Dry socket is a painful condition that happens when bone, nerves, and other delicate tissues in the gums and jaw are exposed to air, saliva, and other materials in the mouth. This commonly occurs after a dental procedure. When your teeth or gums are injured or operated on, they form a blood clot to protect the underlying tissues. Sometimes this clot dissolves or is displaced, causing a painful dry socket with exposed painful tissue. This pain can last as long as a week and feels sharp, hot, and excruciating. It is important to know the signs of dry socket so the condition can be treated by a dentist or doctor.
Dry socket most commonly occurs after a tooth extraction. Removing a tooth leaves a “socket,” or indentation in the gum and jaw where the tooth and roots once were attached. Around 2-5% of people will develop this condition at some point. Because blood clots protect tissues and help them to heal, this condition can be concerning. Having exposed and inflamed tissues is not just painful, but can also predispose people to infection and delay healing. The following seven symptoms of dry socket should always warrant a call to your health care or dental provider.
1. Jaw Pain
The fibrous covering of bones has a large number of nerve endings. When the bone of the jaw is exposed due to dry socket, these nerve endings are exposed. The result is jaw pain. This pain is often constant and throbbing. It can radiate to your ear, your eye socket, or even to areas of your skull. The pain can be worsened with moving the jaw, such as in eating or speaking. It may occur in the upper or lower jaw. Jaw pain is concerning because it indicates that the bone itself is exposed, which can lead to serious infections in the bone.
2. Mouth Pain
Tooth extractions almost always cause mouth pain. However, this pain should steadily get better after the procedure as the area heals. Dry socket pain is different because it will begin suddenly, often around two days after the procedure. It will feel much sharper than the pain a person has after a procedure. Many people find that their pain level increases quickly in a matter of minutes and is not significantly alleviated by their pain medication. Eating and drinking often make this pain worse, because they expose the injured area to new substances and temperatures. A sudden increase or change in pain is reason for an immediate call to the dentist.
3. Bad Breath
The loss of the blood clot covering injured tissues leaves the socket completely exposed. This allows food, drink, and bacteria to accumulate in the socket, which can cause bad breath as well as a foul taste in the mouth. In addition, the mixture of food and bacteria can cause an infection, which also often has a foul smell and taste. Bad breath is not normal after dental procedures. It cannot be alleviated with gum, mouthwash, or other standard halitosis remedies. Dental infections can be especially dangerous, so they should be treated immediately. Any time a wound smells bad, especially a wound in the mouth, it should be evaluated by a medical professional as soon as possible.
4. Pus
It is normal for a wound from a dental procedure to have minor amounts of bleeding. However, pus is always a warning sign. Pus is a white or yellow creamy substance that is produced when white blood cells rush to an area to defend it from infection. It is made mostly of dead white blood cells. Because dry sockets are uniquely prone to infection, they are also prone to pus that results from an infection.
Pus is not just a sign of dry socket, but a sign of infection. Any pus following a dental procedure should be treated in an emergency department. This is an indication that the infection in a dry socket is severe enough to need immediate antibiotic medications.
5. Swelling
Dental procedures such as tooth extraction can cause swelling in the mouth and face. Swelling is a natural response to any kind of trauma. However, in most cases this will subside over time. Most patients see the swelling get steadily better over just a few days. If swelling suddenly returns or does not get better, this can indicate a dry socket. This is particularly true when the swelling occurs with other symptoms of dry socket.
People who have a dry socket may notice swelling in the gum where the extraction was performed or see it throughout their face and neck. Regardless of the area that is swelling, this should be reported to a dentist or physician immediately.
6. Tooth Pain
Even though a dry socket often occurs after a tooth extraction, it can sometimes cause pain that is much like a toothache. This is due to the way that nerves in the mouth and gums operate. They are often long nerves running under the gums, so pain in a dry socket may be mistaken by the brain for pain in one of the nearby teeth on the same side. This is called “referred pain.” New or worsening tooth pain after a dental procedure should be taken seriously. This can indicate several serious conditions, including dry socket, dental infection, and damage to the roots of adjacent teeth.
7. Ear Pain
Ear pain is one of the less common symptoms of dry socket, but it should be taken seriously. In some cases, this is due to referred pain from the jaw. In other cases, it can indicate an infection. The back of the teeth, gums, and jaw are actually very near the ear, so the inflammation of a dry socket can cause pain in the delicate structures of the inner ear. There are a variety of ways that this condition can cause ear pain. However, this and all other signs of dry socket should still be reported to a dentist or a doctor so it can be evaluated further and treated promptly.
