Dry Socket

  • Medical Author:
    Donna S. Bautista, DDS

    Dr. Donna S. Bautista, DDS, completed her undergraduate studies at the University of California, San Diego with a bachelor of arts in biochemistry and cell biology. During her time at UC San Diego, she was involved in basic research including studying processes related to DNA transcription in the field of molecular biology. Upon graduation, she went on to attend dental school at the University of California, San Francisco. In addition to her formal dental training, she provided dental care for underserved communities in the Bay Area through clinics and health fairs. She also worked toward mentoring high school students interested in the field of dentistry.

  • Medical Editor: William C. Shiel Jr., MD, FACP, FACR
    William C. Shiel Jr., MD, FACP, FACR

    William C. Shiel Jr., MD, FACP, FACR

    Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.

What causes a dry socket?

A dry socket is caused by the partial or total loss of a blood clot in the tooth socket after a tooth extraction. Normally, after a tooth is extracted, a blood clot will form as the first step in healing to cover and protect the underlying jawbone. If the blood clot is lost or does not form, the bone is exposed and healing is delayed.

In general, a dry socket is a result of bacterial, chemical, mechanical, and physiologic factors. Below are examples for each:

  • Bacterial: Preexisting infection that is present in the mouth prior to a dental extraction such as periodontal disease (or periodontitis) can prevent proper formation of a blood clot. Certain oral bacteria can cause the breakdown of the clot.
  • Chemical: Nicotine used by smokers causes a decrease in the blood supply in the mouth. As a result, the blood clot may fail to form at the site of a recent tooth extraction.
  • Mechanical: Sucking through a straw, aggressive rinsing, spitting, or dragging on a cigarette causes dislodgement and loss of the blood clot.
  • Physiologic: Hormones, dense jawbone, or poor blood supply are factors that prevent blood clot formation. Continue Reading
Reviewed on 1/11/2016
References
REFERENCES:

Congiusta, M. A. and A. Veitz-Keenan. "Study confirms certain risk factors for development of alveolar osteitis." Evidence-Based Dentistry 14.3 (2013): 86.

Daly, B., et al. "Local interventions for the management of alveolar osteitis (dry socket)." The Cochrane Database of Systematic Reviews 12.12 (2012).

Eshghpour, M., et al. "Effect of menstrual cycle on frequency of alveolar osteitis in women undergoing surgical removal of mandibular third molar: a single-blind randomized clinical trial." Journal of Oral and Maxillofacial Surgery 71.9 (2013): 1484-1489.

Peterson, L., et al. Contemporary Oral and Maxillofacial Surgery, 2nd ed. St. Louis: Mosby, 1993.

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