How to Prevent Dry Socket

After a tooth is removed, the hole where your tooth used to be fills up with blood. That blood turns into a solid clot. That clot is very important. It covers and protects the hole in the bone (socket) underneath.

If the clot comes out too early, the bone underneath can be exposed. That exposed bone is what we call dry socket.

If the clot comes out, your body will not simply make another good clot to replace it. The area will still heal, but it can take about 2 to 3 weeks for your body to cover the exposed bone. During that time, dry socket can be extremely painful. Your dentist may be able to help slightly with the pain, but there is not much he can do to help it heal faster.

You do not want dry socket, and we do not want you to get it…so please follow all of these instructions carefully. Here is how to protect the clot.

Do not smoke, vape, use dip, use chewing tobacco, use nicotine pouches, or use nicotine gum for the first week.

All forms of smoking and vaping are damaging to the clot and can cause it to fall out. All forms of nicotine can cause the blood vessels around the clot to shrink. This can lead to the clot drying up and falling out, causing dry socket. These also make dry socket worse because the area has a harder time healing due to the poor blood flow.

It is best to avoid all nicotine for the first week. However, if you know you cannot go a full week without nicotine, a nicotine patch on the arm is better than smoking, vaping, dipping, chewing tobacco, nicotine pouches, or nicotine gum. Do not put nicotine directly in the mouth while the socket is healing.

For the first 24 hours, the clot is still forming. Leave it alone.

Do not rinse your mouth. Do not swish. Do not spit. Give the clot time to become solid and stable.

After the first 24 hours, start gently rinsing with warm salt water. Do this 3 times a day, especially after meals.

Do not swish the water or any other liquid. Swishing liquids can knock the clot loose.

Instead, gently move your head side to side and forward to back and let the salt water move all around your mouth. Try to make sure the saltwater gets to every corner of your mouth.

Do not forcefully spit. For the first week, avoid spitting because the pressure can pull the clot out. Instead, lean over the sink and let the water gently fall out of your mouth.

Avoid hard work, heavy lifting, running, and exercise for the first 24 hours.

These things can raise your blood pressure and increase blood flow to the area. That can loosen the clot and lead to more bleeding or dry socket. Take it easy the first day.

For the first 2 days, eat soft foods only. Avoid foods that need a lot of chewing. Chewing too much can bump, pull, or damage the clot.

Good examples of soft foods include:

• Scrambled eggs
• Soft fish
• Mac and cheese
• Mashed potatoes
• Soft pasta
• Warm soup, not hot soup
• Yogurt
• Pudding
• Applesauce
• Smoothies eaten with a spoon (Don’t use a straw!!)
• Ice cream
• Protein shakes (Don’t use a straw!!)
• Cottage cheese
• Oatmeal

Do not drink soda or other bubbly drinks for the first 48 hours. This includes carbonated water, sparkling water, energy drinks, and other fizzy drinks.

There are 2 reasons. First, these drinks are very acidic. The acid can weaken and dissolve parts of the clot. Second, the bubbles can disturb the clot and help knock it loose. Both of these can lead to dry socket.

Do not drink alcohol for the first 48 hours.

Alcohol can make bleeding worse. Alcohol can irritate the socket. Alcohol can also make the clot less stable, which makes it more likely to break down or fall out. This can lead to dry socket.

Do not drink alcohol while taking pain medicine that says not to mix with alcohol.

Avoid crunchy and tough foods for the first week. Do not eat things like:

• Chips
• Pork rinds
• Nuts
• Popcorn
• Hard crackers
• Beef jerky
• Hard candy
• Toasted bread
• Crunchy cereal

These are either too difficult to chew, or break into sharp pieces. Excess force or sharp pieces can cut, scrape, or knock out the clot. That can lead to dry socket.

After the first 2 days, you can slowly start eating more normal food, but keep it soft.

A good rule is this: If you can gently pinch through it with your fingers, it is probably soft enough.

For example: A soft sandwich is probably okay. A heavily toasted sandwich is not a good idea. Soft brisket that falls apart with a fork is probably okay. Beef jerky is not a good idea.

The goal is simple: Do not put pressure on the clot.

Pressure in the mouth can pull the clot out. For the first week:

• No straws
• No smoking
• No vaping
• No sucking on candy
• No sucking through anything
• No blowing on anything (including instruments)
• No hard swishing
• No forceful spitting

Anything that creates sucking, blowing, or pressure in the mouth can cause dry socket.

Do not touch the socket with your finger, tongue, toothbrush, toothpick, cotton swab, or anything else.

Looking at the area is okay. Touching it is not.

Touching the socket can damage the clot. It can also put extra germs into the healing area.