Image of a woman in pain, pressing her fingers on on her cheek

Tooth Extraction Pain - 'Dry Socket'

When to go to A+E

  • If you have a swelling in or around your mouth/neck and it is making it difficult for you to breathe, speak or swallow.

When to see an emergency dentist

You can expect a certain level of pain following your dental extraction, but this should subside or begin to improve after a few days. If you find the pain is getting significantly worse and you cannot control the pain with over the counter pain medication, then you should see an emergency dentist.

What to do if you have pain following a tooth extraction

  • Continue to rinse your mouth with warm salty mouthwashes regularly after meals, when you wake up and before you go to bed. Place a teaspoon of salt in a glass of hot water, wait for it to dissolve and cool down enough for you to swirl it around the affected area before spitting out.
  • Don't smoke as smoking can delay healing.
  • Take over the counter painkillers (Ibuprofen/Paracetamol). Make sure you aren't allergic and that they don't interact with any other medication you are taking. Stick to the recommended dosages and do not give Aspirin to children under the age of 16.
  • Avoid hot drinks as they can increase the blood flow in the socket and destabilise the blood clot.
  • Avoid drinking through a straw as this can create negative pressure inside your mouth and disturb any blood clot you may have.

Finally, book an appointment with an emergency dentist near you.

Causes

Dry socket or 'Alveolar Osteitis' is the most common complication following a tooth extraction. It occurs when a blood clot fails to develop or is dislodged before the socket has healed, exposing the underlying bone and causing painful inflammation and sometimes infection. Risk factors include:

  • Improper home-care – The dentist will explain to you how to look after mouth following an extraction. Failure to follow their instructions including regular rinsing and avoiding hot drinks will increase the risk of dry socket.
  • Smoking – Smoking tobacco causes poor wound healing and reduces blood flow to the extraction site.
  • Previous dry socket – If you have had dry socket before, you are more likely to suffer with it again.
  • Difficult extraction – The more difficult and traumatic the extraction, the higher the risk of dry socket.
  • Pre-existing dental infection.
  • Oral contraceptives – High oestrogen levels may reduce the healing process and increase the risk of dry socket.

Emergency Treatment

Your dentist will examine you in order to diagnose the problem as a dry socket. Treatment may include:

  • Flushing out the socket with a suitable solution to help remove any food/debris building up in the socket.
  • Medicated dressing such as Alveogyl, which will help to soothe the area, reduce the inflammation and prevent debris from collecting in the socket.
  • Antibiotic prescription – Your dentist may prescribe an antibiotic if they feel you are showing signs of infection in other parts of your body.
  • Reassurance and further home-care advice.

Prevention

The best way to prevent dry socket is to follow the home-care instructions given to you by the dentist that removed the tooth that has been described above. Additional immediate post extraction advise may include:

  • Drink plenty of water.

  • No exercise/alcohol or hot drinks for the remainder of the day following your extraction.

The best ways to prevent oral health problems include:

  • Visit your dentist regularly at a time period specified by your dentist. Children should visit the dentist every 6 months from when their first teeth appear.
  • Brush your teeth twice daily for two minutes with an appropriate fluoride toothpaste for your age.
  • Clean between your teeth with interdental brushes daily, and use a daily non-alcohol based fluoride mouthwash.
  • Reduce the amount and the frequency of sugar in your diet.
  • Don't smoke and limit your alcohol consumption to the recommended amounts.