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Julian Chen
Julian Chen, Dentist
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Experience:  Practicing General Dentist since 2002
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How long does it take a dry socket to heal I am 28 F who

Customer Question

How long does it take a dry socket to heal?

I am 28 F who was dx with two dry sockets in my lower wisdom teeth after having all four wisdom teeth removed. The affected sockets contained impacted teeth and the top teeth were not impacted.

On the evening of day three dull, throbbing pain began. I saw my oral surgeon on day four who stated that he did not believe it was dry socket, partially because the pain was bad but tolerable (usually it is intolerable?).

I returned on day 6 as the pain had not reduced and a dental assistant (OS was out of the office) examined me and then believed that I DID have a "small" dry socket, packed both lower sockets and I got complete relief within an hour.

It has been almost 24 hours and I still have no pain--though I am due to go back tomorrow to get my dressings replaced.

I am nervous about healing time because I am leaving for a week long trip to visit relatives in three days.

Thanks in advance for any words of comfort you may give!
Submitted: 4 years ago.
Category: Dental
Expert:  Julian Chen replied 4 years ago.
Dry socket pain is usually borderline intolerable, especially if you end up with more than 1 simultaneously. That doesn't mean you didn't develop some kind of infection or a light case of it. But consider yourself rather lucky and your healing should progress along nicely.

But to answer your question, when a patient develops full-blown dry socket, they experience upwards of 2-3 weeks worth of excruciating pain. But if the dressing has been helpful, hopefully the discomfort won't return and can be well-managed with ibuprofen if necessary.

For all intent and purposes, it sounds as though you should be fine for your trip but continue to follow the post-extraction instructions given to you. (The oral surgeon office should have given you printed instructions on foods to avoid, activities to avoid, etc...)

Regards,

JulXXXXX XXXXX, DDS
Customer: replied 4 years ago.
See this is my confusion. You say that I should be in 2 -3 weeks of excruciating pain; however, then you say hopefully the discomfort shouldn't return. I'm baffled! Which is it?

Does that mean that if I keep getting dressings every couple of days it won't return?

In which case will I need to find an oral surgeon in Colorado (my destination) to replace the dressings for me while I am there?

Thanks!
Expert:  Julian Chen replied 4 years ago.
Well, by your description, I am not fully convinced that you have developed full-blown dry sockets. Because oftentimes, the medicated dressing can only offer partial pain relief, but not complete relief. Almost all the dry socket patient's I've come across have been crying in pain, unable to sleep, and the pain meds offer little-to-no relief in pain.

By your own testimony, you are at this time pain free. Unfortunately, we'll have to wait until tomorrow when you get the dressing removed (and possibly replaced) to determine whether any discomfort returns.

Assuming a proper, stable clot has now formed to the point where there is no longer any bone surface exposed to the elements, then the situation should not worsen and should only continue to improve in terms of your healing/recovery process.

But do understand that you have literally 4 "holes" in the jaw right now that are loosely covered by a blood clot (and possible stitches). At any given time while eating a meal, some small particle of food can potentially work its way into the socket and could develop into an abscess/infection. This doesn't mean you ought to starve yourself for the next 2 weeks but it does mean that the situation is fluid/dynamic. Until new epithelium (layer of skin) forms over the bone, there is always the potential for complications to develop. So you just have to be cautious and aware of what you eat, how you rinse you mouth, how you brush, etc... for the next couple of weeks.

Regards,

JulXXXXX XXXXX, DDS
Customer: replied 4 years ago.
I think I understand what you are saying. I will be very careful. Even though I had my wisdom teeth removed almost a week ago I've still remained on a soft diet.

My pain was pretty bad--percocet wasn't doing much for it--but I wasn't crying. If I had known it would only last a day or something I would've been OK. I could sleep with the percocet which made me drowsy.

So is there such thing as a minor or partial dry socket? I'm not sure about infection--the dental assistant indicated that it didn't look infected and I am on penicillin (I believe I was given this after the procedure prophylactically).

I'm sorry to belabor this question so long but I want to make sure I understand my condition.
Expert:  Julian Chen replied 4 years ago.
It is likely possible to develop a partial "dry socket", but the discomfort level would be relatively tolerable and most patients would probably simply assume it was just standard post-extraction pain. If there was an infection, you would be able to look into a mirror and see that gum tissue swell up significantly.

What you experienced may have simply been post-extraction pain. Most of the times when we extract the wisdom teeth, this is because they're either partially or fully "impacted". Which means they are somewhat stuck underneath the bone and we have to surgically go in and remove them, sometimes in multiple pieces via sectioning the tooth and sometimes the bone.

In order to remove the teeth, we have to slowly and carefully expand the bone around the socket. This expansion is similar to causing stress fractures to your jaws. So in essence, it is like breaking an elbow, or a leg.

So some swelling/edema is expected, and moderate amount of pain as well for upwards of 2 weeks. But most of the time, pain is manageable with pain meds (Vicodin/Percocet) and patients can resume some normal function.

But dry socket pain is an intense, constant, in-your-face pain that can incapacitate people. Most patients who suffer from dry socket cannot find any relief and is unable to even fall asleep. It is common to also have a bad case of bad breath (halitosis) at this time as well because there is dead/dying tissue down in the socket. But mostly, patient's can't get away from the pain.

The good news is dry socket or not, the patients recover eventually. Although the medicated dressing provided you with tremendous relief from pain, it also slightly extended the healing time. Because when they go in and remove the dressing, they would irritate and likely re-injure the extraction site. This certainly doesn't mean the assistant did the wrong thing. You went in, complained of pain. The assistant packed a dressing, and your pain was resolved.

You just have to give it time, ample time, to properly heal. Moderate pain is expected of all extractions, especially if any of the wisdom teeth were impacted to begin with. Check your temperature once a day to make sure you're not running a fever. And check the extraction site (when looking with a hand mirror) once a day as well to look for any notable swelling. If no fever, and no appreciable swelling, then you don't have an infection. If you do have a slight temperature or feel that the sockets are swollen and very uncomfortable, then you may need additional antibiotics.

In short, any amount of pain/discomfort should dissipate and resolve within 3-4 weeks after the extraction. Some patients feel fine after 1 week, some will take upwards of 4 weeks. There's no telling where you'll fall along that spectrum.

Best of luck to you. So far, what you've written and stated have given me absolutely no reason to believe there should be further complications to a full recovery. Please go over the post-extraction instructions given to you and continue to follow those recommendations for another week.

Regards,

JulXXXXX XXXXX, DDS
Customer: replied 4 years ago.
One more simple question--

If it was just post-extraction pain, not dry sockets, would the clove dressing have helped? I figured since the treatment helped, the dentist must be right--I do have dry sockets--but you seem to be saying that maybe I just had post-operative pain that the dressings helped. Is that correct?

That would make sense because I didn't have any of the halitosis or whatnot.

Thanks!
Expert:  Julian Chen replied 4 years ago.
The medicated dressing is designed to help relieve pain (but it's not guaranteed to provide complete relief). The dressing is not reserved only for use after a dry socket develops as some dentist routinely pack the dressing after every extraction.

So had you had a case of full-blown dry socket, the dressing would provide some levels of relief, but you would more than likely still feel an appreciable amount of pain. The dressing might be able to reduce the pain to a level where you would be able to get some quality sleep and not wake up in the middle of the night with intense, pounding, throbbing pain.

Unfortunately, this isn't an exact science of you either feel pain, or no pain. There are varying degrees of pain. And by most accounts, patients suffering from dry sockets do not find complete relief simply by the application of a dressing into the extraction socket. Whereas patients without dry socket, but still experiencing some level of pain can often find significant relief with the use of the dressing.

Without a clinical exam, I cannot say for certain that you do not have a dry socket (or dry sockets). But by your description of the events that occurred, and the relief that you felt, the lack of halitosis, the lack of infection/swelling, I do not believe you have dry socket.

There's still the possibility that dry socket WILL form. When the dressing is removed and if somehow, bone is exposed and is not covered by a new blood clot immediately, then you can still develop a dry socket. We'll just have to wait and see and assuming all goes well, and I certainly hope it does, you'll be on your way to recovery and experience little-to-no discomfort from this point forward.

Regards,

JulXXXXX XXXXX, DDS
Julian Chen, Dentist
Category: Dental
Satisfied Customers: 559
Experience: Practicing General Dentist since 2002
Julian Chen and other Dental Specialists are ready to help you
Customer: replied 4 years ago.
Thank you for your extensive help and patience!

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Julian Chen
Julian Chen
Dentist
559 Satisfied Customers
Practicing General Dentist since 2002