Prevention & Management of Dry Socket

[Anonymous]

RISK FACTORS

Extraction of ‘wisdom teeth’ especially impacted
lower ‘wisdom teeth’.
Traumatic & difficult extractions.
Oral / depot contraception.
Immunosuppressant drugs such as steroids,
cyclosporine & methotrexate.
Active / recent history of Acute Ulcerative Gingivitis
(‘Trench Mouth’) or Pericoronitis (infection /
inflammation around the crown of a tooth)
associated with the tooth to be extracted.
Smoking (> 20 cigarettes per day).
Increased bone density either locally or generally
(eg. Paget’s Disease & Osteopetrosis).
Previous history of ‘dry sockets’ following extractions.

PREVENTIVE MEASURES FOR THE PATIENT

Wherever possible pre-operative oral hygiene
measures to reduce plaque levels to a minimum
should be instituted, such as using an antiseptic
mouthwash.
Patients who smoke should stop before the tooth
extraction and for at least two weeks post-extraction
whilst the socket(s) heals.
Patients should avoid vigorous mouth rinsing for the
first 24 hours post extraction and to use gentle tooth
brushing and mouth rinses for 7 days post-extraction.
Patients should return to the Oral Surgeon / Dentist
immediately they develop increasing pain from the
extraction socket, awful taste in the mouth or bad
breath.

DRY SOCKET TREATMENT

The infected socket is gently irrigated with an
antiseptic mouthwash.
The socket is packed with a dressing that contains
sedative and antiseptic ingredients. The dressing
prevents the accumulation of food debris in the
extraction socket, protects the exposed bone from
local irritation and calms down the inflammation-
infection within the extraction socket walls.
Antibiotics may be prescribed or changed (if already
on Painkillers will still need to be taken until the
effects of the sedative dressing become apparent
and the infection has started to clear.
If the pain does not settle within 48 hours, then get
back in contact with the Oral Surgeon / Dentist.