Some soreness after a tooth is pulled is normal, and it should slowly get better. Pain that gets worse two to four days later, often spreading to your ear, may be dry socket. Call the dentist who did the extraction. If they can't see you, an emergency dentist can.
Dry socket isn't dangerous in most cases, but it hurts, and a dentist can usually ease the pain in one short visit.
What dry socket is
After a tooth comes out, a blood clot forms in the empty socket. The clot protects the bone and nerve endings while the area heals. If the clot breaks down or comes loose too early, the bone is left exposed. That's dry socket.
It happens most often after lower wisdom teeth are removed.
Signs of dry socket
- Pain that eases at first, then gets worse around day two to four
- Throbbing that spreads to your ear, eye, temple or neck on the same side
- A socket that looks empty, or where you can see whitish bone
- A bad taste or bad breath that doesn't go away
- Over-the-counter pain medicine helps less than it did
Normal healing vs. dry socket
| Normal healing | Possible dry socket |
|---|---|
| Soreness is worst in the first day or two | Pain gets worse after day two |
| Pain improves a little each day | Pain is severe and spreads |
| A dark clot fills the socket | The socket looks empty |
What raises the risk
- Smoking or vaping in the first few days
- Drinking through a straw
- Spitting or rinsing hard right after the extraction
- A difficult extraction, such as an impacted wisdom tooth
- Having had dry socket before
What to do until you're seen
- Call the dental office. Describe when the tooth came out and when the pain changed.
- Take an over-the-counter pain reliever as directed on the label.
- Keep the area clean, but don't poke the socket with your finger, tongue or a toothpick.
- Avoid straws, smoking and hard foods on that side.
Don't try to pack or treat the socket yourself. Mayo Clinic describes dry socket and how it is usually treated.
When it may be something else
Go to an emergency room if you have swelling that spreads into your neck or near your eye, trouble breathing or swallowing, or a high fever. Fever and spreading swelling can point to an infection, not dry socket.
How a dentist treats dry socket
The dentist gently rinses the socket to clear out food and debris. Then they often place a medicated dressing in the socket to calm the exposed bone. Many patients feel relief within hours. You may need to come back to have the dressing changed. The socket then heals on its own over the next week or two.
Our tooth extraction page explains what to expect before and after a tooth is removed.
Outside resources
If you want to read more, try these:
- American Dental Association: Extractions: why teeth are removed and how to heal
- American Dental Association: Dental emergencies: first aid for common emergencies
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If you have trouble breathing or swallowing, or swelling that is spreading, go to the emergency room or call 911.
Frequently asked questions
How long does dry socket last?
Without treatment, the pain can last a week or more. With a dressing, most people feel much better within a day or two.
Can dry socket heal on its own?
Yes, the socket does heal over time. But treatment can cut the pain down a lot while it heals, so it's worth calling.
Is it dry socket if I can see the clot?
Probably not. If the clot is still in place and the pain is slowly easing, that's normal healing.
If you're in Phoenix
Our office on North 35th Avenue is open Monday through Saturday, 7:00 AM to 5:00 PM, and walk-ins are welcome. To check the wait, call (602) 737-2446. The emergency exam and X-rays are $45.
The $45 covers the emergency exam and diagnostic X-rays. Treatment is priced separately and explained before any work begins.
Payment options are on our cost and insurance page.
This article is for general education and is not a substitute for an exam by a licensed dentist.