How to prevent dry socket after wisdom teeth removal

How do you prevent dry socket?

Cleveland Clinic lists the main steps: avoid smoking and all tobacco, skip straws and avoid warm or fizzy drinks while healing, stick to soft foods and avoid hard, crunchy or chewy items, and follow your post-extraction instructions closely. Healthline gives six tips: avoid straws, avoid tobacco, eat soft foods, ask about medicines, keep the area clean, rest from strenuous activity and follow your dentist's or surgeon's aftercare plan. The clot that forms in the socket is what protects the bone and nerve beneath, so every step is about keeping it in place.

Straws

Healthline says to avoid straws for one week after extraction, since the suction can dislodge the clot. Cleveland Clinic says avoid them for at least a week. Our guides on straws after extraction explain this further.

Smoking and tobacco

Healthline says to cut back before surgery and avoid all tobacco products, which it says carry risk even beyond cigarettes. If you smoke, it says wait at least 48 hours after surgery, inhale gently and keep gauze over the socket, and ask your dentist about stitches or a nicotine patch. It cites a study that found dry socket in 12% of smokers versus 4% of non-smokers. Cleveland Clinic says smokers are more than three times as likely to develop dry socket as non-smokers and advises avoiding smoking altogether. The two advice levels differ, so the safest course is to avoid all tobacco while healing.

Food and drink

Healthline says to eat only soft foods on day one, then try slightly heartier foods on day two, returning to soft foods if pain returns, and to avoid soup, nuts, seeds, crunchy foods and sticky foods. Cleveland Clinic says to avoid warm or fizzy drinks and hard, crunchy or chewy foods. The advice on soup differs from what many surgeons say about warm liquids, so follow your surgeon's leaflet.

Rinsing and cleaning

Healthline says to keep the area clean, rinse with salt water several times a day, brush gently following your dentist's timing and use any prescribed antibacterial mouthwash as directed. Cleveland Clinic lists vigorous rinsing as a risk, since forceful swishing can loosen the clot, and says your dentist may suggest gently letting liquid soak the area instead. Poor oral hygiene is a risk because bacteria can break down the clot.

Medicines and risk factors

Healthline says to ask your dentist whether your medicines, including oral contraceptives, could interfere with clot formation, and lists oral contraceptives, based on some studies, poor oral hygiene and a dislodged clot among risk factors. Cleveland Clinic says pills containing oestrogen may slow healing and make dry socket more likely. Do not stop a medicine without advice.

When does the risk end?

Cleveland Clinic says dry socket usually appears within the first three days after extraction, that if you have no symptoms by day five you are likely past the risk window, and that with proper care it typically heals in about 7 to 10 days. Healthline says to rest from strenuous activity, drink plenty of fluids and use an ice pack on the cheek for swelling.

What if you think you have it already?

Cleveland Clinic says to contact your dentist if pain keeps you awake or does not improve with medication, and that if you cannot reach the provider who performed the extraction you should go to urgent care or the emergency room. Do not wait for it to settle on its own. Our guides on what dry socket looks like and whether it heals on its own explain the signs and the treatment, which usually involves your dentist cleaning the socket and placing a medicated dressing.

Questions to ask your surgeon

Ask these before the extraction.

• How long should I avoid straws, smoking and hot drinks?
• When can I start rinsing, and how?
• Do my medicines or contraceptives raise my risk?
• What should I eat for the first few days?
• Who do I call if pain gets worse?

Frequently asked questions