Having a tooth pulled is a far from pleasant experience, but for a small proportion of dental patients who undergo extractions, their pain and discomfort doesn't stop once the offending tooth has been yanked out. Dry socket, a condition that affects the gum tissue left behind after a tooth extraction, can prolong your pain and misery for days or even weeks. Fortunately, effective treatments are available, but it is important to be aware of the risk of developing dry socket so you can minimise its effects if and when it occurs to you.

What is dry socket?

When a tooth is pulled, a socket is left behind, containing the nerves left behind after extraction and the part of the jawbone that the tooth attached to. In the vast majority of tooth extractions, a blood clot forms quickly after extraction to fill in the cavity, protecting the nerves and bone from their sudden exposure. However, if the clot is dislodged, or if a clot fails to form for whatever reason, the nerves and bone are left exposed, a situation which becomes progressively more painful the longer they are left uncovered.

Dry socket generally starts to become painful one or two days after extraction and may be accompanied by bad breath or a pervasive bad taste in your mouth. In some cases you may even be able to see the bone left exposed by the absent clot.

Who suffers from dry socket?

While dry socket can occur to anybody who has recently had a tooth removed, the risk of developing dry socket is increased by the following:

  • Smoking and/or chewing tobacco
  • Poor oral hygiene
  • Use of birth control pills or implants
  • Particularly traumatic tooth extractions, for example extracting a badly broken tooth
  • Conditions that reduce blood clotting, such as haemophilia
  • Certain medications that can cause dry mouth (xerostomia), such as diarrhoea and asthma medications.

How can dry socket be treated?

Dry socket can fortunately be treated effectively, but you will need to revisit a dental clinic to receive it, so make a repeat appointment as soon as you can. Once they have inspected the dry socket and assessed the scale of the problem, you may be offered one or more of the following treatments:

  • A thorough cleaning of the dry socket by your dentist, who will remove any debris or loose tissue which may impinge the clotting process. After cleaning the socket is generally filled with a medicated paste or dressing to protect the exposed nerves and bone from infection. These dressings usually need to be changed daily by your dentist until the problem subsides.
  • Antibiotics, administered to prevent the exposed socket becoming infected.
  • Painkillers, such as ibuprofen. In cases of severe pain, your dentist may offer you intravenous anaesthesia of the affected area.
  • Medicated or salt-water mouthwashes, to keep the exposed area clean and free of bacteria and food detritus.