If there’s one dental phrase that is even more scary than ‘root canal’ it is probably ‘dry socket’.
Dry socket is a rare but extremely painful complication that can follow tooth extraction.
As well as the immediate, extreme, pain which can last days or even weeks, there may also be long term consequences: cavitation, which can take decades to develop under the extraction site.
For you to avoid dry socket, I think it’s helpful to understand the stages of healthy recovery that most people experience when dry socket doesn’t occur.
Healing after an extraction- without complications
Dry socket is a painful complication that can occur after a tooth extraction. As well as the immediate, extreme pain which can last days or even weeks, there can also be long term consequences: cavitation, which can take decades to develop under the extraction site.
For you to understand what causes dry socket, I think it’s helpful to explain the stages of healthy recovery which most people experience, when dry socket doesn’t occur.
Content warning: If you are squeamish about blood and graphic body processes, you might want to skip the following paragraphs and start reading again at the next heading (How to avoid dry socket).
Ideally, the socket should bleed freely during and for a short time after a tooth extraction. Once the procedure is finished, your body starts slowing the blood flow so that a clot starts to form, starting from the bottom of the socket. Eventually, a jelly-like plug fills the hole left by the tooth root. Where it’s exposed to the air and your oral microbiome, the top surface of this soft clot forms a dry scab within 2-3 days. The scab eventually dissolves or falls off in 1-2 weeks once the danger of infection has passed. At that point, you can be confident that your bone and soft gum tissues are actively regenerating to fill the socket.
During a healthy recovery from extraction, you should be able to see a black spot on the extraction site from about the third day. This black spot gets smaller day by day, perhaps also getting lighter in colour. It usually disappears completely between 7-14 days.
Aren’t bodies amazing? Now that I’ve explained how your body forms a healthy clot that should stay in place until it naturally dissolves or falls out, keep reading to find out how to ensure that happens.
What is dry socket?
Dry socket occurs when something interrupts any stage of the natural healing process described above.
This might happen if :
- the blood is unable to flow freely during and immediately after the extraction.
- something prevents the clot from growing properly from the base of the socket to the top.
- the scab is disturbed before it naturally dissolves or falls off.
These disruptions to the body’s natural healing process leave nerves and bone exposed inside the socket.
Bits of food, drifting bacteria or other loose materials can enter the socket and cause irritation, inflammation, or infection.
Bacteria reaching the bone can lead to cavitation, ie a hole inside the jaw bone, although this usually doesn’t become noticeable for some decades.
How to avoid dry socket
Whenever I talk to anyone who is getting a tooth extracted my intial advice is always ways to avoid dry socket. Most of these recommendations are common sense. However, because most people don’t experience complications, I think that common sense is sometimes taken for granted! Even if you are feeling completely fine after an extraction, you should still take extra care to avoid dry socket, which can get triggered at any point before the scab falls off (7-14 days).
Ask your dentist not to use the drug Epinephrine during your procedure (some dentists routinely inject it with the local anaesthetic). It’s an adrenaline-type of medication which can slow bleeding and interfere in the body’s natural process for forming a healthy clot. Every dentist should be flexible about this, for patients who can’t tolerate adrenaline.
Make sure you follow your dentist’s instructions for aftercare, which are intended to help you to avoid dry socket. In addition I recommend:
Scheduling at least 24 hours to rest and recuperate: You may have a very easy experience in the dental chair and feel fine afterwards, but losing a tooth is still a big adjustment for your body. Immeditately post-extraction is not the time to do any exercise, including walking more than the length of the carpark or to the bus stop. If possible you should avoid lifting anything heavy, especially wriggly children.
Avoiding ‘bitsy’ food until the clot is gone: Stick to liquids for the first 24 hours, then eat soft smooth food for at least another couple of days. After day 3 you can start eating chewier food if you want but don’t eat food with little bits, like rice, rolled oats, chopped parsley, or nuts and seeds. Avoid any foods that might scratch at the clot like chips or toast. Avoid very hot or very cold food or drinks and carbonated drinks.
Don’t suck, squirt, or swish anything in your mouth until the scab is completely gone: That means don’t smoke or vape, drink through a straw, don’t oil pull, don’t use a mouthwash or water flosser, and don’t French kiss or give oral sex until the site has healed over and you can’t see the clot anymore.
What to do with dry socket
You’ll know if you have dry socket because your jaw will hurt with a deep bone ache, maybe worse that any toothache you’ve had before. It’s often a bad kind of pain that doesn’t respond to over-the-counter painkillers. It can keep you awake, rob your concentration and make you sad and cranky.
- Continue with the recommendations above for avoiding dry socket.
- Rinse your mouth gently with warm salty water after every time you eat, but don’t vigorously swish it around your mouth.
- Be careful with what and how you eat, in order to keep the dry socket clean and avoid it getting worse.
- Be very careful brushing the teeth closest to the dry socket.
- Drink lots of water and herbal teas to stay well hydrated.
- Above all, do not smoke or vape or use other tobacco products.
If you do have dry socket, I recommend going back to the dentist or endodontist both to get help with the pain and to rule out other complications. A good dentist will treat your dry socket very seriously.
Your dentist can give you prescription pain killers which should give some relief. They can also flush out anything in the socket (e.g. food debris or other loose material) which may help to ease the pain and speed your healing. If appropriate they may pack the socket with a medicated paste and cover it with a dressing. You might find they recommend another visit in a couple of days.
Learn how to deal with your dental fears so that you can easily open wide when you need to.
Calm & Confident in the Dental Chair is an interactive workbook for adults who are anxious about seeing the dentist, with accessible exercises, insightful journaling and simple tips to help you show up relaxed and stay at ease through any kind of dental visit.
Available as a paperback or ebook.
Extraction energetics
If I can help a client avoid a tooth extraction I will do my best. But if they decide that it’s the best option I will do everything I can to help make it an easy, uncomplicated experience. A ‘good’ tooth extraction can not only lift a physical burden but also be a portal for emotional healing.
Whether you want my help to avoid losing a tooth, or you’ve resigned yourself to a necessary tooth extraction, working with the emotional meaning of a crisis point in a tooth’s life can be profoundly transformative.
Before an extraction, I can help you make confident informed decisions, help you have the easiest, least complicated extraction you can, with no dry socket, while caring for your whole mouth and body holistically, and set yourself up for a lifetime of oral health from here onwards.
After an extraction, if you are dealing with dry socket or another complication, I can help you identify and address any underlying emotional or energetic messages that these symptoms are carrying. Sometimes it can make a difference just to have someone offer support, sympathy and comfort.
Where ever you are on the road through a tooth extraction, I invite you to consider starting a coaching package customised to start where you are now and help get your teeth and gum health to where you want it to be.
To find out which coaching option is most suitable for your circumstances, book a free assessment call. I will always give you my honest opinion about whether I think I can help and how much coaching you’ll need. (Limited appointments available to suit UK and Europe time zones here).
Has a dentist told you that your cavities or receding gums are your fault because you are drinking too much Coke, you don’t floss enough or you need to stop breastfeeding your baby? And you know that isn’t true!
I’m a natural oral health coach and I’m not going to blame you or shame you.
The underlying causes of your oral health issues are not your fault!
Nature or nurture, ancestry or environment, free will or systemic oppression, unconscious emotions or the degraded food system are the factors that make your teeth and gums vulnerable to disease.
Even though your tooth decay and gum disease is not your fault, it is within your power to change.
I can help you to turn your oral health around with natural strategies, healthy habits and intuitive insights.