Tooth extraction and dry socket: causes, symptoms, prevention and treatment

Wisdom teeth tend to come through a bit later in life, usually in your teens or early twenties. You may need a tooth extraction if your wisdom teeth don’t have enough space to come through fully. Wisdom teeth are often impacted, which means they are blocked by other teeth or partially covered by your gums. Impacted wisdom teeth can cause oral issues, including:

• Pain and swelling

• Gum infections 

• Food trapped under the gums

• Gum disease 

• Tooth decay

• Abscess 

So, it’s important that impacted wisdom teeth are removed to avoid these dental health problems.

Following a tooth extraction, some pain and discomfort are normal as your body heals. Signs of normal healing include:

• Some bleeding from the extraction site; this should stop within the first 24 hours post-procedure. 

• Mild swelling of your gums or face around the extraction site.

• Gradual improvement in pain within 2-4 days. The total extracted wisdom tooth healing time is around 2 weeks. 

When wisdom teeth, or any teeth, are extracted, several complications may occur after surgery, including: 

• Infection

• Nerve damage causing numbness of the lower lip or tongue

• Jaw stiffness

• Dry socket

After a tooth extraction, a blood clot forms in the tooth socket, in the space that once held the tooth. This blood clot seals the area so it can heal. A dry socket occurs when the blood clot breaks down, is dislodged or dissolves before your wound heals. A dry socket after tooth extraction can be very painful, especially if food particles get trapped inside. The first 2-4 days after extraction are the most critical, and it’s during this time that the risk for a dry socket is the highest.

Here are some dry socket symptoms to look out for, along with dry socket treatment you may receive at the dentist:

• Severe pain a few days after your tooth extraction

• Loss of the blood clot at the tooth extraction site

• Seeing bone in the tooth extraction site

• A bad taste or smell coming from the tooth extraction site

If you think you have this condition, contact your dentist immediately. Typically, your dentist will rinse out the empty socket, remove any debris and apply medicated dressings to protect the area and decrease pain. Your dentist may also prescribe an antibiotic to prevent infection and a painkiller to ease discomfort. Your dentist can advise you on what to eat or drink as well as how to clean and care for the dry socket area. With proper care and rest, the dry socket should heal within 7-10 days. Your dentist will usually ask for a follow-up appointment to monitor your healing.

To prevent dry socket, it’s important to follow your dentist’s aftercare instructions. Here are a few things you can do to make sure your healing goes smoothly:

• Brush your teeth carefully, avoiding the affected area to prevent damaging the blood clot and the wound. 

• After 24 hours, use a warm saltwater rinse a few times a day to keep your mouth free from bacteria. Don’t use too much force, as swishing can dislodge the blood clot. 

• Sleep with your head propped up on a few pillows. 

• Avoid alcohol and very hot or acidic drinks that can dislodge the blood clot, for example, coffee, fizzy drinks or fruit juice. 

• Stick to soft or liquid foods for the first few days. Avoid foods that can get easily stuck in your extraction site, like nuts, seeds or chewing gum.

• Don’t use a straw when drinking, as the sucking motion can dislodge the blood clot. 

• Don’t smoke for at least 1 week after the procedure.

• Avoid taking medications that can thin your blood and prevent clotting, like aspirin.

If you have bleeding that doesn’t stop, a temperature, a bad taste in your mouth or severe pain and swelling that is getting worse instead of better, make an emergency appointment with your dentist. Having a tooth extraction can be uncomfortable, but the pain should be manageable with over-the-counter pain relief*.

Here are the answers to some commonly asked questions about wisdom tooth extraction and dry socket:

*Always consult your doctor before taking any medication.