From the Research
Dry socket, or alveolar osteitis, is a painful dental complication that occurs after a tooth extraction when the blood clot that normally forms in the socket is dislodged or dissolves before the wound has healed, as described in the most recent study 1. This condition exposes the underlying bone and nerves, causing intense pain that typically begins 2-3 days after extraction and may radiate to the ear, eye, temple, or neck. The condition is characterized by severe throbbing pain, bad breath, unpleasant taste, and visible bone in the empty socket. Some key points to consider about dry socket include:
- The condition typically resolves within 7-10 days as new tissue gradually fills the socket, as noted in 2.
- Dry socket occurs in about 2-5% of all extractions but is more common after difficult wisdom tooth removals, as reported in 3.
- Risk factors include smoking, oral contraceptive use, poor oral hygiene, and not following post-extraction care instructions, as discussed in 4.
- Treatment involves cleaning the socket to remove debris, placing a medicated dressing containing eugenol (clove oil) to relieve pain, and prescribing pain medications such as ibuprofen (600-800mg every 6-8 hours) or acetaminophen with codeine if needed, as described in 5. Patients should rinse gently with warm salt water (1/2 teaspoon salt in 8oz water) several times daily and return for dressing changes every 24-48 hours until pain subsides. It's also important to note that antibiotic use is controversial in the treatment of alveolar osteitis, and systemic antibiotics may provide insufficient efficacy, especially when caused by a multidrug-resistant organism, as highlighted in 1.