Systemic Review of Dry Socket: Aetiology, Treatment, and Prevention (2023)

As a library, NLM provides access to scientific literature. Inclusion in an NLM database does not imply endorsement of, or agreement with, the contents by NLM or the National Institutes of Health. Learn more about our disclaimer.

Systemic Review of Dry Socket: Aetiology, Treatment, and Prevention (1)

About UsAuthor ServicesArchiveSubmitJCDR

J Clin Diagn Res. 2015 Apr; 9(4): ZE10–ZE13.

Published online 2015 Apr 1. doi:10.7860/JCDR/2015/12422.5840

PMCID: PMC4437177

PMID: 26023661

Author information Article notes Copyright and License information Disclaimer

Abstract

Our systemic review is to make a comprehensive review about the aetiology, treatment and the prevention of dry socket, the inclusion criteria were all the studies that discuss the dry socket and its etiology, treatment and prevention and exclusion criteria were all the studies that discuss the other complications of tooth extraction, the materials and methods used for this systemic review was to search in the Pub Medline database between 2008 to 2013, using specific words “dry socket, aetiology, treatment and prevention” and published in the English language, the articles were screened by abstract for relevance to aetiology, treatment and prevention of dry socket, 82 papers were identified in pub med but a total of 36 out of Publications were included in the final systemic review according to the specific keywords and materials mentioned above. The occurrence of dry socket in an everyday oral surgery or dental practice is unavoidable. The risk factors are smoking, surgical trauma, single extractions, age, sex, medical history, systemic disorder, extraction site, amount of anaesthesia, operator experience, antibiotics use prior to surgery, difficulty of the surgery and the previous surgical site infection in addition to oral Contraceptives, menstrual cycle and immediate postextraction socket irrigation with normal saline. The traditional options of treatment are directed toward palliative care, such as the irrigation of the surgical site, avoiding curetting the extraction socket, Packing with a zinc oxide– eugenol paste on iodoform gauze can be considered to relieve acute pain episodes, there is also new agents in the market can accelerate the healing of the socket such as PRGF and GECB.

(Video) What is a Dry Socket? | Diagnosis and Management

The prevention methods include avoiding smoking before and after surgery and a traumatic surgery, the use of antibiotics, such as, azithromycin, can be considered, the other preventive measures such as chlorhecidine rinse or gel can be effective in the reduction of dry socket incidence.

Keywords: Dental practice, Oral surgery, Tooth extraction

Introduction

In this review we will discuss the dry socket and its pathogenesis, treatment and prevention method, the Alveolar osteitis (AO) is one of the extraction wound healing disorder [1], Commonly known as “dry socket” which is one of the common postoperative problem that results in severe pain “postoperative pain” inside and around the extraction site, which increases in severity between the first and third day after the extraction, usually caused by a partial or total disintegrated blood clot within the socket [2], this type of extraction complications usually associated with the extraction of impacted 3rd molar teeth and mandibular molar teeth [3].

Pathogenesis

Of 36, 12 articles discussed the pathogenesis of dry socket.

1-Flap Design: Haraji et al., [4] reported that the modified triangular flap decreases the incidence of Alveolar Osteitis more than the buccal envelope flap. In this study he examined the patients who were candidates for extraction of a bilaterally impacted mandibular third molar with the same difficulty index; a modified triangular flap was placed on one side and a buccal envelope flap (control) was placed on the other side, Alveolar Osteitis and healing were assessed at three and seven days after surgery.

2-Oral Contraceptives and Menstrual Cycle: 2 articles out of 12 studied the association between the menstrual cycle and the frequency of alveolar osteitis.

Another study was done by Eshghpour M et al., [5] to ensure the association between the menstrual cycle and the frequency of alveolar osteitis (AO), in this study the patients with bilateral impacted third molar teeth underwent randomized surgical extraction: one tooth during the menstrual period and one during the middle of the cycle, the postoperative examiner was unaware of the menstrual cycle status of the patients, the overall frequency of AO was 23.45%. The frequency of AO was significantly greater in the middle of the cycle than during the menstrual period in both the Oral Contraceptive users and nonusers, Although Oral Contraceptive users revealed a significantly greater frequency of AO compared with nonusers

Oginni FO [6] reported that control of preoperative infection, persistence on good oral hygiene, avoidance of trauma, and avoidance of surgery on days 1 to 22 of the menstrual cycle in non-menopausal women may reduce the incidence of dry socket in the study population, The use of an oral contraceptive was elicited in 25% of the females, and extractions were performed between days 1 and 22 of their menstrual cycle. Extraction was traumatic in 66.2% of cases, a ranking of the elicited risk factors suggests that a previously infected posterior tooth involves an equal risk in both genders. Poor oral hygiene and traumatic extraction in a mandibular tooth were prominent in males, whereas extractions performed between days 1 and 22 of the menstrual cycle were significant in females.

3-Smoking, surgical trauma, single extractions, age, sex, medical history, systemic disorder, extraction site, amount of anaesthesia, operator experience, antibiotics use prior to surgery, difficulty of the surgery: 4 out of 12 articles observed the effect of smoking, surgical trauma, single extractions, age, sex, medical history, systemic disorder , extraction site, amount of anesthesia, operator experience, antibiotics use prior to surgery, difficulty of the surgery in the incidence of dry socket.

Bortoluzzi MC et al., [7] observed the incidence of dry socket and they reported that there were higher pain levels and pain persisting longer than two days were observed with more traumatic surgeries, or associated with postoperative complications. Smoking was found to be statistically associated with the development of postoperative complications.

Mohammed H Abu Younis and Ra’ed O Abu Hantash [8] reported that smoking, surgical trauma and single extractions are considered predisposing factors in the occurrence of dry socket, on the other hand, factors like: age, sex, medical history, extraction site, amount of anesthesia, and operator experience have no effect on the observation of dry socket. The overall frequency of dry socket was 3.2%. The incidence of dry socket following non-surgical extractions was 1.7% while it was 15% following surgical extractions. The incidence of dry socket was significantly higher in smokers (12%) than in non-smokers (4%). However, there is a strong association between the amount of smoking and the incidence of dry socket. The incidence of dry socket was significantly higher in the single extraction cases (13%) than in the multiple extraction cases (5%), age, sex, medical history, extraction site, amount of local anesthesia and experience of operator play no role in the occurrence of dry socket.

– Two studies were done by Eshghpour M et al., [9] and Hasan Momeni, et al., [10] to identify the risk factor & the risk group of dry socket. Eshghpour M, et al., [9] reported that the incidence of Dry Socket was 19.14%, age, gender, systemic disorder, and antibiotics use prior to surgery revealed no significant associations with Dry Socket and the incidence of Dry Socket was significantly relevant to smoking, difficulty of the surgery according to pre-surgery radiograph evaluation and perception of surgeon post-surgery, length of surgery, and number of carpules used to reach anesthesia, Hasan Momeni, et al., [10] reported that the incidence of dry socket was 0.6% and females were more common involved than males (0.08% versus 0.04%). The ratio of mandible to maxilla was 2.5 to1 and mandibular third molars were more often involved than other teeth, trauma, poor oral hygiene and smoking had increased the incidence of dry socket.

4-Previous surgical site infection, traumatic extraction, and tobacco smoking: 1 article out of 12 reported the effect of previous surgical site infection, traumatic extraction, and tobacco smoking in the occurrence of dry socket.

Halabí D et al., [11] reported that the previous surgical site infection, traumatic extraction, and tobacco smoking are associated with an increased risk of alveolar osteitis, a statistically significant association between traumatic extraction, tobacco smoking after extraction, previous surgical site infection and the development of alveolar osteitis.

5-The use of analgesic: 1 article out of 12 reported the effect of the use of analgesic in the incidence of dry socket.

– Al-Sukhun J et al., [12] compare the efficiency of pain control in the patients who use the selective cyclooxygenase-2 (COX-2) inhibitor celecoxib, pre-emptively, and the patients who use the ibuprufen, and he reported that the ibuprufen group had a significantly higher alveolar osteitis incidence than the celecoxib group and the placebo group.

6- The role of microorganism: 2 articles out of 12 studied the role of microorganism in the incidence of dry socket

– Rodrigues MT et al., [13] studied the effect of experimentally induced infection ( the inoculation material contain Capnocytophagaochracea, Fusobacterium nucleatum, Prevotella melaninogenica, Streptococcus anginosus, Treponema socranskii and Streptococcus sanguis) in the rat sockets, they reported that, it produced higher levels of serum C- reactive protein and showing the potential of disseminated infection and disturb in the alveolar repair process in an interesting experimental model for alveolitis studies.

– Krakowiak PA [14] reported that; in certain patients, the normal process of healing can be delayed in some cases, because the sites was previously affected by osteomyelitis.

7- Immediate post-extraction socket irrigation with normal saline: 1 article of 12 studied the effect of the immediate post-extraction socket irrigation with normal saline in the occurrence of dry socket.

Tolstunov L [15] studied the role of socket irrigation with a normal saline solution that routinely used at the end of extraction on the development of alveolar osteitis (AO) after removal of impacted mandibular third molars and he noticed that there is difference of dry socket incidence (77.8% on the irrigated versus 22.2% on non-irrigated side) which demonstrated between the traditional extraction protocol versus modified approach without the end-of-surgery irrigation. The study demonstrated that the postextraction socket bleeding is very important for the proper uncomplicated socket healing. If it’s not washed away with irrigation solution at the end of extraction, the normal blood clot has a higher likelihood to form, and therefore, can potentially lead to an uncomplicated socket healing without development of alveolar osteitis.

The Options of Treatment

To describe the options of treatment in our research we evaluated 9 articles.

1- The role of antibiotics: 2 articles out of 9 studied the role of antibiotics in the treatment of dry socket.

Vessal G et al., [16] and Bezerra TP et al., [17] studied the use of antibiotics in the management of dry socket, and they reported that the most commonly used antibiotics is amoxicillin.

2- The use of sutures and local haemostatic: 2 articles out of 9 reported the effect of the use of sutures and local haemostatic in the treatment of dry socket.

– Osunde OD et al., [18] reported that the operation time was found to be significantly longer in the multiple sutures group, there was significantly less pain, swelling and trismus in the suture-less group, and there was no significant difference between the two treatment groups in terms of pain, swelling and trismus.

– Svensson R, Hallmer F et al., [19] showed that the use of (local hemostatic, primary closure, sutures and tranexamic acid) the risk of postoperative bleeding after tooth removal in patients on continued warfarin medication is low.

3- Low level laser, alvogyl and the Salicept patch: 1 article out of 9 reported the effect of Low level laser alvogyl and the Salicept patch in the treatment of dry socket.

– in other study Kaya G. et al., [20] compare the effects of alvogyl, the SaliCept patch, and low-level laser therapy in the management of alveolar osteitis and he found that no significant differences in the management of alveolar osteitis between the patients that treated by curettage and irrigation followed by alvogyl applied directly to the socket and the patients that treated by curettage and irrigation followed by a SaliCept patch applied directly to the socket, but the management of alveolar osteitis was significantly better in patients treated by curettage and irrigation followed by continuous-mode diode laser irradiation more than the patients who treated by curettage and irrigation alone- curettage and irrigation followed by alvogyl applied directly to the socket- curettage and irrigation followed by a SaliCept patch applied directly to the socket.

4- The use of eugenol on a gauze strip and a thermosetting gel containing 2.5% prilocaine and 2.5% lidocaine: 1 article out of 9 assessed the efficacy of the use of eugenol on a gauze strip and a thermosetting gel containing 2.5% prilocaine and 2.5% lidocaine in the treatment of dry socket.

– Burgoyne CC et al., [21] assessed the efficacy of pain control for post-extraction alveolar osteitis comparing the use of eugenol on a gauze strip versus a thermosetting gel containing 2.5% prilocaine and 2.5% lidocaine and he reported that the efficacy of the two preparations was not significantly different.

5-The use of pastille GECB: 1 article out of 9 investigated the efficacy of the use of pastille GECB in the treatment of dry socket.

Abbas Haghighat et al., [22] investigated the efficacy of pastille GECB (3% Guaiacol, 3% Eugenol, 1.6%Chlorobutanol), compared to ZOE and he found that GECB showed more significant efficacy in reducing complications after tooth extraction.

6-The use of plasma rich in growth factors: 2 articles of 9 reported the use of plasma rich in growth factors in the treatment of dry socket.

– Afshin Haraji et al., [23] reported that the application of PRGF may significantly reduce the incidence of AO or its associated pain and may accelerate healing.

– US Pal et al., [24] compare between the zinc oxide eugenol dressing and plasma rich in growth factor (PRGF) with gelatin sponge in the treatment of dry socket and he reported that patient’s healing was better in patients treated by PRGF with gelatin sponge than the patients who treated by zinc oxide eugenol group, but symptomatic pain relief was faster in the second group.

(Video) Dry Socket/ Alveolar Osteitis I Prevention and Treatment I Oral Surgery I Dental Guide I

Preventive Measures

– In our research 12 articles were assessed which have described the preventive measures of the dry socket such as:

1-Antibiotics: 3 articles out of 12 reported the use of antibiotics in the prevention of dry socket. One of the Pharmacologic methods used in the prevention of dry socket have included use of antibiotic preparations after extraction and antiseptic rinses. They recommend that the use of antibiotics in the extraction socket be reserved for those with history of multiple dry sockets or for immunocompromised patients.

– Ishihama Ket al., [25] reported that there was significant effectiveness of azithromycin in comparison with other antimicrobials as prophylactic use in impacted mandibular third-molar surgery in which penicillins and cephalosporins were mainly used.

– Bezerra TP et al., [17] studied the use of amoxicillin 500 mg as prophylaxis against the alveolar ostitis, and they didn’t report any difference in the incidence without the use of the amoxicillin.

– Winiewska I et al., [26], studied the effect of application of lincomycin on Beta-tricalcium phosphate (TCP) to the alveolus and they reported that Lincomycin on TCP can be used to prevent alveolar ostitis and reduces complications in the form of pain and trismus, Beta-tricalcium phosphate also prevents atrophy of the alveolar process.

2-Chlorhexidine: 8 articles out of 12 reported the effect of the use of chlorhexidine in the prevention of dry socket. In view of the hazards of random use of antibiotics, research was directed into looking at the effects of chlorhexidine rinses on dry socket, all the studies that were done to assess the efficacy of chlorhexidine for the prevention of alveolar osteitis [2734] reported that there is significantly decrease in the incidence of Alveolar osteitis after the use of the different forms of chlorohexiden either rinse or gel form.

3-“gelatamp” colloidal silver gelatin sponge: 1 article out of 12 reported the effect of the use of “gelatamp” colloidal silver gelatin sponge in the prevention of dry socket.

– Wang YZ et al., [35] reported that that “gelatamp” colloidal silver gelatin sponge can prevent the occurrence of dry socket after teeth extraction.

(Video) DRY SOCKET | fully explained | BDS, NEET, MDS

Discussion

The systematic review showed variety of papers including review and research papers. This study included (24 research papers and 12 review papers). These 36 articles illustrated that the dry socket is one of the most common post-extraction complications in dental practice [13] and the general practioners should be aware of the predisposing factors such as flap design [4], oral contraceptive pills, menstrual cycle [5,6], tobacco smoking, surgical trauma, single extraction, age, sex, medical history, systemic disorders, extraction site, amount of anesthesia, operator experience, antibiotic and difficulty of surgery [710], previous site infection [11], analgesic use [12] the role of microorganism [13] and postextraction irrigation [14,15]. They should have the knowledge of all the traditional methods of treatment like antibiotic [16,17], suturing, the use of local haemostatic agent [18,19] alveogel and euogenol [21]. Newer agents have been introduced to the market such as low level laser, Salicept patch [20], pastille GECB [22] and plasma rich in growth hormone [23,24]. Finally, since prevention is better than cure, therefore, all dental practioners must have a good idea about the preventive measures against the dry socket like antibiotic [17, 25, 26], chlorohexidine [2734] and the use of gelatamp sponge [35].

Conclusion

The occurrence of dry socket in an everyday oral surgery or dental practice is unavoidable. The risk factors for this temporary and debilitating condition are clearly identified. Surgeons must recognize this risk factors in patients with particular medical conditions and include this information as a part of the informed consent, some of this factor could be Smoking, surgical trauma, single extractions, age, sex, medical history, systemic disorder, extraction site, amount of anesthesia, operator experience, antibiotics use prior to surgery, difficulty of the surgery and the previous surgical site infection in addition to oral contraceptive use and menstrual cycle.

Treatment options for this condition are generally limited and directed toward palliative care. Prevention methods include avoiding smoking before and after surgery and a traumatic surgery, the use of antibiotics, such as, azithromycin, can be considered, chlorohexidine rinse or gel can be effective in the reduction of dry socket incidence.

Notes

Financial or Other Competing Interests

None.

References

[1] Jovanovi G, Uri N, Kruni N, Tijani M, Stojanovi S. Assessment of the effectiveness of low level laser in the treatment of alveolar osteitis. Vojnosanit Pregl. 2011;68:506–10. [PubMed] [Google Scholar]

[2] Kolokythas Antonia, Olech Eliza, Miloro Michael. Alveolar osteitis: comprehensive review & controversies. Int J Dent. 2010;2010:249073. [PMC free article] [PubMed] [Google Scholar]

[3] Daly B, Sharif MO, Newton T, Jones K, Worthington HV. Local interventions for the management of alveolar osteitis (dry socket) Cochrane Database Syst Rev. 2012;12:CD006968. [PubMed] [Google Scholar]

[4] Haraji A, Motamedi MH, Rezvani F. Can flap design influence the incidence of alveolar osteitis following removal of impacted mandibular third molars? Gen Dent. 2010;58:e187–89. [PubMed] [Google Scholar]

[5] Eshghpour M, Rezaei NM, Nejat A. Effect of menstrual cycle on frequency of alveolar osteitis in women undergoing surgical removal of mandibular third molar: a single-blind randomized clinical trial. J Oral Maxillofac Surg. 2013;71:1484–89. [PubMed] [Google Scholar]

[6] Oginni FO. Dry socket: a prospective study of prevalent risk factors in a Nigerian population. J Oral Maxillofac Surg. 2008;66:2290–95. [PubMed] [Google Scholar]

[7] Bortoluzzi MC, Manfro R, De Déa BE, Dutra TC. Incidence of dry socket, alveolar infection, and postoperative pain following the extraction of erupted teeth. J Contemp Dent Pract. 2010;11:E033–40. [PubMed] [Google Scholar]

[8] Mohammed H, Abu Younis, Ra’ed O Abu Hantash. Dry socket: frequency, clinical picture, and risk factors in a palestinian dental teaching center. Open Dent J. 2011;5:7–12. [PMC free article] [PubMed] [Google Scholar]

[9] Eshghpour M, Nejat AH. Dry socket following surgical removal of impacted third molar in an Iranian population: incidence and risk factors. Niger J ClinPract. 2013;16:496–500. [PubMed] [Google Scholar]

[10] Momeni Hasan, Shahnaseri Shirin, Hamzeheil Zeinab. Evaluation of relative distribution and risk factors in patients with dry socket referring to Yazd dental clinics. Dent Res J (Isfahan) 2011;8:S84–87. [PMC free article] [PubMed] [Google Scholar]

[11] Halabí D, Escobar J, Muñoz C, Uribe S. Logistic regression analysis of risk factors for the development of alveolar osteitis. J Oral Maxillofac Surg. 2012;70:1040–44. [PubMed] [Google Scholar]

[12] Al-Sukhun J, Penttilä H. The cyclooxygenase-2 inhibitor celecoxib and alveolar osteitis. J Ir Dent Assoc. 2011;57:50–53. [PubMed] [Google Scholar]

[13] Rodrigues MT, Cardoso CL, Carvalho PS, Cestari TM, Feres M, Garlet GP. Ferreira O Jr: Experimental alveolitis in rats: microbiological, acute phase response and histometric characterization of delayed alveolar healing. J Appl Oral Sci. 2011;19(3):260–68. [PMC free article] [PubMed] [Google Scholar]

[14] Krakowiak PA. Alveolar osteitis and osteomyelitis of the jaws. Oral Maxillofac Surg Clin North Am. 2011;23(3):401–13. doi: 10.1016/j.coms.2011.04.005. [PubMed] [Google Scholar]

(Video) How To Manage Dry Socket ? / Complications Management Series /Part 1

[15] Tolstunov L. Influence of immediate post-extraction socket irrigation on development of alveolar osteitis after mandibular third molar removal: a prospective split-mouth study, preliminary report. Br Dent J. 2012;213(12):597–601. doi: 10.1038/sj.bdj.2012.1134. [PubMed] [Google Scholar]

[16] Vessal G, Khabiri A, Mirkhani H, Cookson BD, Askarian M. Study of antibiotic prescribing among dental practitioners in Shiraz, Islamic Republic of Iran. East Mediterr Health J. 2011;17(10):763–69. [PubMed] [Google Scholar]

[17] Bezerra TP, Studart-Soares EC, Scaparo HC, Pita-Neto IC, Batista SH, Fonteles CS. Prophylaxis versus placebo treatment for infective and inflammatory complications of surgical third molar removal: a split-mouth, double-blind, controlled, clinical trial with amoxicillin (500 mg) J Oral Maxillofac Surg. 2011;69(11):e333–9. doi: 10.1016/j.joms.2011.03.055. Epub 2011 Jul 29. [PubMed] [Google Scholar]

[18] Osunde OD, Adebola RA, Saheeb BD. A comparative study of the effect of suture-less and multiple suture techniques on inflammatory complications following third molar surgery. Int J Oral Maxillofac Surg. 2012;41:1275–79. [PubMed] [Google Scholar]

[19] Svensson R, Hallmer F, Englesson CS, Svensson PJ, Becktor JP. Treatment with local hemostatic agents and primary closure after tooth extraction in warfarin treated patients. Swed Dent J. 2013;37:71–77. [PubMed] [Google Scholar]

[20] Kaya G, Yapici G, Sava Z, Güngörmü M. Comparison of alvogyl, SaliCept patch, and low-level laser therapy in the management of alveolar osteitis. J Oral Maxillofac Surg. 2011;69:1571–77. [PubMed] [Google Scholar]

[21] Burgoyne CC, Giglio JA, Reese SE, Sima AP, Laskin DM. The efficacy of a topical anesthetic gel in the relief of pain associated with localized alveolar osteitis. J Oral Maxillofac Surg. 2010;68:144–48. [PubMed] [Google Scholar]

[22] Haghighat A, Bahri Najafi R, Bazvand M, Badrian H, Khalighinejad N, Goroohi H. The Effectiveness of GECB Pastille in Reducing Complications of Dry Socket Syndrome. Int J Dent. 2012;2012:587461. Published online 2012. [PMC free article] [PubMed] [Google Scholar]

[23] Haraji Afshin, Lassemi Eshagh, Hosein Mohammad, Motamedi Kalantar, Alavi Maryam, Adibnejad Saman. Effect of plasma rich in growth factors on alveolar osteitis. Natl J Maxillofac Surg. 2012;3:38–41. [PMC free article] [PubMed] [Google Scholar]

[24] Pal US, Singh Balendra Pratap, Verma Vikas. Comparative evaluation of zinc oxide eugenol versus gelatin sponge soaked in plasma rich in growth factor in the treatment of dry socket: An initial study. Contemp Clin Dent. 2013;4:37–41. [PMC free article] [PubMed] [Google Scholar]

[25] Ishihama K, Kimura T, Yasui Y, Komaki M, Ota Y. Azithromycin as prophylaxis for the prevention of postoperative infection in impacted mandibular third molar surgery. J infect chemother. 2006;12:31–35. [PubMed] [Google Scholar]

[26] Winiewska I, Slósarczyk A, Myliwiec L, Sporniak-Tutak K. Lincomycin applied to the alveolus on TCP carrier and its effect on wound healing after surgical extraction of a third molar. Ann Acad Med Stetin. 2009;55(2):59–64. [PubMed] [Google Scholar]

[27] Torres-Lagares D, Gutierrez-Perez JL, Hita-Iglesias P, Magallanes-Abad N, Flores-Ruiz R, Basallote-Garcia M, et al. Randomized, double-blind study of effectiveness of intra-alveolar application of chlorhexidine gel in reducing incidence of alveolar osteitis and bleeding complications in mandibular third molar surgery in patients with bleeding disorders. J Oral Maxillofac Surg. 2010;68:1322–26. [PubMed] [Google Scholar]

[28] Haraji A, Rakhshan V, Khamverdi N, Alishahi HK. Effects of intra-alveolar placement of 0.2% chlorhexidinebioadhesive gel on dry socket incidence and postsurgical pain: a double-blind split-mouth randomized controlled clinical trial. J Orofac Pain. 2013;27:256–62. [PubMed] [Google Scholar]

[29] Richards D. Does chlorhexidine prevent dry socket? Evid Based Dent. 2012;13:91. [PubMed] [Google Scholar]

[30] Minguez-Serra MP, Salort-Llorca C, Silvestre-Donat FJ. Chlorhexidine in the prevention of dry socket: effectiveness of different dosage forms and regimens. Med Oral Patol Oral Cir Bucal. 2009;14:e445–49. [PubMed] [Google Scholar]

[31] Yengopal V, Mickenautsch S. Chlorhexidine for the prevention of alveolar osteitis. Int J Oral Maxillofac Surg. 2012;41:1253–64. doi: 10.1016/j.ijom.2012.04.017. Epub 2012. [PubMed] [Google Scholar]

[32] Hita-Iglesias P, Torres-Lagares D, Flores-Ruiz R, Magallanes-Abad N, Basallote-Gonzalez M, Gutierrez-Perez JL. Effectiveness of chlorhexidine gel versus chlorhexidine rinse in reducing alveolar osteitis in mandibular third molar surgery. J Oral Maxillofac Surg. 2008;66:441–45. [PubMed] [Google Scholar]

[33] Sridhar V, Wali Greeshma G, Shyla HN. Evaluation of the Perioperative Use of 0.2% ChlorhexidineGluconate for the Prevention of Alveolar Osteitis After the Extraction of Impacted Mandibular Third Molars: A Clinical Study. J Maxillofac Oral Surg. 2011;10:101–11. Published online 2011. [PMC free article] [PubMed] [Google Scholar]

[34] Haraji A, Rakhshan V. Single-dose intra-alveolar chlorhexidine gel application, easier surgeries, and younger ages are associated with reduced dry socket risk. J Oral Maxillofac Surg. 2014;72:259–65. [PubMed] [Google Scholar]

[35] Wang YZ, Guan QL, Li YX, Guo JL, Jiang L, Jia MY, et al. Use of “gelatamp” colloidal silver gelatin sponge to prevent dry socket after extracting mandibular impacted teeth. Shanghai Kou Qiang Yi Xue. 2013;22:108–10. [PubMed] [Google Scholar]

Articles from Journal of Clinical and Diagnostic Research : JCDR are provided here courtesy of JCDR Research & Publications Private Limited

FAQs

What is the fastest way to get rid of a dry socket? ›

Flushing out the socket can remove any food particles or other debris that may contribute to pain or possible infection. Medicated dressings. Your dentist or oral surgeon may pack the socket with medicated gel or paste and medicated dressings. These can provide relatively fast pain relief.

Do systemic antibiotics prevent dry socket and infection after third molar extraction a systematic review and meta analysis? ›

Conclusions: Systemic antibiotics significantly reduce the risk of dry socket and infection in third molar extraction.

What is the recommendation for dry socket? ›

Your dentist may prescribe antibiotics to prevent the socket from becoming infected. To care for the dry socket at home, your dentist may recommend that you rinse with salt water or a special mouthwash every day.

Does honey help dry socket? ›

Honey will act as an anti-inflammatory and analgesic for your case of dry socket but is also linked to preventing infection. To use honey, simply pour some on a clean gauze, and apply it to the affected area. You can leave it for a few minutes or leave it for a few hours.

What is the longest time for dry socket to heal? ›

Dry socket usually occurs within 3-5 days of an extraction and more commonly in the lower jaw. Symptoms include severe pain, a throbbing sensation, an unpleasant taste, a fever, or swollen glands. It can last for up to 7 days. By following your dentist's instructions carefully, dry socket can usually be prevented.

How long does it take for a dry socket to heal completely? ›

With proper care, a dry socket usually heals in seven to 10 days. In that time, new tissue grows and covers the exposed socket. Regular brushing and flossing during this time helps keep your mouth healthy and reduces your risk of infection. People who've had dry sockets in the past are more likely to get them again.

What systemic antibiotics treat dry socket? ›

Prevention methods include avoiding smoking before and after surgery and a traumatic surgery, the use of antibiotics, such as, azithromycin, can be considered, chlorohexidine rinse or gel can be effective in the reduction of dry socket incidence.

What antibiotics do you take for dry socket after tooth extraction? ›

Antibiotics given just before or just after surgery (or both) may reduce the risk of infection and dry socket after the removal of wisdom teeth by oral surgeons. However, antibiotics may cause more (generally brief and minor) unwanted effects for these patients.

Will dry socket go away with antibiotics? ›

Share on Pinterest A dentist can prescribe antibiotics to help prevent dry socket. Some research suggests that antibiotics significantly reduce the risk of a dry socket in molar extractions.

What is the number 1 cause of dry socket? ›

Dry socket may be caused by a range of factors, such as an underlying infection in the mouth, trauma from the tooth extraction or problems with the jawbone. The condition occurs more often with wisdom teeth in the lower jaw than with other teeth. You are also more likely than others to develop dry socket if you: smoke.

What makes dry socket worse? ›

Factors that can increase your risk of developing dry socket include: Smoking and tobacco use. Chemicals in cigarettes or other forms of tobacco may prevent or slow healing and contaminate the wound site. The act of sucking on a cigarette may physically dislodge the blood clot prematurely.

What not to do to get a dry socket? ›

How To Avoid Dry Socket After Tooth Removal – Our Tips & Advice
  1. Do Not Use A Straw For 24-48 Hours After Your Surgery. ...
  2. Avoid Spitting Vigorously After Rinsing For 24-48 Hours After Extraction. ...
  3. Don't Smoke Or Use Oral Tobacco For 48 Hours. ...
  4. Do Not Brush The Extraction Site Directly For 3-4 Days.

Is Coffee good for a dry socket? ›

Coffee and Dry Socket

After a tooth extraction, a blood clot should form at the site of the missing tooth. The clot is a vital part of the body's healing process. Unfortunately, drinking coffee can prevent that clot from forming or disturb a newly formed clot, leading to a painful condition known as dry socket.

What foods help heal dry sockets? ›

Yogurt, pudding, applesauce and Jell-O are some go-to recovery foods: no chewing involved! Stick to these post-extraction staples for the first 24 hours after your surgery before moving on to soft foods that require chewing.

Does sugar make dry socket worse? ›

Also, stay away from crunchy foods and snacks. Not only are they hard to chew and aggravate the wound, but also some food particles may get stuck in the tooth socket. Sugar is also bad as bacteria feeds on it thereby increasing the risk of infection and worse still tooth decay.

What happens if dry socket never heals? ›

Delayed healing or continual dry sockets can pose a high risk of infection and pain. In some cases, it may be necessary to place medication or a bone graft down into the opening to facilitate appropriate healing.

How does a dentist treat dry socket? ›

If you have dry socket, your dentist will clean the socket to make sure it's free of food and other particles. This may alleviate any pain and can help prevent infection. Your dentist may also pack the socket with a medicated dressing or paste to help numb the pain.

Can dry socket cause permanent damage? ›

dry socket – where a blood clot fails to develop in the tooth socket, or if the blood clot becomes dislodged. nerve injury – this can cause temporary or permanent problems, such as tingling or numbness.

Can you reverse dry socket? ›

Warm salt water

The Mayo Clinic recommends dissolving ½ teaspoon of salt into 8 ounces of warm water. Swish this around in your mouth for a minute, or use it to flush out the dry socket with a syringe your surgeon gives you. Do this at least three times per day or after meals.

Can coughing cause dry socket? ›

Coughing, sneezing, or spitting can also cause debris to fall into the open socket, causing a dry socket. Poor oral hygiene and touching the wound area increases the risk of developing dry sockets, as well as women who take birth control medication.

What painkiller is good for dry socket? ›

Yes, you can take nonsteroidal anti-inflammatory drugs (NSAID), such as aspirin or ibuprofen to ease the discomfort of dry socket pain. Often times these over-the-counter medications aren't strong enough to relieve the pain and you'll need a doctor to prescribe a stronger drug or anesthetize the area.

What bacteria causes dry socket? ›

Although it has been difficult to discover these organisms, it has been found that significant anaerobes are common in dry sockets. In one study by Nitzen et al. they found Treponema denticola, which is known to be a putative micro-organism in the development of periodontal disease.

Will amoxicillin stop dry socket? ›

Amoxicillin also reduces the chances of developing dry socket, swelling, and trismus. There's no need to worry about postsurgical infections after a long-duration surgery. Dental surgeons may prescribe Amoxicillin before and after third molar surgery, trans alveolar extraction, and impacted tooth extraction.

Will the dentist give me pain meds for dry socket? ›

The great news is that dry sockets are treatable and the pain can be managed while you heal! When you get to the dentist's office, they will likely flush out the socket site to remove debris and check for further problems. They will then pack the socket with medical dressings and prescribe pain medication.

What is the strongest natural antibiotic for tooth infection? ›

Fenugreek and Goldenseal are the two most effective and healthy choices for tea as they help alleviate any symptom of a tooth infection. In addition, both the plants have immunity-boosting antibiotic properties and can be found easily across grocery stores.

How long does it take for a dry socket to heal without antibiotics? ›

Most cases of dry socket typically heal between 7-10 days after they happen, with untreated, severe dry socket causing potential pain for up to 2-3 weeks.

Can a dry socket heal without being packed? ›

Dentists will typically diagnose dry socket based on the presence of pain and breakdown of the clot after a tooth extraction. The primary treatment for dry socket is pain management, so if the condition causes little or no pain, it does not require treatment. The socket will heal and get better on its own.

Is dry socket a bacterial infection? ›

Food particles that collect inside a dry socket can also ferment due to bacteria. This fermentation may result in the formation of toxins or antigens that may irritate the exposed bone, produce an unpleasant taste or halitosis, and cause pain throughout the jaw.

How rare is dry socket? ›

The facts about dry socket

Dry socket can occur anywhere from 2% to 5% of the time with the extraction of a tooth. Mandibular teeth are affected by this condition more often than maxillary teeth.

When is dry socket most painful experience? ›

When the blood clot from the extraction site falls out prematurely (within the first 4 days after surgery), dry socket causes extreme pain that may radiate to the jaw, face, and ear. It also causes bad breath. The highest risk for this condition is between days 2-3 after tooth extraction.

Is dry socket one of the worst pain ever? ›

Dry Socket or alveolar osteitis is a very painful condition that sometimes follows difficult tooth extractions. To give you an idea of just how painful it can be, people who have had toothache, say it is the worst pain imaginable.

How can I make my tooth extraction heal faster naturally? ›

How to Speed Up Recovery after Tooth Extraction
  1. Keep the Gauze in Place. If your dentist has placed a gauze over the wound, leave it in place for two hours unless you've been told differently. ...
  2. Take It Easy. ...
  3. Don't Touch the Wound. ...
  4. Pain Killers. ...
  5. Don't Smoke or Drink. ...
  6. Avoid Mouthwash. ...
  7. Eat Carefully. ...
  8. Sip Drinks.
Sep 22, 2020

Can salt water rinse prevent dry socket? ›

In a study published in Evidence-Based Dentistry, researchers discovered that patients who didn't rinse their mouth with salt water after their surgery were more likely to develop dry sockets as opposed to those that did. Doing this will also help speed up your recovery.

Should I drink water to prevent a dry socket? ›

Keep your mouth clean with a saltwater rinse a few times a day. Brush teeth very gently. Drink plenty of fluids. Avoid food, beverages, and activities that threaten your blood clot.

Why can't I eat dairy after tooth extraction? ›

Dairy contains proteins that can encourage the growth of bacteria and increase the risk of infection. This is because dairy provides an ideal environment for bacteria to thrive, which can lead to swelling and discomfort in the gums and surrounding area.

What is the best tea for dry socket? ›

Green and black teas

They have antibacterial properties that can help prevent infection. Green tea also has anti-inflammatory properties that may help reduce pain. People can soak a green or black tea bag in hot water before letting it cool. Once the teabag is cool, they can place it over the dry socket.

What not to drink after tooth extraction? ›

Both alcohol and carbonated beverages can damage the clot in your extraction site and cause complications, so avoid drinking them for at least four days after your extraction.

How can I speed up my socket healing? ›

6 Tips for Faster Recovery After a Tooth Extraction
  1. Rest. It is crucial to get adequate rest after your tooth extraction. ...
  2. Eat a Soft Food Diet. ...
  3. Avoid Using a Straw or Smoking. ...
  4. Cold Therapy. ...
  5. Use Over-the-Counter Medications. ...
  6. Maintain Good Oral Hygiene.
Oct 7, 2021

Can you eat bananas after tooth extraction? ›

Bananas. Many oral surgery specialists recommend eating bananas after the surgery. The soft texture is easy to chew and doesn't irritate your gums. Bananas are loaded with minerals and vitamins, including folate, manganese, vitamin B6, and potassium, which are good for your oral health.

What supplements should I take after tooth extraction? ›

Taking oral vitamin C 600 mg/d over three doses for 10 days after tooth extraction enhances extraction wound healing by reducing mesiodistal extraction wound and reduces postoperative pain.

What drinks cause dry socket? ›

The bubbles in carbonated drinks can also cause dry socket by loosening blood clots, so it's best to avoid sodas. Don't eat crunchy foods like nuts, chips, and popcorn because they are hard to chew and can easily get stuck in your extraction sites.

Do tea bags help prevent dry sockets? ›

Saliva and air irritate dry sockets and intensify pain. To avoid either, bite down on moist gauze or tea bags. The tannic acid in tea bags causes blood vessels to contract, which promotes blood clot formation. Take a moistened tea bag and place it over the dry socket.

Does ice cream prevent dry socket? ›

Dry socket prevention starts with eating the right food to promote proper healing. After tooth extractions, the right food is anything that's soft and doesn't require much chewing. Great examples to stock up on in advance include broth, mashed potatoes, ice cream, applesauce, yogurt, mashed beans, and smoothies.

Can dry socket heal overnight? ›

In most cases, the pain of dry socket improves within 24–72 hours, according to the Canadian Dental Association. In some people, the pain may last up to 7 days.

How do you flush a dry socket at home? ›

Warm salt water

The Mayo Clinic recommends dissolving ½ teaspoon of salt into 8 ounces of warm water. Swish this around in your mouth for a minute, or use it to flush out the dry socket with a syringe your surgeon gives you. Do this at least three times per day or after meals.

What antibiotic is good for dry socket? ›

Prevention methods include avoiding smoking before and after surgery and a traumatic surgery, the use of antibiotics, such as, azithromycin, can be considered, chlorohexidine rinse or gel can be effective in the reduction of dry socket incidence.

Can you stop dry socket from getting worse? ›

Avoid making it worse

People with dry socket should avoid smoking and any other tobacco use, which can slow down the healing process. It is also best to avoid drinking any fluids through a straw and spitting too hard, as these actions can dislodge any blood clots that are forming.

Does packing a dry socket help it heal? ›

Many dentists pack a dry socket with eugenol based medications that help decrease the pain temporarily. However, the packing process itself can irritate the dry socket and may slow healing. In addition, when the temporary effects wear off, the pain will likely return.

Does salt water help with dry socket? ›

One of the best things you can do is rinse your mouth with warm saltwater. This will help to remove any food particles that could be irritating your dry socket and promote blood clotting. You want to make sure that you're using warm water and not hot because hot water could further irritate your wound.

What does a dentist do for dry socket? ›

If you have dry socket, your dentist will clean the socket to make sure it's free of food and other particles. This may alleviate any pain and can help prevent infection. Your dentist may also pack the socket with a medicated dressing or paste to help numb the pain.

Can I leave a dry socket alone? ›

If you leave the dry socket alone, it will eventually heal and will normally take around a month or so, although the pain won't let up during the healing period. The best way to fight a dry socket is to go back to your dentist and have them pack the exposed area.

What foods cause dry socket? ›

This includes nuts, popcorn, rice, and pasta. These types of foods can dislodge blood clots from extraction sites and cause dry socket.

Can you brush over a dry socket? ›

Brush Carefully

To be on the safe side, don't brush or rinse the mouth in the first 24 hours after the tooth extraction procedure. Thereafter, brush with care and don't allow the toothbrush to get close to the extraction site. Also, don't swish water, mouthwash or any oral care fluid in your mouth.

Videos

1. DRY SOCKET
(DENTISTRY TO THE POINT)
2. Acute Osteomyelitis of the Jaws, Dry Socket
(Muhammad Arif)
3. A Case report about Severe Tissue Defect in Esthetic Zone - Dr. Ying Wang
(Geistlich Pharma)
4. Otolaryngology | The National EM Board (MyEMCert) Review Course
(The Center for Medical Education)
5. Pharmacologic Management of Selected Oral Conditions
(Edilia Marshall, DMD, MAGD, AAACD)
6. Management of severe bone defect in the aesthetic zone with the minimally invasive concept by Yue Sa
(Geistlich Pharma)
Top Articles
Latest Posts
Article information

Author: Gregorio Kreiger

Last Updated: 03/26/2023

Views: 5699

Rating: 4.7 / 5 (77 voted)

Reviews: 92% of readers found this page helpful

Author information

Name: Gregorio Kreiger

Birthday: 1994-12-18

Address: 89212 Tracey Ramp, Sunside, MT 08453-0951

Phone: +9014805370218

Job: Customer Designer

Hobby: Mountain biking, Orienteering, Hiking, Sewing, Backpacking, Mushroom hunting, Backpacking

Introduction: My name is Gregorio Kreiger, I am a tender, brainy, enthusiastic, combative, agreeable, gentle, gentle person who loves writing and wants to share my knowledge and understanding with you.