Health   |    Holistic Healing   |    Lifestyle & Fitness  
|    Peace & Spirituality   |    Sex & Health   |    Dentists    

Dry Socket- A post dental extraction complication

Dry socket is a condition which affects millions of patients around the world who undergo tooth extraction. This painful event can be avoided in majoirty of cases by proper understanding. It will then save unnecessary agony to patients and loss of countless hours of dentist's practice in dealing with it. We have compliled this section in the hope of achieving this goal.

This condition occurs after tooth extraction, particularly after traumatic extraction, resulting in a dry appearance of the exposed bone in the socket, due to disintegration or loss of the blood clot. It is basically a focal osteomyelitis without suppuration and is accompanied by severe pain (alveolalgia) and foul odor. It is also called alveolar osteitis and alveolitis sicca dolorosa. (Dorland, 27th Ed)

The most common, most dreaded and most painful complication of tooth extraction. Clinicians call it a "dry socket" a misnomer that fails to stress the importance of infection in its etiology. Affected person complains of unbearable pain and sensitivity of intake of food or drinks.

Dry socket usually develops after 3 to 5 post surgical days. The pathogenesis of dry socket (also called fibrinolytic alveolitis) is a subject of debate with two main opinions. The first one is based on the presumption that there is a absolute absence of blood clot. According to the second opinion there is initial blood clot formation, which subsequently gets lysed leaving behind an empty socket. Streptococci have been implicated as causative organisms, but lysis might occur without bacterial presence also.

Excellence in Rotary Endodontics

The following factors are considered important in causation of dry socket:

    1. Insufficient blood supply to the alveolus.
    2. Preexisting infection. (Granuloma, periodontal or pericoronal infection)
    3. Use of large amounts of local Anesthetic, leading to vasoconstriction.
    4. Post operative bleeding.
    5. Trauma to alveolus during extraction.
    6. Infection during or after extraction.
    7. Root/bone fragments or foreign bodies left in the socket.
    8. Excessive irrigation and curettage.
    9. Fibrolytic or proteolytic activity in the clot.
    10. Loss of clot due to patient's negligence
    11. Patient actions like sucking liquids, sneezing, coughing, rinsing water post extraction
    12. Predisposing factors in patient, eg smoking, poor general health

Dry socket is more often seen in the mandibular molars particularly the third molars. This condition is associated with  excruciating pain, foul breath, unpleasant taste, empty socket and gingival inflammation and Lymphadinopathy.

By avoiding all possible averse factors, risk of dry socket becomes less. Prophylactic packing of alveolus with medicated dressing and advising patient to use 0.2% chlorhexidine mouth rinse may be helpful to avoid dry socket in suspect cases.

Treatment of dry socket is mainly done to control pain by analgesics, advice warm saline rinse to remove food debris, dressing the cavity to protect & heal the socket. In early stages just initiating fresh bleeding in the socket and giving a pack will resolve this condition.

Zinc oxide dressings also have been advised, commercial dressings are also available in international market. Here are the name of some commercial products :
D.S. Dressing/paste
To download a guide for these products CLICK HERE

With these precautions and treatment the pain should reduce and granulation of the socket should be observed. Antibiotic therapy may be used if desired. Most sockets resolve in 4-5 days.


Always compress the socket after extraction so that chances of clot retention are better.

Give all instructions to patient so that he does not disturb the ext wound.

Ask smoker to stop until extraction wound has healed.

Body has great healing capacity, avoid unnecessary routine irrigation of socket with antiseptic solutions.

If dry socket develops do a simple trick it works for 99.99% cases, take a sharp sickle scaler and scrap the gums surrounding socket, let fresh blood fill the socket, give a pack (wet squeezed gauze)

Also as a precaution if you feel a case has more infection/ trauma during extraction, it may be helpful to suture to socket and that would reduce/eliminate chances of dry socket.

This webpage on dry socket has been voted as one of the top pages, thanks. Funny thing is that over 80% visitors are from USA and Europe. Why is it so, 80% extractions are being done in India, Asia, but it would appear that dry socket is more common in Western countries ?

LATEST News about Dry Socket HERE

See British Asso.Guidelines for treatment of Dry Socket

Now that you know a good deal about this condition Read on how to achieve single visit Endo

Want to read still more on dry socket ? Go to Mayo site

Animated Teeth

If you liked info here please leave a line in our Guest Book, Thanks.

Dry Socket

Oral Prophylaxis made Easy

Tooth whitening

Teeth Whitening Facts and Myths

Fiber reinforced composites in dentistry

Changing concepts in Class I and II cavity preparation

Latest Research On Dental Pain

Caries Vaccine

Curing lights for composite resins

Fluorosis, epidemiology, indices and treatment

Lasers in Root canal treatment and Endodontics

Abfractions? How they are important in Restorative Dentistry

Mouth Healthy Guide

Caries Prevention in Children - The Indian Challenge

Mouth Rinsing before dental procedures.

Infection Control Routine for the Dental Clinic

Aids and Dentistry

Dental Journals by Subject

Rational Use of Medicine

Evidence Based Dentistry

Shade selection and Management

Obstructive Sleep Apnea- Do you know about it?

Genetically modified bacteria may prevent cavities - Put you out of Business?

Fiber Reinforced composites

A primer on all composite class materials

Options for esthetic restorations

Immediate and Early loading of Implants

Treatment of Fluorosis Stains

Dental Abfraction

Emergency in a Dental Clinic

Preparation of Root Canal

Placement of gingival restorative margins

Bonding for the New Millennium

Nanodentistry- the Future

Access Cavity Preparation

Access Cavity Preparation - Molars


Selection of Analgesics

Fifth generation bonding

Restoration of endodontic teeth

About whitening agents

Caries disclosing agents

Composite polishers

LED curing lights

Recurrent Aphthous Stomatitis

New cavity-fighting agent shows promise

Tooth Loss Linked to Pancreatic Cancer in Smokers

2-min brush helps achieve cleaner teeth: Study

Snoring can kill

Gum disease raises death risk in diabetics: study

Brushing Right After Drinking Soda may Harm Teeth

What are Giomers

Benefits of Pre-procedural mouth rinsing?

To Bond Or not to Bond Amalgam

Flowable Composites