Dry socket in relation to predisposing factors in Mosul dental teaching hospital patients

Dry socket is one of the popular side effects of exodontia. It is an annoying problem that causes discomfort for the patient and affects their daily activities, reducing quality of life. It occurs more in the lower teeth than the upper, especially during lower third molar removal, and increases when a high difficulty percentage of extraction is present. It is associated with various agents like young age, female sex, high local anesthetic dose, smoking, and contraceptive drugs. It is characterized by severe throbbing radiating pain that increases gradually with red inflamed gingiva surrounding dental sockets that appear either empty or filled by food debris accompanied by bad odor and taste. The treatment of this matter is easy, but it takes time and resources, so preventing or reducing its prevalence is easier and more effective in saving time and resources, and most importantly, avoiding patients from this harmful experience. Our study focused on revealing the precise factors that can increase the occurrence of dry socket and avoiding them.

OBJECTIVES: To detect dry socket development in patients with predisposing factors at present and if there are any changes in relation to these factors and dry socket.

MATERIALS AND METHOD: The study includes 110 patients who attended a teaching hospital in a dentistry college and need extraction of lower molar teeth exclusively due to different causes (unrestorable tooth, orthodontic, periodontal). Verbal consent has been taken from all patients and extraction done by the same operator. The patients are divided into 2 groups, one group having predisposing factors of dry socket development post-extraction, while another group does not have these factors. Post-extraction instructions verbally and written had been given for all patients; only analgesics were prescribed for the patients. Follow-up with clinical assessment was done for 2-4 and 7 days after extraction to detect any sign or symptoms of dry socket development in both groups.

RESULTS: Thirty-five females have dry sockets against 25 male patients; according to age, patients in the third decade of life showed dry sockets more than other groups, with 27 patients developing dry sockets post-extraction; and 18 smoker patients develop dry sockets than 7 non-smokers patients, with highly significant results. 37 patients from 54 taking 2 cartridges of anesthesia have dry socket, while all the patients (8) in number who need 4 cartridges of anesthesia develop dry socket, 18 from 30 females with contraceptives develop dry socket, and conversely 17 from 28 females with no contraceptives have dry socket. Conclusion: It has been found that dry socket is more common in the 3rd decade of life with sex predilection to female; it increases with high anesthetic dose, contraceptive, and cigarette consumption.

CLINICAL SIGNIFICANCE: It can aid in prevention or decreasing frequency of dry socket development with decreasing its effects on patients’ daily life activities by detecting the exact promoting factors and avoiding it.

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