The extraction is done. The numbness is wearing off. You were told to take it easy for a few days. But then — instead of the expected mild ache, you feel something else: a deep, throbbing pain that spreads to your ear and doesn't respond to standard painkillers.

You might have a dry socket. It is manageable, but it needs treatment — and the sooner, the better.

After a tooth is removed, a blood clot forms in the socket — the space where the tooth root sat. That clot is the foundation for new bone and soft tissue to grow. It protects the exposed bone and nerve endings beneath.

A dry socket — clinical name alveolar osteitis — occurs when that blood clot either fails to form properly, dissolves too quickly, or becomes dislodged. The bone and nerve are left exposed to air, food, fluid, and bacteria.

The result is intense pain that typically starts 1 to 4 days after the extraction. It is one of the most common complications after a tooth removal.

Not everyone who has a tooth extracted develops a dry socket. Certain factors increase the risk:

• Smoking. Smoking reduces blood flow to the healing site. Chemicals in tobacco also impair clot formation. Smokers have significantly higher rates of dry socket.
• Wisdom teeth removals. Dry socket occurs in up to 30% of wisdom tooth extractions, particularly lower wisdom teeth. The deeper the extraction site, the higher the risk.
• Oral contraceptives. Oestrogen affects clot formation. Women on the pill may have a slightly elevated risk.
• Previous dry socket. If you've had one before, your risk is higher in future extractions.
• Poor oral hygiene. Pre-existing gum disease or poor hygiene increases bacterial contamination of the socket.

The pain pattern is the key clue. Normal post-extraction pain improves steadily over 2 to 3 days. Dry socket pain starts mild on day one, peaks dramatically on day 2 or 3, and is disproportionate to what you'd expect from a routine extraction.

Specific signs:

• Severe, throbbing pain that radiates to your ear, temple, or eye on the same side
• Visible bone in the extraction socket — you can see it if you look
• Partial or complete loss of the blood clot — the socket looks empty or half-empty
• Bad taste or foul breath that doesn't go away
• Pain that is relieved temporarily by a cold drink, then returns

Treatment focuses on relieving pain and promoting healing. It is not a medical emergency, but it does need same-day or next-day attention.

Socket cleaning. Your dentist will gently flush the socket to remove any debris and bacteria.

Medicated dressing. A dressing containing eugenol — oil of cloves — is placed in the socket. This soothes the nerve and reduces pain significantly within hours.

Pain management. You may need a prescription painkiller in addition to standard over-the-counter options.

Follow-up. The dressing needs to be changed every few days until the socket starts to form healthy tissue. Usually 2 to 4 visits.

The pain relief from a properly placed dressing is usually dramatic — patients feel significantly better within the same day.

• Do not smoke for at least 48 to 72 hours after extraction
• Avoid sucking actions — no straws, no smoking, no spitting
• Eat soft foods for the first 24 to 48 hours
• Do not rinse your mouth aggressively for the first day
• Follow your dentist's specific aftercare instructions — they are there for a reason

If you've had a tooth extracted and the pain is getting worse rather than better after day two, call us. Don't wait. Dry socket is treatable — and the longer you wait, the longer you suffer unnecessarily.

Meads Village Dental Practice manages dry socket cases promptly. If you're experiencing these symptoms after an extraction, phone 01323 723757 and tell us — we'll see you as soon as possible.