One of the most common complications of having a tooth taken out is developing a dry socket. A dry socket is when the blood clot that is supposed to be in the extraction site either doesn’t form or is displaced. This exposes the bone in the area causing a severe toothache type pain. Many of my patients have told me that the dry socket pain is worse than the toothache that caused the tooth to need to be extracted! This pain can last anywhere from a week up to 5 weeks. Most dry sockets resolve in the shorter end of that range and will always resolve on their own whether you seek treatment or not. Some types of treatment will actually extend the healing time so keep that in mind.
So how do you know if you have a dry socket? Most dry sockets follow a relatively predictable pattern.
- Tooth pain from an extraction generally peaks and starts to quickly decrease within 24-48 hours after the extraction. A dry socket on the other hand usually starts 3-5 days after having a tooth taken out.
- Dry sockets have a much higher incidence after removal of impacted wisdom teeth (especially bottom wisdom teeth) as well as after difficult extractions.
- Risk factors include smoking, using straws, spitting, taking birth control medication, and the intake of hot liquids and foods in the first day or two after the extraction.
- Oftentimes you’ll see a hollow area where the tooth came out and sometimes you can see or feel the exposed bone.
- If you notice pus coming out of the area, it may be infected rather than a dry socket. This is much less likely than a dry socket but can cause similar pain and in a similar time frame. See your dentist for sure if you are concerned it may be infected.
It is important to realize that while a dry socket can be miserably painful, there are no health consequences associated with it. All treatment seeks to manage the symptoms until the area is able to heal on it’s own. Studies have been pretty inconclusive as to what treatment, if any, is best for managing dry sockets. Let’s take a look at some of the things you can do at home.
- Practice prevention. Avoid smoking for as long as you can manage after the extraction. 3 days minimum and longer is better. Don’t use straws or spit. Avoid hot foods for the first day or two after the extraction.
- Take 600-800 mg of Ibuprofen every 6 hours on the dot. If you only take it when it hurts you’ll get into a bad pain cycle that is hard to get out of. Staying ahead of the pain is important.
- Rinse any debris out of the socket. Food tends to get trapped down in there and can cause problems. The easiest way to do this is with a curved monoject syringe. Your dentist usually has these or you can sometimes get them at a pharmacy. An alternative would be a standard oral medication syringe (like you’d use to give medications to kids). As long as you reach the tip into the socket, it’ll work fine. Put some water in it and gently rinse the socket out. Don’t be forceful as this can also displace blood clots.
- DIY Dry Socket Medications – Most medication materials that dentist’s use for dry sockets have some combination of eugenol (oil of cloves) and an anesthetic such as benzocaine as well as some other minor ingredients. Oil of cloves and benzocaine (like in Anbesol) are both medications you can purchase over the counter. The best thing to do is make a 50/50 mixture of these two things and dip a piece of cotton in it. Take a pair of tweezers or something similar that can hold the cotton and push the cotton into the socket. Make sure your cotton piece is big enough that when you push it into the socket you have enough sticking out the top to remove it. Leave it in for a couple of minutes and then remove. You don’t want to leave this in the socket long term as it will slow/stop healing. This combination of medications will help relieve some of the pain and you can do this several times a day.
- If all else fails, remember that the pain will go away on it’s own.