Dry socket

Diagnosis

Severe pain following a tooth extraction is often enough for your dentist or oral surgeon to suspect dry socket. He or she will also ask about any other symptoms and examine your mouth to see if you have a blood clot in your tooth socket and whether you have exposed bone.

You may need to have X-rays taken of your mouth and teeth to rule out other conditions, such as a bone infection (osteomyelitis) or small fragments of root or bone remaining in the wound after surgery.

Treatment

Treatment of dry socket focuses on reducing symptoms, particularly pain. Dry socket treatment may include:

• Flushing out the socket. Flushing out the socket can remove any food particles or other debris that may contribute to pain or possible infection.
• Medicated dressings. Your dentist or oral surgeon may pack the socket with medicated gel or paste and medicated dressings. These can provide relatively fast pain relief. The severity of your pain and other symptoms will determine whether you need dressing changes and how often or if you need other treatment.
• Pain medication. Ask which pain medication is best for your situation. You'll likely need a prescription pain medication.
• Self-care. Once the dressing is removed, you may need to flush the socket at home to promote healing and eliminate debris. Typically you'll receive instructions and a plastic syringe with a curved tip to squirt water, salt water or a prescription rinse into the socket. You'll likely need to continue the rinse until the socket no longer collects any debris.

Once treatment is started, you may soon begin to feel some pain relief. Pain and other symptoms should continue to improve and will likely be gone within a few days. However, keep scheduled appointments with your dentist or oral surgeon for dressing changes and other care.

Lifestyle and home remedies

You can help promote healing and reduce symptoms during treatment of dry socket by following your dentist's or oral surgeon's instructions for self-care. You'll likely be told to:

• Take pain medications as prescribed
• 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
• Use caution with eating or drinking, avoid carbonated beverages, and avoid smoking or using a straw to prevent dislodging the dressing

Preparing for your appointment

Make an appointment with your dentist or oral surgeon as soon as possible if you develop new or worsening pain after a tooth extraction.

What you can do

To get ready for your appointment, make a list of:

• Any symptoms you're experiencing, including any that may seem unrelated to the reason for your appointment
• Key personal information, such as any medical conditions you have
• All medications you take, including vitamins, herbs or other supplements, and the dosages
• Questions to ask your dentist or oral surgeon to make the most of your time together

Some questions to ask your dentist or oral surgeon may include:

• What are the likely causes of my pain?
• Do I need any tests?
• What type of treatment will I likely need to improve my symptoms?
• What can I take for the pain?
• Is there a generic alternative to the medicine you're prescribing?
• How soon will I feel better?
• How long should I wait to eat or drink after this procedure?
• Are there any restrictions I need to follow?
• Are there any brochures or other printed material that I can have?
• Are there any websites you recommend?

Don't hesitate to ask other questions during your appointment.

What to expect from your doctor

Your doctor is likely to ask you these questions:

• When did the severe pain begin?
• Does the pain occur on its own or does it happen when you drink or touch the area?
• How would you rate the pain on a scale of 1 to 10, with 10 being the most severe?
• Where is the pain located?
• Have you taken pain relievers? What dosage and how often?
• Have the pain relievers helped to some degree?
• Do you have any other symptoms that seem unrelated to your dental pain?
• Have you had a fever?