Dry socket


You would have thought that once a tooth is removed that the pain related to that tooth would soon disappear. It is common to have some pain after an extraction. However in around 1-5% of extractions and around 30% when the tooth removed is a lower wisdom teeth,  the pain after the extraction can be as bad or worse than the toothache before it. Dry socket, or alveolar osteitis is an acute inflammation of the alveolar bone around the site of an extraction of an adult tooth. It is characterised by:

  • Severe pain
  • Breakdown of the clot formed within the socket making the socket empty and often filled with food debris
  • Swelling and redness of the gum around the socket
  • Halitosis, 
  • Exposed bone which is very tender to touch

There are a number of factors that make you more susceptible to dry sockets:

  • Traumatic, difficult length extraction 
  • Smoking
  • Oral contraceptives
  • Bone disorders and underlying pathologies
  • Radiotherapy to the head and neck
  • Systemic illness such as diabetes
  • Clotting problems,
  • Failure to comply with post-extraction instructions
  • Other possible risk factors include gum disease and previous dry socket after extraction

Home care advice

As getting dental care has been extremely difficult then it is quite unlikely that you will have had an extraction. However the emergency hubs have been doing them so it is possible.

Generally the socket should be irrigated with saline or corsodyl mouthwash to clean out the debris and detached piece of bone. In a dental surgery the socket would then be packed with a material called alvogyl which contain Butamen, Iodoform and Eugenol. Together they offer pain relief and antiseptic qualities. At home you will not be able to use alvogyl. An alternative may be to use some clove oil on a gauze and apply this to the area for 20 minutes at a time.

  • Corsodyl (chlorhexidine) mouthwash rinses throughly in the area
  • Salty water rinses
  • Pain relief through Ibuprofen and paracetamol if medically appropriate
  • Clove oil applied on gauze

If however there is significant swelling in the area and in the regional lymph nodes then antibiotics may be necessary

Written by Andrew Bain BDS MJDF (RCS Eng)
Apr 27, 2020