket at home, patients should:

• Take pain medicine and oral antibiotics as prescribed
• Apply ice to the jaw
• Carefully rinse the dry socket as recommended by the dentist
• Apply clove oil to the extraction site for pain relief 
• Eat soft foods until fully healed
• Refrain from smoking or drinking alcohol

Oral antibiotics do not significantly decrease the risk of dry sockets because there are hundreds of bacteria types in the mouth. For that reason, even if patients have good oral hygiene, they may still develop dry sockets.

How to Prevent Dry Sockets

There are a few ways to prevent a dry socket from forming. The most important prevention technique is to rinse your mouth a few times each day. Make sure you gently rinse your mouth because aggressive rinsing/spitting can make the blood clot fall out.

Also, do not brush the extraction site for at least a week post-op. Only eat soft foods like smoothies, eggs, soup, and mashed potatoes. Refrain from drinking hot liquids, carbonated drinks, alcohol, and caffeine until the extraction site heals.

Smoking tobacco products can also increase the risk for infection and dry socket.

Common Questions and Answers