Dry socket (alveolar osteitis) happens when the blood clot in a tooth extraction site dissolves or is dislodged before the wound heals. This exposes bone and nerve endings, causing intense pain that usually starts two to four days after the extraction. It is not an infection, and a dentist can relieve the pain quickly.
Dry socket symptoms
- Severe, throbbing pain starting two to four days after extraction, often worse rather than better
- Pain that spreads to the ear, eye, temple or neck on the same side
- An empty-looking socket, or visible whitish bone
- Bad breath or an unpleasant taste
- Painkillers that stop working
Normal healing gets steadily better each day. Pain that gets worse after day three is the main warning sign.
Who is at higher risk?
- Smokers and vapers
- People who use straws or spit forcefully soon after extraction
- Lower wisdom tooth extractions, especially difficult ones
- People with a history of dry socket
- Those taking oral contraceptives
- Poor oral hygiene
How dry socket is treated
At Melrose Advanced Dentistry, we gently clean the socket and allow for new blood clot formation. In complex cases we may use PRF (a super clot formed from your own blood) and place it into the extraction site. Most patients feel significant relief within hours. You may need the dressing changed every few days, and we will advise on pain relief. The socket then heals normally, usually within seven to ten days.
How to prevent dry socket
- Do not smoke for at least 48 to 72 hours, ideally longer.
- Avoid straws, spitting and vigorous rinsing for the first 24 to 48 hours.
- Eat soft food and chew on the other side.
- Begin gentle salt-water rinses after 24 hours.
- Follow all aftercare instructions from your dentist.
Frequently asked questions
How do I know if I have dry socket or normal pain? Normal pain improves day by day. Dry socket pain typically worsens around day two to four and is severe.
Will dry socket heal on its own? Eventually it can, but it is very painful. Treatment relieves pain fast, so call your dentist.
How long does dry socket last? With treatment, pain usually eases within a day or two, and full healing takes about a week or more.
Worsening pain after an extraction? Call Melrose Advanced Dentistry in Melrose, Johannesburg on 072 200 1774 for a same-day review.