Some people are at greater risk for dry socket. People with poor oral hygiene habits, and people with a prior history of dry socket after a tooth extraction, are at an increased risk for developing the condition. So are patients who are having their third molars (their wisdom teeth) pulled, or who have more trauma than usual during extraction surgery.
If you're a woman and you're taking birth control pills your risk also rises -- women who take oral contraception have a 30 percent higher chance of developing dry socket after a tooth extraction during the first 22 days of their monthly cycle than women who are not on the pill [source: Academy of General Dentistry]. It's the estrogen -- high levels of estrogen circulating through the body affect the blood's ability to clot, so plan your extraction surgery during the last week of your cycle to give yourself the best odds against dry socket.
Some personal habits may also increase your odds of dissolving or damaging the blood clot. Smoking has poor oral health ramifications, including increased risks for gum disease, bone loss and oral cancer, among other health concerns. And now, smokers have one more thing to worry about -- an increased risk of dry socket after a tooth extraction. Smokers should stop smoking for at least 24 hours after an extraction, since smoking can decrease the blood supply to the wound and delay healing.
In addition, coughing, sneezing, spitting and sucking through a straw also increase your odds of dry socket. While your wound is healing, and especially during the first 24 hours, it's best to avoid any activities or habits that may damage the blood clot.
After your tooth extraction surgery, your dentist will pack the empty socket with gauze to help stop the bleeding -- sometimes, you may also need stitches. You'll be sent home with a few at-home care tips, including instructions to take over-the-counter nonsteroidal anti-inflammatory drugs to relieve pain, and advisement not to touch your wound -- not with your fingers, your tongue, or anything else, for that matter. Keep bacteria away, and you'll help keep infection away.
It's also important to understand the best practices for rinsing. To avoid damaging the blood clot forming in your empty tooth socket, it's best not to rinse your mouth during the first 24 hours after your tooth is extracted. Beginning the day after your surgery, though, a gentle rinse with warm salt water several times a day will help keep the wound clean, and will also help to reduce pain and inflammation.
Despite following preventative care instructions to the best of their abilities, it's estimated that between 2 and 5 percent of patients will develop dry socket anyway [source: MedicineNet].
Treatment usually includes a combination of cleaning and packing the wound. Your dentist will rinse and clean out any debris that has become lodged in the socket, and pack the empty socket with medicated dressings which will be changed every day or two. Some patients may also need antibiotics if the socket has become infected, or as a preventative measure.
With treatment, the pain of dry socket will begin to subside after about four or five days and is normally healed in less than two weeks.