Symptoms and causes

Symptoms

Signs and symptoms of dry socket may include:

  • Severe pain within a few days after a tooth extraction
  • 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 odor coming from your mouth
  • Unpleasant taste in your mouth

When to see a doctor

A certain degree of pain and discomfort is normal after a tooth extraction. However, you should be able to 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.

Causes

The precise cause of dry socket remains the subject of study. Researchers suspect that certain issues may be involved, such as:

  • Bacterial contamination of the socket
  • Trauma at the surgical site from a difficult extraction, as with an impacted wisdom tooth

Risk factors

Factors that can increase your risk of developing dry socket include:

  • Smoking and tobacco use. Chemicals in cigarettes or other forms of tobacco may prevent or slow healing and contaminate the wound site. The act of sucking on a cigarette may physically dislodge the blood clot prematurely.
  • Oral contraceptives. High estrogen levels from oral contraceptives may disrupt normal healing processes and increase the risk of dry socket.
  • Improper at-home care. Failure to follow home-care guidelines and poor oral hygiene may increase the risk of dry socket.
  • Having dry socket in the past. If you've had dry socket in the past, you're more likely to develop it after another extraction.
  • Tooth or gum infection. Current or previous infections around the extracted tooth increase the risk of dry socket.

Complications

Painful, dry socket rarely results in infection or serious complications. However, potential complications may include delayed healing of or infection in the socket or progression to chronic bone infection (osteomyelitis).