Dry Socket is a very painful condition which is a result of dislodgement of the blood clot 2-3 days after the extraction and looking at Dry Socket pictures gives you an idea of whether it is really a Dry Socket or just a healing Socket after extraction. This leads to exposure of the bone which is the cause of the pain. Dry socket leads to radiating pain which can be felt at the site, extra orally as well with pain in the ears and the side of the head. Dry socket after wisdom tooth removal is seen more commonly as compared to other teeth due to the surgical procedure which is followed such as removal of bone etc.
In the Normal healing process, the Blood clot is present in the socket which gives the bone a chance to fill in the empty socket space overtime. With the loss of clot, the socket and bone are exposed delaying healing which leads to the excruciating pain felt by the patients. You can check here the complete details about – “Dry Socket or Alveolar Osteitis“
Dry Socket Tooth Extraction Symptoms:
Severe Radiating Pain to the Ear or other parts of the face.
The socket is devoid of clot or contains brown, friable clot which is easily washed out.
Foul smell: Due to Food debris accumulated in the socket which starts disintegrating.
On washing away of the food debris the bare pocket floor can be seen which is extremely sensitive to touch.
Regional Lymph nodes: Tender and enlarged.
Occasionally Pyrexia is seen.
dry socket formation
With the main reason for Dry Socket being loss of Blood clot it is important that the main emphasis on treating Dry socket be restoring the Blood clot in the extraction site which will help in starting the healing process. If you are a Dental Student looking for how a dry socket looks or a patient suffering from dry socket, the set of images listed below is how a dry socket looks clinically. Normal socket after a tooth extraction should be without any food particles being stuck in it along with a healthy blood clot.
Dry Socket With Necrotic Bone
In the Images shown above and below, it is clearly visible that there is a loss of Blood clot from the extraction site as the necrotic bone is clearly visible which is a typical appearance of Dry Socket. Clinically we can also see that there is a foul smell being emitted from the site another typical sign of Dry Socket.
Dry socket with unhealed Socket
The image shown below shows the presence of slough or necrotic substance in the extraction site which is a sign that the extraction site is not healing and it is infected. This infection leads to loss of normal healing tissue and in turn loss of blood clot and exposure of bone. So treatment in such cases required copious irrigation of the extraction site and the use of a ZOE pack after the site is cleaned and bleeding is instigated to help in future blood clot formation.
Necrotic tissue or Slough formation in extraction site of Dry Socket
Who are more likely to get Dry Socket?
Here are some of the habits of things when done is likely to result in Dry Socket. So it is important to note that the things mentioned below are to be avoided at any cost to help in proper healing and prevent Dry Socket formation after extraction.
Smoking – It is a strict “NO” after Tooth extraction, it is seen that the major percent of Dry socket patients are known to be smoking after extraction. It is best to avoid smoking for a couple of days after extraction.
Poor Oral Hygiene: This is also one of the major causes of Dry socket, it is important to maintain good oral hygiene after tooth extraction.
History of Dry Socket: Patients who have earlier faced Dry socket are more likely to get dry socket.
Oral Contraceptive Pills: Patients on Contraceptive pills are seen to get Dry Socket.
Increased Bone cutting and Trauma during Wisdom tooth removal:
Aggressive rinsing immediately after extraction, drinking with a straw: These are two things which result in dislodgement of the Blood clot in the Socket and exposure of the bone which is one of the causes of Dry Socket.
It is important to note that the above mentioned points are to be avoided at any cost the make sure that you do not get Dry Socket.
Dry Socket with Slough formation – The slough seen is the cause of the Foul smell and Foul taste which you experience in Dry Socket.
Dry Socket in the upper left 2nd molar
It is very important for a Dentist to keep regular followups with the patients after extraction to make sure that any initial signs of Dry socket formation are detected and treated. The patient needs to follow all the post-extraction instructions given by the Dentist to the point and make sure that no instruction is taken for granted which might lead to a Dry Socket formation.
Does a dry socket look like a deep black hole. I can’t tell if my daughter has a dry socket. She has lots of pain, Tylenol 2 not effective. Had to start Tylenol 3.
The post op instructions were to rinse gentle with warm salt water when we arrived home. However, I used to work in a dental office years ago and instructions were to avoid rinsing for the first few days to prevent removing the blot clot.
My daughter followed the instructions and she rinsed when we arrived home a few hours after 4 wisdom teeth were extracted under GA.
I am wondering if I should have made my daughter rinse in a couple of days instead of when we arrived home.
She didn’t use a straw. No carbonated drinks. She doesn’t smoke or oral contraceptives.
Most the if YouTube videos says to avoid rinsing for a few days.
Thank you.
how long after surgery can one have a dry socket? I had teeth pulled 4 weeks ago and now all of a sudden my extraction site is painful
Yes rinsing immediately after Tooth extraction can result in removal of Blood clot and thus result in Dry Socket. As Dry Socket is the inflammation of the underlying bone, on removal of the blood clot the bone is exposed and can result in a Dry Socket infection. It will be better if you visit a Dentist, a ZOE pack will be placed which will help.
I had an extraction 5 days ago the site is really painful especially when I talk alot & pain killers just ease the pain for maybe 2 hours max.Please My mouth has a foul smell. The socket has a grey to black colour with a little bit of white & at both sides I can feel like there’s a little piece of tooth left. Please give me your opinion.
Hi, it is most likely that you are having a bony projection in the site of extraction which is impinging the extraction site and causing the pain. It is better to visit the dentist and have the bony projection trimmed to give you relief.
Hi. My name is Marissa and I just had my upper wisdom teeth removed last Friday morning. It is now Tuesday and I have little to no pain but my Jaw is still stiff and I get ear pain sometimes. I’ve looked at the hole several time and it looks fine but there doesn’t appear to be a blood clot. Does this mean I have dry socket?
Hi Marissa, this is not Dry Socket as you do not have continuous pain in the extraction site. As for the Blood clot, you cannot see the clot directly after a couple of days directly. There is no need to worry as slight stiffness and pain is expected as you have to keep your mouth open for long duration and also due to Local anesthesia injection which will subside on its own in a couple of days.
Dear Dr.Varun,
Thanks for the article and information. I had upper tooth (4th on left) extraction 2 days ago as a result of infection on root. Now, I feel itchiness and stiffness there. I checked it, the hole is filled with a gray and white tissue With some blood traces on it. Is it going to be a Dry Socket?
And another question: Dry Socket is like a hole from the first moment of extraction or the filling get empty after some days?
I will be thankful if you can reply asap.
I forget to mention that I had a bad headache a day after extraction and also a metal taste in my mouth,but after 40 hours I am ok.
If it is dry socket, what should I do now?
Waiting for your prompt reply
thanks in advance
Hi Mariam, the first sign of Dry Socket is extreme and un-bearable pain associated with bad smell. What you are seeing in the socket is normal healing procedure where the blood clot is present. If you are not having severe pain and bad smell it is most likely not dry socket.
Headache is a common symptom post surgical extraction which will last for 24 hours post extraction. As for the metal taste it is most likely due to the Blood clot and the oozing blood from the site which is nothing to worry about.
Hi, I just removed my lower left wisdom tooth and the tooth in front of it last Friday. I have been very paranoid over if I will get a dry socket. My dentist sew stitches over both wounds. Today I began to see a small hole appearing next to the stitches. Cannot see inside, but it’s kind of black. Are the stitches giving way? Will I get a dry socket? Also, there is this layer of yellowish white layer on the gums, what is it?
Hi Michelle,
There is nothing to worry about, all the signs which you have mentioned are part of the normal healing process. You have to start worrying when you get unbearable pain, swelling etc.
The small hole beside the sutures is normal as the tissue swells first and when the swelling decreased there will be a gap between the tissue.
Thanks for the reply. It’s about 2 weeks after the extraction. There is a hole at the wisdom tooth extraction site. Can I know if food particles happen to be trapped in the hole, will it cause infection? Will the gums cover or grow over the particles if unable to remove it? There seems to be 2 or 3 small white particles in the hole. Could it be the recovery tissue?
Hi doc my tooth extraction site is grey and black more grey than black and it’s been day 4 and the extraction is very painful
I had my wisdom tooth removed 5 days ago and still can’t open my mouth I keep getting headaches and a little earache but I don’t no if I have dry socket as can’t see in my mouth also I have tiny fluters of pain not a lot just a little can you help me please.
I had both of my back bottom molars removed yesterday. I ate food and it looked white so I swished with salt water they went back to being red/black holes. I ate more food later same thing I swished. I feel like I’m seeing more white (possibly puss) then the red is this normal or is it most likely dry socket. (28 hours into healing)
The white is just exudate from the Blood clot and some of the food substances being stuck. There is nothing to worry about until you keep the extraction site clean, avoid smoking for a few days (if you smoke), avoid poking around the extraction site with your tongue or any substance.
In Dry socket you will start feeling severe pain along with foul smell from your mouth, if none of these are present there is nothing to worry about.
It is common for some people to face difficulty in opening their mouth after wisdom tooth extraction for a few days, this can be due to swelling or due to injury to the medial pterygoid muscle while giving an inferior alveolar nerve block.
If it is painful and foul smell is coming from the tooth, it is better to get it checked as it can be Dry Socket.
I had my wisdom tooth extracted 6 days ago but the day after extraction i was in pain and meds werent working so i went to dentist and he said i had a dry socket well that day he cleaned it and put packing in it . It has now been almost 7 days the stuff fell out and once again i am in horrible pain :( do i need to go back to the dentist?
Hi my name is cindy, i just had a tooth pulled last week and its not black, and it feels like a dont have a hole.. , but it just feels like a bubble . im not in pain but i do have a earache, is this called a dry socket.
Hope I’m not too late. I’m a 20 & I had my tooth extracted about 5 days ago ( by the time you read this it’ll have been 5 days most likely) and if I’m correct it was #15 on the top left side of my mouth. Ive had zero pain which is very surprising for me since I’m horrible with pain usually. 48 hrs after the extraction I had to get a root canal on the oppisite upper side of my mouth and I told my dentist I was reeeeaaaallllyyy paranoid about developing dry socket as I heard it’s horrible. She looked at it and told me I was being paranoid and she said it looked like it was healing perfectly and just to be safe she told me not to smoke for another 24 hrs just in case. (Not cigarettes) so I did that and just because I’m THAT scared I didn’t for another 48 hours. The excitation site looks like a blackish grey hole and like I said there’s been no pain or uncomfortablity at all whatsoever ( even with the root canal) even when I eat and drink water. It’s now been a little over 96 hours and I’m going crazy over here. Honestly, would you say I’m still at a risk for developing dry socket? ( also to add both procedures went perfectly. It took a little bit more to get me numb for the root canal but other than that they finished that day and the tooth extraction was so quick it took MAYBE 20 minutes it felt like)
OK I just had my left bottom molar extracted about 26 hours ago. I’m so worried about dry socket! Should I continue to use gauze after the first day? Its dark on the bottom but not like a puddle of blood like it was yesterday. I’m assuming that’s the clot.
Hi Erin,
There is nothing to worry about until you see foul smell and severe pain. You yourself cannot ascertain whether it is Dry Socket just by Visual inspection as the exudate while healing varies from person to person depending on the food which is consumed.
Just follow all the post extraction instructions given by your Dentist and keep the extraction site clean. You will not be having Dry Socket or any post extraction complication and a smooth healing process will take place.
I had all 4 wisdom teeth removed 6 days ago and the bottom 2 have been bothering me since. The site it’s self is not painful however my jaw is tight and is in a lot of pain. I also believe I got food stuck in one side but can’t get it out. Will that cause dry socket or do I already have it?
Hey Varun, I had my lower wisdom tooth removed two days ago, on the day after pain was minimal and jaw was not stiff. However today I have woken up to a stiff jaw as well as some dull pain in the lower jaw as well as the extraction site. In appearance the site is yellow and white in colour with some red. My query is that I do have a foul odour but the pain is not severe, also I followed all the instructions. Any help?
Hey I had an upper molar extracted two and a half days ago. So far not much pain. Its bearable and dull. And the tissue over the clot is all white now. I’ve followed the post op instructions so then why am I experiencing a foul taste and odor? I’m really worried. I’ve got a dry socket years ago when my wisdom teeth were removed. It lasted for weeks. A foul smell and taste is a bad sign right? But the white is a good thing and the pain ain’t too bad.
I just had a molar extracted last nite and it bleed all through the nite. Now there is a tannish white covering over the whole where the tooth was is that normal look of a healing socket ???
Yes it is normal if you do not have any more bleeding or pain.
I just had a molar extracted last nite and it bleed all through the nite. Now there is a tannish white covering over the inside of the hole where the tooth was. Is that the normal look of a healing socket ???
Ok, thx for your help !!
If the pain isn’t too bad, you don’t need to worry. Make sure that you gargle well now that its been 3-4 days. Mix Salt in lukewarm water and gargle well 3-4 times a day. Make sure that you visit your dentist immediately if you find that your pain is increasing.
Happy Recovery !!!
Make sure you follow all the post extraction instructions properly and do not worry much about the foul smell, as it can be due to the fact that you have not been throughly brushing or gargling form the past 2 days. In case you see an increase in pain and foul smell along with foul odor visit your dentist the earliest.
You can gargle properly to clean the socket or visit your dentist who will give it a good saline wash.
Hello I had my wisdom tooth’s extracted one of them did not close food will go in there I tried cleaning it today I checked I hole and noticed there’s a hole but with a skin color bubble inside the hole
If there is a pink color bubble and there is no pain then there is noting to worry about. It is the normal healing process.
Hi i had a tooth extracted on Tue. The pain has been constant since I got it removed it isn’t got any better or worse. Paracetamol and ibuprofen just aren’t helping . The sight looks ok and there isn’t a smell but I’m just a bit worried it’s dry socket?
I had an abscesses molar pulled Tuesday and still in severe pain. The site is green and bubbly. Should I go back in?
I just had my bottom molar removed about 35 hours ago and there is a kind of white coating over the blood clot. No pain. A little sore but worried about the color of the clot. Shouldn’t it be dark red?
Dr. Varum
I had my upper molar on my left side number 14 to be exact 2 days ago. I now have a whitish gray coating around hole is covered so no exposure. I’m having extreme anxiety of having a dry socket. Is it normal for it to look like that right now?
It feels a little tight and little sore. Do you think I’m getting a dry socket or am I over reacting?
Thank you
I had a bottom tooth pulled 5 days ago i started noticing on the 3rd day the pain was getting worse and well as the same side of my neck is stiff i looked in the socket and it does not have a full blood clot in it instead it dips down and has brownish whitish stuff in it that moves (my tongue actually got a piece of it out) im having pretty significant pain and now besides my neck its in my jaw and my ear is it dry socket?
Hi Rachel,
From the symptoms it can either be that there is food stuck in your extracted socket which is causing the pain (it will be relieved once the food is removed) or it can be early stage of Dry Socket. It is better to get it checked by your Dentist.
Hi Ram,
Frankly speaking as you mentioned (you are over reacting) what you are seeing and feeling is quite normal. Do not think much about it until you get pain and foul smell from the extracted site. Just make sure you gargle properly after eating something.
No, the color is not going to be Red all the while. Initially the Clot is visible and it appears Red in color but once the healing process starts the clot will be submerged under the Plasma and Fibrin mesh etc which comes over the clot.
Its better you get it checked
You should have waited 24 hours because she actually rinsed away the blood clot which is very important in the healing process
Hi….I had extraction on Monday which didn’t stop bleeding so went back to dentist two hours later and they put in four stitches. I saw that there was blood clot on the thread at one point but assumed that the fact my gum was bleeding that it was ok. However I have been in severe pain from that night to today and had a bad taste all the way through. My neck and check up to my ear are swollen. I visited the dentist yesterday who said there was start of infection so prescribed painkiller and antibiotics. The pain has significantly reduced however I have tingling in my lips. Further, tonight I swilled mouthwash around the site and had immediately significant pain that subsided when I lay down…..could I have inadvertently removed the clot? The site is grey colour all over. Sorry this is a long list….please can you advise? Finally what is a “Zoe pack”?
Hi Beth,
From what you have written it looks like there was secondary infection at the site of extraction, using Antibiotics course is the best option. As for the dislodgement of clot for the second time, it is common after swisshing that you loose the clot after a couple of days. If the swelling and pain have subsided then it is quite normal there is nothing to worry.