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NEET MDS REVIEW 2017-18 Clinical Features, Causes & Treatment of dry Socket / Alveolar Osteitis - Complete Management


What Is dry socket?- Postoperative complication causing moderate to
sever pain which develops on 3rd or 4th day after tooth extraction,
due to dislodgement of clot but it is not associated with an
infection.Socket bone get exposed and painful.
Occurrence-Rare (2%) after routine tooth extraction.
Frequent (20%) after removal of impacted mandibular 3rd molar.
Clinical appearence-
Tooth socket appears to be empty with a partially or completely lost
blood clot.
Some bony surface of socket is exposed which is sensitive and source
of pain
Area of socket has a bad odor.
Patient usually complains of foul taste.
Cause-
High level of fibrinolytic activity in and around extraction socket
Resulting in lysis of the blood clot
Causing exposure of bone surface.
Management:-
Give a nerve block or apply topical anesthesia if patient is in severe pain.
Tooth socket is gently irrigated with sterile saline
Socket is carefully suctioned of all excess saline and a small strip of iodoform gauze soaked with
medication is inserted into socket
Prescribe NSAID for relive of pain ( ibuprofen).
Medicated dressing contains-
Eugenol- obtundent
Benzocain- a topicl anesthetic
Balsum of peru- Carrying vehicle
This dressing is changed evry other day for the next 3-6 days depending on the severity of pain.
Note- Once patients pain decreases the dressing should not be changed repeatedly  because it acts as a
foreign body and prolongs the healing.
Who are at risk-
smoker
Poor oral hygiene
Wisdom teeth pulled
Have greater than usual trauma during the tooth extraction surgery
Use birth control pills
Have a history of dry socket after having teeth pulled

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