Treat a Dry Socket

If you've recently had a tooth or teeth removed, you may develop one or more dry sockets (Alveolar osteitis). A dry socket occurs when the blood clot from the site is lost too soon, and the bone (as well as some sensitive nerve endings) become exposed and are vulnerable to oral bacteria and other stimuli. The alveolar bone suffers and fights to create a new protective membrane, which takes about four days. This can lead to infection, pain, and inflammation, usually two to three days after a tooth has been removed.[1] Although dry sockets are a self-limiting condition, they can be quite painful and intense. Knowing how to treat a dry socket may help you limit the pain and speed up the recovery time of this condition.

Steps

Diagnosing a Dry Socket

  1. Identify the symptoms. Dry socket has some common symptoms that may help you to determine if that is the problem. The most common symptoms of dry socket are:
    • Severe pain, especially radiating from the site of tooth extraction out across that side of your face. The pain is intense and you have to manage it continually.
    • Visibly "empty" appearance at the site of tooth extraction and the entire area will have a grey color compared to the usual purple, red, white, or yellow which indicates good healing.
    • Visible bone in the open wound on your gums.
    • Swollen lymph nodes in the jaw and/or neck.
    • Fever.
    • Foul taste or odor in the mouth.[2]
  2. Know who is at risk. While a dry socket may develop in anyone's mouth following a dental surgery, certain risk factors such as tobacco use, estrogen-based oral contraceptives, and use of corticosteroids or very bad oral hygiene and not following the instructions of your dentist may increase the chances of developing a dry socket.[3]
  3. See a doctor or dentist. If you suspect that you've developed a dry socket following a dental surgery or tooth extraction, contact your dentist or doctor immediately.

Easy Treatments

  1. Take pain relievers. Though pain medication will not help the wound heal or prevent infection, it will help you manage the pain associated with a dry socket. Your doctor may recommend a prescription-strength pain medication, or you may wish to stick with over-the-counter medications like aspirin or acetaminophen.[4]
    • Do NOT give aspirin to children or adolescents. Use of aspirin in children or teenagers may cause complications with the liver and brain. Consult with your child's pediatrician for guidance on what medication would work best for your child.[5]
    • Don’t exceed the dosage with ibuprofen either because this can lead to severe stomach or intestinal bleeding.
  2. Use ice or a cold compress on the side of your face experiencing pain. Use cold packs only for the first 48 hours.
    • Fill a sandwich bag with ice cubes, or wrap ice cubes in a clean towel. In a pinch, you can also use a bag of frozen vegetables wrapped in a paper towel.
    • Apply to the affected side of the face. Remove the bag if it starts to feel like it is burning your skin or you may damage your skin.
    • Keep the ice pack on for 20 minutes, then off for 20 minutes.
    • After two days you should switch to using a warm compress, as a cold compress will no longer reduce swelling or inflammation after the first 48 hours.[6]
  3. Stay hydrated. Drinking clear liquids, especially water at room temperature, is crucial following any surgical procedure.[6]
    • Avoid alcohol after any surgery.
    • Water at room temperature is the best beverage to stay hydrated. If you like, you may wish to alternate water with a sugar-free sports drink.
  4. Use a salt water rinse. This will remove debris and help sooth inflammation.[6]
    • Add approximately half a teaspoon of salt to one cup of lukewarm water.
    • Stir the salt water thoroughly, so that it is mostly dissolved.
    • Very gently swish the salt water around in your mouth, focusing on the affected side of your mouth without creating negative pressure which can dislodge the clot.
    • Repeat after each meal and before bed, and any times in between when you believe a saltwater rinse might be helpful.
  5. Avoid using tobacco products. The physical act of smoking a cigarette may cause a blood clot to come dislodged, and using chewing tobacco or passing smoke over the socket may further irritate the wound and prolong the pain and inflammation.[6]
    • Try using a nicotine patch if you don't believe you can't quit smoking during the time it takes for your mouth to recover.
    • Talk to your doctor about smoking alternatives.
  6. Try clove oil. Some patients have found that using a few drops of clove oil to treat the site of an open dental wound may alleviate some of the pain.[7] This should not be done as an alternative to seeking professional medical advice and assistance. Rather, it is meant to provide temporary pain relief in the event that immediate medical assistance is not available.
    • Apply one or two drops of clove oil to a clean cotton swab.
    • Dab the swab against your gum where the tooth was extracted.
    • Repeat as necessary to help relieve pain and inflammation.

More Difficult Treatments

  1. Flush the socket. One common method of treating a dry socket is by flushing the socket. This removes any external debris, such as food or dirt, and may help reduce the chances of infection. This can be done by a dentist or oral surgeon, or at home with the right equipment.[4]
    • Use a clean, plastic syringe with a curved tip.
    • Fill the syringe with clean water or clean salt water, or use a prescription rinse if your doctor has given you one. Or, you can even use an alcohol-free diluted mouthwash.
    • Flush the socket from multiple angles starting on the third day after the extraction. Be sure that any visible debris is completely removed.
    • Continue to flush after every meal and before bed until the wound begins to heal and debris no longer pools in the socket.[4]
  2. Pack with medicated dressings. The oral surgeon or dentist who performed your tooth extraction may pack the wound with medicated dressings. The medication applied to these dressings can help relieve pain and prevent infection. You will most likely have to change the dressings every day, but your oral surgeon will determine the frequency and duration of medicated dressing applications.[4]

Preventing Dry Socket

  1. Have your oral surgeon pack the wound immediately after surgery. This has been shown to reduce the incidence of developing a dry socket. Having the wound sutured by your oral surgeon may also prevent dry socket.[8]
  2. Use antibacterial mouthwash. This should be done immediately before and after surgery for best results.[9]
    • Unscrew the cap and pour mouthwash into the cap. Dilute it with water so that it is 50% water and 50% mouthwash.
    • Gently swish the mouthwash around in your mouth moving your tongue from one cheek to another. You may wish to concentrate your swishing efforts around the affected area.
    • Spit out the mouthwash into the sink.
    • Rinse your mouth out with water immediately afterward if the sting of mouthwash becomes too intense.
  3. Stick to soft foods. This is especially important during the first 24 hours after surgery. Gradually move from soft foods to semi-soft foods as your wound heals, but it's generally best to avoid hard, chewy, crunchy, and spicy foods, as these are most prone to pooling in the socket and causing irritation or infection.[9]
  4. Avoid using tobacco. If you're recovering from oral surgery, avoid smoking for at least 48 hours after the procedure. If you use chewing tobacco, avoid using it for at least one week after the procedure. Use of tobacco products may increase irritation, prolong the healing process, and leave wounds more susceptible to infection.[9]



Tips

  • Be prepared. Don't plan to go out for several hours without bringing along your Tylenol, syringe, etc. You may feel alright now, but if the pain comes back, you'll want to be prepared.
  • Don't smoke until your gums have had a chance to heal.
  • Avoid bacon bits, hamburger and rice for a few days.

Warnings

  • Use of drinking straws within the first week of an extraction will greatly increase the risk of a dry socket.
  • 30% of women taking oral contraceptives experience dry sockets after their surgery. The best time to have your wisdom teeth removed is during the last week of your menstrual cycle (days 23 through 28).
  • Do not increase dosage or mix pain killers without speaking to a healthcare professional.
  • Smoking within the first 24 to 48 hours of an extraction can also lead to increased risk of a dry socket.

Related Articles

Sources and Citations

  1. ↑ http://www.mayoclinic.org/diseases-conditions/dry-socket/basics/definition/con-20025990
  2. ↑ http://www.mayoclinic.org/diseases-conditions/dry-socket/basics/symptoms/con-20025990
  3. ↑ http://www.mayoclinic.org/diseases-conditions/dry-socket/basics/risk-factors/con-20025990
  4. ↑ 4.0 4.1 4.2 4.3 http://www.mayoclinic.org/diseases-conditions/dry-socket/basics/treatment/con-20025990
  5. ↑ http://www.mayoclinic.org/diseases-conditions/reyes-syndrome/basics/definition/con-20020083
  6. ↑ 6.0 6.1 6.2 6.3 http://www.mayoclinic.org/diseases-conditions/dry-socket/basics/lifestyle-home-remedies/con-20025990
  7. ↑ http://www.medicinenet.com/dry_socket_overview/page2.htm#what_is_the_treatment_for_a_dry_socket
  8. ↑ http://www.medicinenet.com/dry_socket_overview/page3.htm#is_it_possible_to_prevent_a_dry_socket
  9. ↑ 9.0 9.1 9.2 http://www.mayoclinic.org/diseases-conditions/dry-socket/basics/prevention/con-20025990
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