Blog Articles

Topic: Dry Socket

Carrie is our Clinical Operations Manager and a Registered Nurse here at Nebraska Oral & Facial Surgery. We sat down with Carrie and asked her the top questions patients ask her. Today's topic, dry socket!


What is a dry socket?

When a tooth is extracted, a blood clot will naturally form in the socket.  This provides protection to the area, like a scab.  It covers up the nerves and bones underneath and allows for healing to take place.  However, if the blood clot is removed, disappears, or becomes dislodged, then the bone and/or nerve is exposed.  This is known as a dry socket or alveolar osteitis. Though you cannot see a dry socket, this can be very painful and more prone to infection at the site. Only about 2-5% of patients develop dry socket, although smokers have a 10% higher risk of symptoms developing.


High Risk Factors:

Advancing age

Bone density

Pre-existing infection

Lower molars


Chewing tobacco

Women who use oral contraceptives or estrogen products

Poor oral hygiene


Symptoms of Dry Socket:

1) Increasing pain.  Typically, symptoms begin four to five days postoperatively.  If multiple teeth were extracted, it is usually the bottom sites, or just one site.  Other sites may feel like they are improving, but maybe one is persistent or worsening. 

2) Foul taste occasionally

3) Foul breath occasionally


What can you do to avoid Dry Socket?

No smoking for one-week post operation.  The suction motion during smoking may remove the blood clot prematurely.  Smoking also decreases blood supply and reduces hydration to the new wounds which prolongs healing. 

Avoid using a straw for a week’s timeframe

Avoid irritating foods (spicy, hard, crunchy)

Avoid touching the socket

Avoid spitting

No vigorous activity

No vigorous swishing of fluids


What should I do if I believe I may have Dry Socket?

If you think you may have a dry socket, please call our office as soon as possible, 402-327-9400. Our staff will ask a series of questions to evaluate your symptoms.  It may be possible to give advice over the phone for next steps and may offer a follow up visit with the oral surgeon.  If treatment is necessary, we gently irrigate the socket and place a paste into the offending socket.  This paste mimics a blood clot and you should have pain relief within an hour or two.  We will send you home with additional paste for continued use if needed.



Nebraska Oral & Facial Surgery is the premier oral and maxillofacial surgery center in Nebraska with offices in Lincoln & Columbus. David Rallis, DDS, MD; David Cleverly, DDS; Kevin Rieck, DDS, MD; and Matthew Davis, DDS, MD have been trained in the full scope of oral and maxillofacial surgery. Their expertise ranges from wisdom teeth removal to dental implant placement to facial reconstruction












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