The incidence of dry sockets worldwide is between 1% and 4 %. There are no specific reasons for its occurrence. In the same way, there is no specific treatment for it. However, the following risk factors have been associated with it:
- Difficult extraction
- Consumption of alcohol
- Use of oral contraceptives
- Use of a straw while drinking something
- Pre-existing infection
Dry socket healing timeline
What to expect in the first 24 hours after tooth extraction
- Blood clots form at the extraction site within four hours
- The sterile dressing put at the site by your dentist helps gum tissues to heal
- Some pain remains, which can be managed by taking the prescribed medications
- There may be some bleeding at the site
- Some swelling is common
What to do or not to do in the first 24 hours following extraction:
- Do not engage in heavy physical activities
- Do not use mouthwash to rinse your mouth
- Alcohol may damage the clot. Do not consume alcohol
- Do not brush your teeth aggressively
- Take a lot of rest, although you may begin regular activities
- Do not use oral contraceptives
- Do not touch your socket with your finger or push the socket with your tongue.
You still do not have a dry socket.
Also Read: What Does a Dry Socket Look Like?
24 to 48 hours after the extraction
- Your tissues continue to heal
- Pain continues to subside
- If the pain does not subside and instead intensifies, it may indicate that you have a dry socket.
3 to 5 days after the extraction
If your blood clots and your body fails to heal the extraction site, you may have a dry socket. The symptoms are as follows:
- You have serious pain at the extraction site
- The pain spreads to your jaw, ears, and neck
- You can see your jawbone exposed at the extraction site
- There is food debris at the socket
- Your gums have swelling and inflammation
- You have a bad taste in your mouth
- You have a mild fever
What to do and not to do during this time:
- Rinse your mouth with warm water and salt
- If your doctor has prescribed a chlorhexidine mouthwash, use it
- Brush your teeth but the socket regularly
- Floss your teeth to maintain good oral hygiene
- Do not consume alcohol or use tobacco products
- Do not undergo radiotherapies.
It is time to call your doctor for an examination.
6 to 15 days after the extraction
The earlier you see a doctor, the better. A delay may encourage bacteria to infect the socket.
- Your doctor flushes the socket clean
- Your doctor packs the socket with a medicated dressing
- The dressing may require changing a few times
- Your body begins to heal the socket
- Granulation tissues begin to fill the socket until it is healed.
The granulation tissues are soft and have a swollen appearance to them. They contain collagen. Usually, they look red or pink and often feel soft to the touch. They are made of blood vessels and inflammatory cells. Inflammatory cells replace the damaged cells, helping create healthy tissues for your socket.
Your doctor may dress the site with Alvogyl. It helps numb the site and reduce inflammation. It may contain the following antimicrobial agents:
- Butamben: local anesthetic
- Eugenol: natural anti-inflammatory substance. It can reduce swelling and irritation in the affected area.
- Iodoform: a pale yellow, crystalline substance. It has a disagreeable odor.
16 to 30 days after the extraction
- Granulation tissue fills the socket
- Osteoid, a gelatinous substance made up of collagen, begins to form
- Trabeculae form on the periphery of the socket. They are spongy bone tissues that help connect the bones
- The base of the socket appears less hollow
- The regenerated tissue looks less red
- By the end of the month, the surface of the socket is covered by epithelial tissue
- Any healing that is left continues to happen beneath the epithelial layer
What to do or not to do at this time:
- Avoid irritating the socket with your tongue
- Do not brush the site aggressively, as it may damage the new layer of tissues
- Avoid using this side of your mouth to chew tough food
- Maintain your daily oral hygiene schedules to avoid infection
This dry socket healing timeline is for reference only. Conformance to this timeline will depend on your overall health condition and age. You have more possibility of having a dry socket after single extraction than after multiple extractions. Then, more people aged between 18 and 33 develop dry sockets after extraction than those aged between 34 and 49. Therefore, it is always advisable to speak to your dentist about your dental problems before they go out of control.
First, you are more likely to develop dry sockets than non-smokers. Secondly, your body may have lost some of its healing capacity due to smoking. Thirdly, you may force the blood clot out of its position while pulling smoke inside your mouth. Your dentist will instruct you not to smoke in the first 48 hours following the extraction. After that, you may smoke only gently during the recovery process.
Severe pain 3-4 days after extraction is an indication you have a dry socket. The pain may spread to your ears, eyes, jaw, and neck. But not everyone has the same pain tolerance. Therefore, how painful will your dry socket be will depend on you. Your dentist will not rely entirely on how painful your dry socket is for you. They will also examine if the blood clot has moved away from its position and if it is damaged. The pain, however, will subside as you take pain-relieving medicine prescribed by your dentist.
- My Pathology Report. ‘Inflammatory Cells.’
- NIOSH Pocket Guide to Chemical Hazards. ‘Iodoform.’
- Sharif, M., Dawoud, B., Tsichlaki, A. et al. Interventions for the prevention of dry socket: an evidence-based update. Br Dent J 217, 27–30 (2014). https://doi.org/10.1038/sj.bdj.2014.550
- Abu Younis MH, Abu Hantash RO. Dry socket: frequency, clinical picture, and risk factors in a Palestinian dental teaching center. Open Dent J. 2011;5:7-12. Published 2011 Feb 7. doi:10.2174/1874210601105010007
- Healthline. ‘6 Ways to Prevent Dry Socket.’
- Santhosh Kumar, Suhas Manoharan, Nabeel Nazar. Dry Socket and Its Management – An Overview. Int J Dentistry Oral Sci. 2021;08(04):2158-2161.2158 OPEN ACCESS https://scidoc.org/IJDOS.php