Dry Socket – Diagnosis and Management
Dry Socket - Diagnosis and Management
Objectives
By the end of these revision notes, you should:
What is a Dry Socket?
Alveolar osteitis, or dry socket, is a relatively common post-extraction complication. We have discussed at length other complications associated with dental extractions here.
A dry socket occurs when a blood clot fails to form, or is dislodged/lost from the socket, following an extraction.
The post-extraction blood clot has two main purposes:
- Protect underlying bone and nerves
- Foundation for new bone and soft tissue formation
Therefore, if a blood clot is lost, then both of these functions are not fulfilled and the patient will experience pain (as underlying structures are not protected) and delayed healing.
Aetiology of a Dry Socket
There are multiple risk factors that are thought to increase the chances of a dry socket. Majority of these factors impact haemostasis process directly or the immune system. Common risk factors include:
- Failure to follow post-operative instructions – rinsing within the first 24 hours following an extraction or failure to maintain good oral hygiene may impact the clot.
- Smoking or tobacco use – nicotine causes vasoconstriction which will reduce blood flow to the area. Other chemicals and agents may disrupt wound healing.
- Radiotherapy – radiotherapy causes hypovascularity, therefore, reducing the ability to form a stable blood clot.
- Extraction site – dry sockets are more common in the mandible compared to the maxilla (due to relatively poorer blood supply). Dry sockets are also more common in posterior teeth, due to poorer blood supply in larger sockets.
- Trauma – the greater the trauma during an extraction, the higher the risk of a dry socket.
- Oral contraceptive pill – any change in hormone levels can impair wound healing.
- Infection – infective processes will disrupt wound healing.
🚨 Access Restricted
Subscribe to access ALL revision notes and cheat sheets!
We provide a wide range of revision notes and cheat sheets to help you study and prepare for exams! To access all we have to offer, head over and subscribe to ExamineDental now to supercharge your revision!