Dry socket is a painful condition that can occur following a tooth extraction, such as the removal of an impacted wisdom tooth.

It happens when the blood clot forming over the socket is displaced; leaving bone and nerves exposed.

If you develop a dry socket, the pain usually begins three to four days after the tooth is removed. If this happens, notify your dentist right away.

Signs and symptoms

After a tooth extraction, you will find a dry-looking opening where the tooth was pulled. When dry socket occurs, there is whitish bone at the operation site instead of a dark blood clot.

Signs and symptoms of dry socket may include:

• Severe pain within a few days after your tooth is extracted.
• Partial or total loss of the blood clot at the tooth extraction site, which you may notice as an empty-looking (dry) socket.
• Visible bone in the socket.
• Pain that radiates from the socket to your ear, eye, temple or neck on the same side of your face as the extraction.
• Bad breath or a foul odour coming from your mouth.
• An unpleasant taste in your mouth.
• Swollen lymph nodes in your jaw or neck.
• Slight fever.

There may be other signs or symptoms not listed above. If you have any concerns about a symptom, consult your doctor or pharmacist.

What to do

Although dry socket rarely results in infection or serious complications, getting the pain under control is a top priority.

After a tooth extraction, you can help promote healing and reduce symptoms of dry socket by following your dentist’s instructions for self-care.

• Place a cold pack on your face in the first 48 hours after extraction and warm packs after that to help decrease pain and swelling.
• Take pain medications prescribed by the dentist.
• Avoid smoking or using tobacco products.
• Drink plenty of clear liquids to remain hydrated and to prevent nausea that may be associated with some pain medications.
• Rinse your mouth gently with warm salt water several times a day.
• Brush your teeth gently around the dry socket area.

Keep scheduled appointments with your dentist or oral surgeon for dressing changes and other care. If your pain returns or worsens before your next scheduled appointment, call your provider.

When to see your dentist

A certain degree of pain and discomfort is normal after a tooth extraction. You can manage normal pain with the pain reliever prescribed by your dentist or oral surgeon, and the pain should lessen with time.

If you develop new or worsening pain in the days after your tooth extraction, contact your dentist or oral surgeon immediately.

How to prevent dry socket

You will receive instructions on what to expect during the healing process and how to care for the wound after an extraction. These instructions can help you in pain prevention:

• You should plan to rest for a few days after surgery. Limit vigorous exercise and sports for at least a week after the tooth extraction because that could dislodge the blood clot in the socket.
• Drink lots of water after surgery and avoid beverages containing alcohol and caffeine as well as carbonated or hot drinks in the first 24 hours.
• For the first day, you should eat only soft foods. If you can tolerate the pain, semi-soft foods are okay. However, avoid hard, chewy and hot or spicy foods that might get stuck in the socket or irritate the wound
• Following surgery, you may rinse your mouth and brush your teeth gently, trying to avoid the extraction site. After the first 24 hours, gently rinse your mouth with warm salt water every two hours while awake and after meals for a week after surgery.
• If you’re a smoker, do not smoke for at least 48 hours after surgery. If you chew tobacco, refrain from doing so for at least a week because tobacco products after oral surgery can delay healing and increase the risk of complications.

This article first appeared on Hello Doktor and medically reviewed by the Hello Doktor Medical Panel. The Hello Health Group does not provide medical advice, diagnosis or treatment.