You have had a tooth extracted and the pain is getting worse, not better — three or four days later. That could be dry socket, a common complication where the blood clot fails to form properly. Here is what to do.
After a tooth is removed, a blood clot forms in the socket — the space where the tooth used to be. This clot acts as a protective layer over the exposed bone and nerves underneath. Dry socket, also called alveolar osteitis, occurs when that clot either fails to form or becomes dislodged before the wound has healed.
What dry socket feels like
The most obvious sign is pain that peaks three to four days after the extraction, rather than improving. The pain is often severe and can radiate to your ear, temple, or the side of your face. You might also notice an unpleasant taste or smell coming from the socket.
If you look in the mirror, the socket may appear empty — you might even see exposed bone. It will not have the dark blood clot you would normally expect to see. The surrounding gum may look grey or dry rather than healthy and pink.
Why dry socket happens
Several factors increase your risk. Smoking is one of the biggest — the chemicals in cigarettes constrict blood vessels and slow healing. Using straws, rinsing aggressively, or spitting in the first few days after extraction can dislodge the clot. Women taking oral contraceptives are at higher risk, as are patients over 30.
Sometimes it happens despite every precaution. Dry socket is not necessarily a sign that your dentist did anything wrong — it can simply be bad luck, particularly with lower wisdom teeth where the bone is denser.
What your dentist will do
Dry socket is treatable. Your dentist will clean the socket gently to remove any debris, then pack it with a medicated dressing that soothes the exposed bone and reduces pain. This often provides relief almost immediately.
You will likely need to return every couple of days for a dressing change until the socket starts healing properly. Your dentist may also prescribe a strong analgesic to manage the pain while you recover.
How to reduce your risk
Follow your dentist is aftercare instructions carefully. Do not smoke for at least 48 hours after an extraction — ideally longer. Avoid straws, aggressive rinsing, and spitting for the first few days. Eat soft foods and chew on the opposite side of your mouth.
If you are on the contraceptive pill and have a scheduled extraction, ask your dentist whether timing the procedure during your placebo week might reduce your risk. Small adjustments like this can make a meaningful difference.
The bottom line
Dry socket is miserable but treatable. If your pain is worsening three or four days after an extraction, do not tough it out — contact your dentist. The sooner it is addressed, the faster you will feel better.
Call 01323 723757 or book at www.meadsdental.com
Meads Village Dental Practice