Extracting a wisdom tooth or teeth is a surgical procedure that often requires stitches. The tooth can sometimes be trapped under the gum or bone tissue, so when the tooth is removed, it leaves behind a hole or socket.
Most people recover from wisdom tooth extraction within a few days, but it can take a few months to heal completely. During the healing process, the extraction hole slowly closes over. A rare but uncomfortable condition that can slow healing and prevent full recovery is dry socket.
What Is Dry Socket?
Alveolar osteitis or dry socket is a complication that can happen after an adult tooth extraction. Dry socket is a rare complication, but it’s more likely to develop after removing a molar—including wisdom teeth—than other tooth extractions. It’s also more likely if you’ve had dry socket before.
Molars are your biggest, strongest teeth. When removing a molar, the empty space is larger than incisors or canines. After removing a tooth, a blood clot forms to protect the hole (socket) during healing. Dry socket occurs when the blood clot does not form correctly or is dislodged.
While it can be more difficult for a clot to cover the larger space created by a molar, it’s still rare even with wisdom tooth removal.
Dry socket can be painful, but it also poses additional risks. Without the protective blood clot, the nerves and bone are exposed. As a result, untreated dry socket can lead to severe complications, including:
Infection in the socket
Infection that spreads to the bone
Dry socket usually develops 3-5 days following surgery and can last up to 7 days. Symptoms include:
Throbbing or radiating pain
Pain radiating up to the external ear (periauricular area)
An initial pain decrease followed by a sudden severe increase
What Causes Dry Socket?
Dry socket is challenging to prevent because it can occur because of multiple factors. However, patients can limit their risk of developing dry socket by following their surgeon’s aftercare instructions.
Notably, patients are more likely to experience dry socket if they have a medical condition or take medication that affects clotting. For example, smoking and birth control pills can interfere with clotting.
During recovery, your dentist may recommend additional treatment options to promote healing and prevent infection. Depending on your risk factors, your surgeon or dentist may recommend:
Can Stitches Prevent Dry Socket?
After removing a wisdom tooth, an oral surgeon uses stitches (sutures) to prevent excess bleeding from the incision site and help support healing. The stitches attach to the gums and stabilize the tissue.
Stitches help close a wound and protect the tissue from infection. The improved stabilization and closure prevent the blood clot from being dislodged. Using stitches after tooth extraction can help prevent complications during healing, including dry socket.
Oral surgeons often use dissolving stitches. The stitches disintegrate naturally, eliminating the need to remove them. It can take between a few weeks up to a month for the sutures to disappear, depending on:
Stitch size and type
The extent of the procedure
Less commonly, an oral surgeon may use removable stitches. The stronger stitches cannot be absorbed by the body and must be removed, typically 7–10 days after the surgery. Your surgeon will tell you when to return for stitch removal when necessary.
Preventing Dry Socket
Your oral surgeon will provide detailed instructions on caring for your incision and stitches. Keeping your stitches and extraction area clean prevents infection and promotes healing. In particular, anything that causes suction in your mouth can potentially dislodge a blood clot or your stitches.
Stitches can sometimes come loose or stick out. In most cases, some shifting is normal but can be a cause of concern if:
The wound opens or is bleeding
You notice signs of infection (redness, discharge, pain)
The stitch irritates gums or cheeks
Never pull on or remove a loose stitch. Instead, talk to your oral surgeon as soon as possible as they can offer a solution. Contact your surgeon for emergency dental care if you experience bleeding, sudden pain, or increased swelling.
Treating Dry Socket
Dry socket must be treated by a dentist. First, your dentist will clean the socket to prevent infection and prescribe treatment to alleviate discomfort. Then, your dentist may pack the socket with medical dressing and apply medicated gel or paste to protect the socket.
The symptoms of dry socket can be painful and pose risks to long-term oral health. Please contact us for care after your wisdom teeth extraction. Your smile is our top priority!
At Symmetry Dental, we’re committed to listening to our patients and delivering personalized care for their long-term oral health. We want you to feel welcome and comfortable from the moment you enter.
Our team is proud to be a long-standing part of the Calgary community. Request an appointment to discuss wisdom teeth or dental care services.
Wisdom teeth, the third set of molars at the back of your mouth, often present a unique challenge for dental health. When these teeth lack sufficient space to grow, a common recommendation from dentists is to undergo wisdom tooth extraction. This surgical procedure, which frequently involves the use of stitches, aims to remove these problematic teeth, which may be partially or fully impacted below the gum line. As with any surgical intervention, there is a healing process involved, and most individuals experience a relatively swift recovery, typically within a few days. However, complete healing can take a few months as the extraction site gradually closes over. Yet, within this healing journey, there exists a rare but discomforting condition known as dry socket, formally referred to as alveolar osteitis. Dry socket is a post-extraction complication, more likely to occur after the removal of molars, including wisdom teeth, compared to other tooth extractions. It is also more prone to manifest in individuals who have experienced dry socket previously. Molars, being the largest and sturdiest teeth in the mouth, leave behind a more substantial void when extracted. After tooth removal, a crucial step in the healing process involves the formation of a blood clot that shields the empty socket. However, dry socket emerges when this vital blood clot either fails to form correctly or becomes dislodged. The larger space created by the removal of a molar, such as a wisdom tooth, may pose additional challenges for the proper clot formation, but it remains an infrequent occurrence. Understanding the nuances of dry socket is essential as it has the potential to significantly complicate the healing process following tooth extraction, impacting an individual’s overall well-being and necessitating prompt dental care intervention. Therefore, delving deeper into the intricacies of this condition and its management is crucial for both patients and healthcare professionals alike. Dry socket is not a condition to be taken lightly, as it can introduce a level of pain and discomfort that extends beyond the typical discomfort associated with wisdom tooth extraction or any tooth removal procedure. To comprehensively understand this dental concern, one must explore the causes, risk factors, symptoms, diagnosis, prevention, and treatment options associated with dry socket. The first critical aspect to consider is the etiology of dry socket. What precisely causes this condition, and why does it predominantly affect the extraction of molars, particularly wisdom teeth? The answer lies in the complex anatomy of the mouth and the intricacies of the tooth extraction process. Wisdom teeth, scientifically known as third molars, usually make their debut in a person’s late teens to early twenties. However, these latecomers often find themselves unwelcome guests due to a lack of sufficient space in the dental arch. As a result, they can become impacted, meaning they do not fully erupt or grow properly. This impaction can lead to a range of problems, from pain and discomfort to the potential for damage to adjacent teeth and infections. To alleviate these issues, dentists frequently recommend wisdom tooth extraction. The procedure involves surgically removing these problematic molars, often performed under local or general anesthesia. In many cases, the dentist may need to make incisions, remove bone, and even section the tooth into smaller pieces for easier extraction. This surgical complexity is one reason why wisdom tooth extraction can be more involved compared to the removal of other teeth. Moreover, the unique position of wisdom teeth at the back of the mouth, with limited visibility and accessibility, adds to the challenge. In some instances, these teeth might be fully encased in bone or covered by a flap of gum tissue. The extraction process may necessitate raising a flap and, at times, suturing the incision post-extraction. As the surgery concludes, a critical phase of the healing process begins. The extraction site, now devoid of its troublesome occupant, must undergo a sequence of events to heal properly. Blood vessels in the surrounding tissue constrict to limit bleeding, and a blood clot forms within the empty socket. This blood clot is a linchpin in the healing process; it serves as a protective barrier, guarding the socket against bacteria, debris, and the intrusion of food particles. The role of the blood clot is multifaceted. It not only seals the wound but also promotes tissue and bone regrowth. Additionally, it acts as a cushion, shielding the exposed nerves and bone in the socket from external irritants. All of these functions are vital in ensuring a smooth and uneventful recovery after tooth extraction. The journey to recovery post-wisdom tooth extraction typically involves some level of pain, swelling, and discomfort. However, these symptoms are expected and manageable. They usually peak within the first few days and gradually subside as the days progress. The body’s natural healing mechanisms, coupled with appropriate aftercare and pain management, enable most individuals to return to their regular daily activities relatively quickly. But here lies the twist in the tale – dry socket. Despite being relatively rare, dry socket is a condition that can turn this healing journey into a torturous ordeal. It occurs when the essential blood clot that should form in the extraction site fails to do so correctly or is prematurely dislodged. As a result, the socket becomes exposed, with the underlying bone and nerve endings left vulnerable and unprotected. The absence of this protective blood clot has various consequences, primarily centered around the heightened sensitivity and susceptibility of the exposed socket. Without the clot’s shielding effect, the bone and nerves are susceptible to external factors that can trigger intense pain and discomfort. This discomfort can radiate not only within the mouth but also affect the surrounding areas, including the jaw and ear. One might wonder why dry socket seems to have a predilection for molar extractions, especially wisdom teeth. The answer lies in the complexity of these dental structures and the specific challenges they present during extraction. Wisdom teeth, as molars, are larger and positioned further back in the mouth. Consequently, the sockets left behind after their removal are more extensive, creating a substantial void that necessitates a more robust blood clot for protection. While the intricacies of dry socket development are better understood, it remains a rare occurrence. Not everyone who undergoes wisdom tooth extraction will experience this complication. Still, certain factors and conditions can increase the risk of dry socket, and it’s essential to be aware of these factors to take preventive measures and be prepared for potential symptoms. One of the most significant risk factors for dry socket is a history of dry socket after a previous tooth extraction. Individuals who have experienced dry socket in the past are more likely to develop it again. The reasons behind this predisposition are not entirely clear, but it may be linked to an individual’s oral health and healing tendencies. Tobacco use is another substantial risk factor. Smokers or individuals who use other tobacco products are at a higher risk of developing dry socket. Smoking introduces various harmful chemicals into the mouth, which can interfere with the healing process and the formation of the protective blood clot. Moreover, the act of smoking itself, with the sucking motion and negative pressure, can dislodge the blood clot from the extraction site. Furthermore, the use of birth control pills and hormonal contraceptives has been associated with an increased risk of dry socket. Hormonal changes can affect blood clot formation and overall healing capacity, potentially making individuals more susceptible to this condition. Oral hygiene is a crucial aspect of dental health, and it plays a role in dry socket risk. Poor oral hygiene practices, such as inadequate brushing and flossing, can lead to the accumulation of harmful bacteria in the mouth. These bacteria can infect the extraction site and disrupt the blood
Dr. Saleema Adatia earned her Doctorate of Dental Medicine (DMD) from Tufts University in 2006. Since then, she’s been committed to serving her patients’ needs with the utmost passion. Dr. Adatia has owned and operated Symmetry Dental since 2013 and has integrated high-quality services with friendly care into the philosophy of the practice.
With a goal of providing the best patient care possible, Dr. Adatia ensures that her practice stays up to date with the latest dental technologies and techniques. Her personal passion for dentistry stems from a desire to create a positive impact on each patient’s quality of life. Whether that means treating people’s pain or restoring function and beauty to their smiles, the goal is always the same: to help make patient’s lives just a little bit better by working together in harmony.