The Dry Socket after Oral Surgery


Anyone who has had a dry socket, won’t soon forget the experience. It can happen within a couple of days after a tooth is taken out and the pain is so intense that normal medication, even prescription strength, won’t usually touch it.

When a tooth is taken out, the socket usually begins to bleed forming followed by a clot. This is the normal and healthy progression of healing from a dental extraction. But, on occasion, this doesn’t happen. The bone is left without a clot and is exposed to the oral environment. When looking at the socket, you can frequently see the white of the bone which has no clot.


The most common solution is to place a medicated thin strip of gauze in the socket. A common choice is gauze treated with iodoform, and sometimes there is a cement paste, for example zinc oxide and eugenol. The pain usually reduces immediately. The gauze should be taken out the next day if it does not fall out on its own. This process may need to be repeated if the pain persists. It is really amazing how well this procedure works for those unfortunate to get a dry socket.

Keep in mind that complete healing in the extraction site will be extended.

The most common extraction site to have this complication is the lower wisdom teeth (third molars), so when young adults tell of severe pain when they had their wisdom teeth out, it is probably from this.

The most common cause of dry socket is from smoking. The nicotine could cause a decrease of blood flow to the socket resulting in this condition. There are other possibilities since some patients will get dry sockets despite not being a smoker. This could be due to the anesthetic or surgical trauma during the procedure just as a couple of examples.

It is important to consult with the surgeon rather that just loading up on pain medicine when this sort of pain occurs. The patient will know because the pain meds won’t take care of the pain.