How do I know I have a Dry Socket?

The classic complaint:

A severe pain in the tooth socket that appears 3-5 days after the tooth was removed. It is a constant, dull and penetrating pain not touched by aspirin or paracetamol that stops you from carrying out a normal routine. It often wakes you during the night.

What are the Signs and Symptoms of a Dry Socket?

Pain in the extraction socket that is:

  • Not improving
  • Constant- day and night
  • A severe ache or throbbing
  • Often not helped by common painkillers.

What does a Dry Socket look like?

A dry socket often has the following features:

  • The area around the socket will be red, tender and swollen
  • Sometimes the teeth either side will be painful to pressure
  • The socket itself does not have a blood clot or even part of one- often exposed bone can be seen
  • The smell and taste are pretty horrible
  • It just doesn’t look healthy- there may be greyish/ whitish remnants of a clot
  • Your glands may be up- which can cause pain on swallowing.

What else could it be?

  • Osteo-necrosis of the jaw (ONJ) has received a lot of attention in the dental world recently because it is largely misunderstood and has a debilitating impact on patients who get it. On the surface it can appear very similar to a dry socket, but it is much more serious and much more difficult to treat. If you suffer from osteoporosis or bone cancer and have been on any medication for it, this potential complication should be discussed with your dentist before extracting the tooth. Different medications pose different levels of risk, they change how your body reacts to an extraction and sometimes your mouth simply doesn’t heal. This nasty non- healing condition is called Osteo-necrosis of the jaw or ONJ for short.
  • Osteo-myletis also has a similar presentation to a dry socket but it is less easy to pinpoint the area of the pain. It is rare- difficult to treat and will take several weeks to show itself. It is normally only ever seen in severely immuno-compromised patients (those who can’t mount a normal response to infection) such as HIV, cancer patients etc. or those with sclerosis of the jaw bones.
  • Surgical trauma. If you have a particularly nasty extraction, then the tissues around the tooth can be very tender and it could just take your body that bit longer to heal. Pain tends to starts straight away and is not delayed like a dry socket- normally this will be relieved by painkillers.
  • Fractured mandible. This is very rare, but a remote possibility.