Dry socket treatment and prevention What to tell your patients

When it comes to dental pain, dry sockets just might be the worst. David Rice, DDS, offers commonsense steps on how to help patients keep this painful condition from happening—and advice on how to guide them if it does.

David R. Rice, DDS

When it comes to dental pain, dry socket pain just might be the worst. When it comes to being a hero, helping your patients avoid it just might be the best. With that, experience is an incredible teacher and if experience has taught dentistry anything, it’s that prevention is our very best medicine whenever possible.

Prevention often begins with the end in mind. Here’s a simple, repeatable, step-by-step process that will help educate your extraction patients and prevent a great many problems.

Step one: Get real about dry socket

Let your extraction patients know dry socket pain is a pain they do not want. When you and I make something important, our patients do too. I highly recommend you get real:

  • In conversation prior to extraction
  • In written consent format prior to extraction
  • In review of your written, take-home instructions
  • In a follow-up call the evening of the extraction

If the third time’s a charm, the fourth time’s a great shot your patient is dialed in and digesting how important this is.

Dodging the dreaded dry socket

Step two: Emphasize what not to do after surgery

It’s easy for dentists to forget what we’re doing—surgery. If you’re like many dentists, you’re worried you’re going to scare your patient out of the procedure at hand. If you want to be a hero, drop the worry and calmly share the objective risks. Your patients are counting on you. Tell them not to:

  • rinse for the first 24 hours
  • spit for the first 24 hours
  • use a straw for the first 24 hours
  • drink excessively hot beverages for the first 24 hours
  • smoke or vape for at least three days


Step three: Tell them what to do if they do get a dry socket

You know that packing a dry socket will not be pleasant for your patient. When patients know what you know, most will do their best to follow your recommendations. Worst-case scenario, they’ll be prepared for what needs to happen to help them if they do get a dry socket:

  • Clean out the socket to flush out any food or debris
  • Fill their socket with a medicated dressing without anesthesia
  • Let them know that it hurts
  • Prescribe antibiotics if their swelling is risky


Step four: Explain the potential symptoms

You and I do this all day, every day, so it seems simple. Our patients don’t. You also know that there are a few factors that are out of our patients’ control. Share these potential symptoms so they know what to look for:

  • Severe pain typically starting from one to three days after their tooth was pulled
  • Pain that radiates from where their tooth was pulled up or down (eye, ear, neck areas)
  • Bad breath
  • Bad taste
  • Potential fever


Step five: Reshare all the causes

Wrapping up, our goal is to avoid our patients going through any unnecessary pain or infection. Reshare the above do not list, and don’t forget the causes we didn’t address:

  • Difficult extractions
  • Poor oral hygiene
  • History of past dry sockets

As you know, there’s always more to it, so stay on top of your oral surgery game. Continue your clinical education. Complement it with better communication skills. Dry sockets are a complication that happen. Reducing them for your patients makes everyone happy.