What's the difference between a tooth extraction infection and a dry socket?

After you've had a tooth extraction, infection is always a possibility. Sometimes people call it a dry socket. But they are NOT the same thing. Most folks who think they have a tooth extraction infection actually have a dry socket.

What is a dry socket? It's the empty socket in the gum that's left behind when you've had a tooth out. It's empty because there's no blood clot in there. And that's the problem.

The pain is caused by an inflammation of the bone surrounding the socket, which happens when there is little or no blood clot to cover the bone.There is NO infection, no bacteria.

Without a blood clot, the walls of the socket are basically exposed bone.

An empty socket will also trap bits of food.

What a drag! You get a tooth pulled because it's causing a problem, and you still end up with pain!

What's a tooth extraction infection? This is an infection in the gum, where you've had a tooth removed. It's caused by bacteria in the gum. Either the tooth had an infection on the root before it was pulled, or bacteria got into the socket somehow.

There are a number of things that increase the chances of getting a dry socket. In general, lower teeth are more likely than upper teeth. Molar teeth (back teeth) are also more at risk than front teeth.

Other things that increase the risk are:

  • Smoking within 48 hours of the extraction.
  • Rinsing out too soon after the extraction. (Within 24 hours.)
  • A difficult extraction that takes a long time.

How do you know if you have a dry socket?

You only need to know 3 things;

1. You have had a tooth removed within the last 5 days. The pain typically starts 3 to 5 days AFTER the extraction.

2. The jaw where you had the tooth out is very painful. But there's no swelling.

3. You also have a bad taste in your mouth, and may be aware of a foul-smelling odor. This is caused by bits of food getting stuck in the socket.

What's the treatment?

If it really IS a dry socket, without any infection, it will settle down by itself within about 10 days. Take ibuprofen 800mg three times a day to deal with the pain in the meantime.

In mild cases, you may speed things up by rinsing around the socket with really hot salty water, several times a day.

But for fastest results, you should go back to the dentist. He will freeze up the gum, and gently clean out the the socket. Then he should put a dressing in the socket afterwards. Some dressings dissolve on their own over a few days, while other types will need to be removed a week later.

Antibiotics will only help if you actually have a true bacterial infection in the socket.

A true tooth extraction infection is usually painful within a day or two of getting the tooth out, and there is swelling and redness in the gum.

Things that increase the risk of infection are:

  • A tooth that had an infection before it was pulled.
  • If you are a smoker.
  • Poor blood supply in the jaw, for example after radiation treatment for cancer.

The words "tooth extraction infection" and "dry socket" are frequently used to mean the same thing. But as you can see there are big differences between the two! An infection happens soon after the extraction, and causes swelling in the gum. A dry socket happens 3 to 5 days AFTER the extraction, and there is NO swelling. BUT BOTH OF THEM ARE PAINFUL!

For a true infection, you will need antibiotics. Have a look at the antibiotics page. This runs down a list of commonly-used antibiotics in dentistry.