Updated: Oct 20
If there is white pus coming out of your wisdom tooth hole, it means that you have a post-extraction infection. In other words, your wisdom tooth hole got infected during the healing process after the third molar was removed.
Yes, that means you will need to return to your dentist for additional treatment because you've a surgical complication.
Pus is a sign of infection
If you see pus (purulence) oozing out of the wisdom tooth hole, that is a tell-tale sign that you've an infection. According to the CDC, the presence of purulence is sufficient evidence of an active infection.
Signs and symptoms of purulence:
White fluid or white liquid.
Bad tasting drainage.
Foul odor or malodor.
Pain or tenderness around socket.
If you notice any of the above, there is a good chance you've a post-operative infection at the surgical site. A healthy extraction socket does not have any of these signs/symptoms.
What is purulence?
Pus is primarily composed of live and dead neutrophils, which are the immune cells in our body that protects us against infections. The fact that our immune cells are active means that there is an active infection.
If the body is unsuccessful in fighting off the infection and there is no path for drainage, an abscess will develop. In other words, the surgical site will swell up and it'll be filled with pus.
For the most part, after a wisdom tooth extraction there will be a path of drainage so it is unlikely that you'll swell up. However, you still need to see your dentist to have the source of the pus treated.
How did wisdom tooth hole get infected?
It's not unusual for a surgical site to get infected because that is a common complication. Having your wisdom teeth removed is a surgical procedure so it is not an exception to the rule.
Socket infection causes:
You didn't take the antibiotics as prescribed.
You weren't prescribed any antibiotics.
You didn't keep the surgical site clean.
Bacteria escaped detection during the extraction.
Pure coincidence that it got infected.
Since we weren't the ones who performed the procedure, we wouldn't know the exact cause of your infection. The above are all potential reasons as to how it may have gotten infected.
There is just one thing that we wish to expand upon and that is if you weren't given any antibiotics after the procedure.
Weren't prescribed antibiotics
Believe it or not, the standard of dental care is to NOT give any antibiotics after a routine wisdom tooth extraction. That applies to taking out any other type of tooth in your mouth was well.
Typically the chances for infection after surgical removal of teeth are very low. So low that the dental community thinks that the chances of you developing antibiotic resistant bacteria far exceeds the possibility of an infection.
Due to the chance of getting bacteria that are resistant to antibiotics, you're typically not prescribed any antibiotics. Unfortunately that also means that your chances of getting a wisdom tooth socket infected also increases.
How to treat an infected socket
A wisdom tooth socket that has pus coming out of it will need to be treated by a dentist. It cannot be managed with at home care so don't even try!
Debride the socket and remove all of the infection.
Place you on antibiotics.
Debriding the socket
Debriding the socket includes scraping the inside walls of the wisdom tooth hole. You will need to be numb for this procedure.
Essentially your dentist will clean all four of the alveolar walls of the tooth socket. They will curette it with a sharp stainless steel instrument. You will feel and hear scraping sounds.
Afterwards they'll flush out the third molar hole with an antibiotic solution, chlorhexidine. If there is an abscess forming, this would also be the time that your dentist will drain the infection. That all depends on whether or not the pus is self-draining.
You will definitely be given antibiotics after this visit since any sign of purulence is an indication for it. The most common prescription for dental infections would be amoxicillin which is a penicillin.
Take 1 tablet (500 mg) every 8 hours.
The entire course is typically for 7 days.
Take the pill with a meal to prevent an upset stomach.
If you're allergic to penicillin, the next antibiotic of choice would be Azithromycin or Doxycycline.
Is this condition a dry socket?
In case you were wondering, pus coming out of the third molar hole is NOT a dry socket. A dry socket as its name implies, is a condition where the hole is completely dry.
It is devoid of ALL fluids and that includes pus. There will also be no blood in there either. Although technically the definition of a dry socket is a lack of a blood clot.
But to answer your question, no you do not have a dry socket if you see white pus coming out of the extraction socket. It is an infection though but that isn't quite the same thing.
If you see or notice white purulence coming out of your wisdom tooth socket, that is a tell-tale sign that it is infected. Don't panic because the condition is treatable but you will need to return to your dentist sooner than anticipated. While this condition may not cause the hole to reopen, it'll merely delay its closure.