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A tooth socket is a hole in the jawbone where a tooth was previously located. After a tooth is removed, a blood clot forms in the socket, similar to a scab. This blood clot gradually turns into new bone and gum tissue as part of the healing process.
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. They commonly develop in:
A dry socket appears as a hole where the tooth was removed. You will see the bone that once surrounded the extracted tooth. The opening where the tooth was pulled may appear empty, dry, or have a whitish, bone-like color.
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.
By contrast, a socket with a blood clot that is healing properly should appear dark red. As the blood clot continues to transform into new tissue, it should gradually blend in with the rest of your gums.
A dry socket forms when the blood clot does not form, dissolves, or dislodges before the extraction site heals.
According to Dr. Nandita Lilly, one of NewMouth's in-house dentists, "the highest risk for dry socket is within the first 4 days after surgery."
Common risk factors for dry sockets include:
Symptoms of dry socket include:
The pain from a dry socket typically begins within the first 2 to 4 days after extraction, and it can last several weeks.
If you had a tooth extracted more than a week ago and haven’t experienced this kind of pain, the clot has probably already begun to heal. This means you’re unlikely to develop a dry socket.
If you begin to experience symptoms of a dry socket, contact your dentist or oral surgeon as soon as possible.
Professional treatment for a dry socket typically consists of the following steps:
To care for a dry socket at home, you should:
Oral antibiotics do not significantly decrease the risk of dry sockets because there are hundreds of bacteria types in the mouth. For that reason, you can still develop a dry socket even if you have good oral hygiene.
There are a few ways to prevent a dry socket from forming. The most important things to avoid are smoking, sucking motions, and drinking through straws. Your dentist will probably also advise you to avoid strenuous exercise while the area is still healing.
You should also make sure to rinse your mouth gently because aggressive rinsing/spitting can make the blood clot fall out. Do not brush the extraction site for at least a week post-op. Only gently brush the neighboring teeth around the extraction site.
Your diet can also play a role in preventing a dry socket from forming. Until the extraction site heals, you should:
After having a tooth extracted, your dentist or oral surgeon will give you instructions like the ones above. These instructions are intended to help your mouth heal and prevent a dry socket from forming. Be sure to follow them carefully.
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