A dry socket is a painful complication that can sometimes occur after having a tooth removed. Just after a tooth extraction, blood fills into the tooth socket, forming a clot. During the first 24 hours this clot is very soft and fragile, somewhat like half-set Jell-O. If you are not careful this clot can accidentally be pushed or sucked out of place.

It is very important to leave the clot in place whenever possible, as the body will use it as a matrix in which to form new bone. This is especially necessary if there are plans to replace the missing tooth with a dental implant. Good bone support is critical in helping implants to last.

Dry sockets occur when there is too much vacuum or explosive pressure. This can happen when someone sneezes hard, spits, sucks on a cigarette or rinses too vigorously too soon after tooth extraction. Therefore it is very important to carefully follow all oral and written instructions given to you after your procedure.

Losing a clot can also occur if blood pressure is elevated or the patient gets overheated. It is imperative that you rest and do not lie out in the sun or exercise. This is because if you get too hot, your circulation increases and the clot may come out.

If you do get a dry socket, it is not serious and it is very easy to treat. You may begin to experience symptoms 4-5 days after the extraction such as lingering or worsening pain or a bad smell which might indicate that part or all of the clot has been lost and a dentist should be consulted. We will check the area for infection, rinse out any debris, and if needed place a sedative material into the area to calm it down and relieve pain until the bone can heal over on its own in a few days.

Do’s and Don’ts

Do:

Rest and relax- watch your favorite Netflix!

Gently eat your favorite soft, mushy foods. Pretty much anything you can roll over your tongue and swallow; cottage cheese, yogurt, soft stew or soup. (Nothing with tiny berry seeds or husks.)

Use your cold packs the first 24-48 hours, applying off and on every 10-20 minutes. (Frozen peas work great!)

Don’t:

Spit, such through a straw, rinse or smoke!! It is normal to ooze for several hours after your tooth is pulled. Just drool into the sink and blot your mouth with a tissue.

Do not vomit. This usually occurs from taking prescribed narcotics on an empty stomach. Remember to take food with your medications.

Do not sunbathe. Though lying in the sun is very relaxing, getting overheated will cause your blood to circulate more rapidly in an attempt to cool you off and you may bleed more. If you really want to be outside, stay in the shade and use your cold packs.

Do not work out, exercise or play sports. The more you rest and are a couch potato, the faster your body can knit you back together. The discomfort from having a tooth removed may not fully manifest itself for up to 48 hours due to lingering anesthetic and pain relievers. It is easy to think that you can resume activities you are not really ready for yet. If you do, you may pay for it later with a painful dry socket.

Chris Cassinelli, R.D.H.