Fact Checked

Dry Socket vs. Normal Socket After Tooth Extraction

Written by Fernanda Elizalde

December 09, 2022

Medically Reviewed

By Dr. James Younan, DDS

Do you have a tooth extraction coming up? If so, you’ve likely heard the warning, “Whatever you do, make sure you don’t get dry socket.” Your dentist may have also warned you about dry socket and given tips on preventing this painful complication after dental surgery.

While it is great advice, you may still be wondering exactly what dry socket is, how it happens, and what symptoms you should look for during the healing process. In this article, we’ll discuss the differences between a normal, healthy tooth socket and a dry socket, including how to tell if you’re healing properly.

Ideally, once you understand more about this condition, you’ll be able to avoid developing dry socket yourself, or at the very least, know how to deal with it if it happens to you.

tongue cleanser


What is dry socket?

After you have a tooth pulled, the hole or socket left behind takes a while to heal. In the meantime, a blood clot forms in the socket, protecting the exposed nerve and bone underneath from food, air, and other debris.

Dry socket, also known as alveolar osteitis, is a painful condition that occurs when the blood clot dissolves or becomes dislodged from the socket before the body can heal. Consequently, the underlying bone and nerves are exposed, resulting in severe pain that often radiates down the side of the face and up to the ear. A dry socket may also become inflamed or filled with food debris, adding to the intense pain.

If you develop dry socket, the pain will typically begin one to three days after your tooth extraction and may last for several days. Left untreated, it can lead to serious complications, including dangerous infections and delayed healing.

Symptoms

Several symptoms may indicate dry socket, including:

  • Increasing, intense pain that radiates from the extraction site to your ear, eye, forehead, or neck on the same side of your face
  • Bad breath or a foul odor coming from your mouth
  • No visible blood clot in the empty socket
  • Unpleasant taste in your mouth
  • Visible, exposed bone or tissue
  • Extreme sensitivity
  • Slight fever

Why is a blood clot important after an extraction?

As we previously discussed, a blood clot forms after a tooth extraction to protect the socket as it heals. Essentially, after a tooth is removed, the body creates inflammation, which causes mild swelling around the affected area. Then, small blood cell fragments known as platelets clump together to form a clot, which protects the open wound by sealing it shut.

If the blood clot becomes dislodged or is removed prematurely, or if it doesn’t form at all, the empty tooth socket is exposed and made vulnerable to infection. This lack of protection also increases the risk of a person experiencing intense pain.

Blood clots also serve as a protective layer for the underlying bone and nerves in the tooth socket as it’s healing. Additionally, they provide the foundation for the growth of new bone and soft tissue development over the clot.

normal socket after tooth extraction


How does a normal tooth socket heal after an extraction?

Now that you know what a dry socket looks and feels like, it’s essential to understand how a normal tooth socket should heal after an extraction. Typically, an empty socket will heal on its own. And although there will likely be some pain initially, it should gradually subside.

If you’re healing normally, you should notice the following signs:

  • No change in the taste of your mouth or how your breath smells
  • Pain that continues to improve and decrease in intensity
  • A visible blood clot in the tooth socket
  • No visible bone in the area

Most importantly, although it will take at least a few days before you start to feel like yourself again, you should wake up each day feeling slightly better than the last. Before you know it, you will be able to use a teeth whitening kit to whiten your new, healed smile.

Is severe pain normal after tooth extraction?

After having a tooth pulled, most people feel a throbbing pain in the extraction area and sensitivity. It may be unpleasant, but this pain is completely normal, and your dentist will typically prescribe a potent pain reliever to help minimize discomfort.

In most cases, pain after dental surgery becomes noticeable after the oral anesthetic wears off and worsens over the next several hours. The pain will most likely peak after about 24 hours and gradually improve over time.

However, if you experience agonizing, prolonged pain that lasts longer than ten days, it’s best to call your dentist or oral surgeon immediately. This persistent or severe pain could signify further complications, including an infection or dry socket.

How to prevent dry socket

The best way to prevent dry socket is to carefully follow all of your dentist’s postoperative instructions, which may include the following:

  • Change cotton gauze covering the tooth socket as they become soaked with blood
  • After 24 hours, gently brush your teeth and rinse with salt water at least twice daily
  • Do not rinse your mouth or disturb the extraction site for at least 24 hours
  • If you smoke, limit or avoid smoking before and after your extraction
  • Consume only liquids or very soft foods for at least a few days
  • Avoid alcoholic, carbonated, caffeinated, and hot beverages
  • Do not drink through a straw

snow teeth whitening kit
Treatment for dry socket

Even if you take every precaution, you may still be unfortunate enough to develop a dry socket. If that’s the case or you’re experiencing severe pain, the American Dental Association recommends going to the dentist immediately to control any symptoms.

Once a dentist confirms that you have a dry socket, the goal of treatment will be to ease your pain and minimize discomfort. First, they will typically flush the socket with a saline solution to cleanse the area and prevent infection. Next, they will pack the open socket with a medicated dressing to control the pain and encourage the body to form another blood clot so it can heal correctly.

After it’s been applied, you will usually need to return to the dentist every few days to change the dressing, have the wound cleaned, and make sure the dry socket is improving. Throughout this time, your dentist may also prescribe painkillers or anti-inflammatory drugs to speed up the healing process.

It’s also normal to receive a plastic syringe with a curved tip to squirt water, salt water, or a medicated mouthwash into the socket to promote a healthy recovery. With diligent care and follow-up appointments, your pain and other symptoms should continue to improve and will typically be gone within a few days.

When can you stop worrying about dry socket?

Most cases of dry socket develop about 3-5 days after tooth extraction. So, if you can see a blood clot forming in the wound and you’ve hit the five-day mark, it’s safe to say that you’re out of the woods and your tooth socket is healing correctly.

Simple tooth extractions typically require a couple of weeks’ recovery time. Wisdom tooth extractions may take much longer to heal. However, once your wound has healed completely, there is no risk of developing dry socket.

When to contact your dentist

Some pain and sensitivity are to be expected after any dental surgery. However, they should be manageable with pain relievers prescribed by your dentist and lessen over time.

It’s essential to call your dentist anytime you experience severe pain or pain that is worsening several days after your extraction. You should also see a medical professional if you notice any of the following symptoms:

  • Bad breath or a bad taste in your mouth
  • Pain that does not respond to medication
  • Pain elsewhere in your mouth
  • Any signs of dry socket
  • Swelling, pus, or fever

Summary

Dry socket is a particularly painful condition that can occur after a tooth extraction if a blood clot becomes dislodged or doesn’t form properly. Typical signs of dry socket include visible bone in the socket, loss of a blood clot, an unpleasant smell coming from the wound, and severe pain that doesn’t seem to improve with time.

Luckily, dry socket is a treatable condition. If you suspect you’re suffering from this dental complication, it’s best to visit your dentist as soon as possible. They can flush out the infected area, apply surgical dressings, and prescribe painkillers to minimize your pain and discomfort.

FAQs

What is the socket supposed to look like after tooth extraction?

After an extraction, a normal tooth socket should develop a blood clot that stays in place while the wound is healing. It should look like a dark-colored scab with no visible bone in the surrounding area.

What is the color of a normal socket after tooth extraction?

A healthy tooth extraction site should appear deep red in color with white gelatinous tissues forming over the socket as it heals.

How do I know if my tooth extraction is healing properly?

If your wound is healing properly, the empty socket should be covered by a blood clot with no visible bone in sight after tooth extraction. Additionally, although some pain is standard in the early stages of recovery, a persistent, throbbing pain that doesn’t seem to improve is a sign of complications, such as dry socket or infection.

What does dry socket look like vs. normal?

If you have dry socket, there will be no visible blood clot, and the underlying bone and tissues will be exposed. As a result, dry sockets typically appear white and look dry rather than moist.