Dry socket, also known as alveolar osteitis, is a painful condition that can happen after the removal of an adult tooth. Typically, after a tooth is removed, a blood clot forms at the site to protect the area and help start the healing process. However, in people with dry socket, the blood clot is either dislodged or dissolved, causing the bone and nerves to be exposed. Symptoms of dry socket include severe pain that radiates from socket, bad breath, bad taste in the mouth, or a fever. Pain after tooth extraction that gets better with over-the-counter pain medication is normal. However, if the pain is severe, worsens over time, or starts a few days after the tooth is removed, it may be a sign of dry socket.
The exact cause of dry socket is unknown. However, researchers believe that there are many factors that play a role, including bacteria in the socket, bone or tissue injury at the surgical site, and small pieces of roots or bone left in the socket after surgery. Risk factors include smoking and tobacco use, oral birth control (contraceptives), poor at-home care of the site, past dry sockets, tooth or gum infection, corticosteroids, or having your wisdom teeth removed. If you have severe pain after a tooth extraction, your dentist or oral surgeon may suspect dry socket. They will exam the affected area and may use X-rays to confirm the diagnosis. Treatments include flushing out the socket to remove debris, having your dentist insert medicated dressings in the socket, antibiotics to treat an infected socket and medication to control the pain. If you have dry socket, talk to your dentist to discuss your treatment options.