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Causes
By Mayo Clinic staffNormally, a blood clot forms at the site of a tooth extraction. This blood clot serves as a protective layer over the underlying bone and nerve endings in the empty tooth socket. The clot provides the foundation for the growth of new tissue and bone.
In some cases, though, the clot doesn't form properly or is physically dislodged before complete healing. With the clot gone, bone and nerves in the socket are exposed to air, fluids and food. This can cause intense pain, not only in the socket but also along the nerves radiating to the ear and eye on the same side of your face.
But the precise cause of dry socket remains the subject of study. Some researchers suspect that several issues may be at play, including:
- Bacterial contamination of the socket
- Difficult or traumatic tooth extraction surgery
- Roots or bone fragments remaining in the wound after surgery
Dry socket occurs in about 3 to 5 percent of all tooth extractions. It's much more common after extraction of wisdom teeth and impacted wisdom teeth in particular.
- Adeyemo WL, et al. Clinical evaluation of post-extraction wound site healing. Journal of Contemporary Dental Practice. 2006;7(3):40-49.
- Roberts JR, et al. Clinical Procedures in Emergency Medicine. 4th ed. Philadelphia, Pa.: Saunders Elsevier; 2004.
- Neville BW, et al. Oral and Maxillofacial Pathology. 3rd ed. St. Louis, Mo.: Saunders Elsevier; 2009:150-153.
- Hita-Iglesias P, et al. Effectiveness of chlorhexidine gel versus chlorhexidine rinse in reducing alveolar osteitis in mandibular third molar surgery. Journal of Oral and Maxillofacial Surgery. 2008;66:441-445.
- Noroozi A, et al. Modern concepts in understanding and management of the "drysocket" syndrome: Comprehensive review of the literature. Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology & Endodontics. In press. Accessed Sept. 9, 2008.
