Aims: The aims of this study were to determine the prevalence, clinical picture, and risk factors of dry socket
at the Dental Teaching Center of Jordan University of Science and Technology (DTC/JUST).
Methods and Materials: Two specially designed questionnaires were completed over a four-month period.
One questionnaire was completed for every patient who had one or more permanent teeth extracted in the Oral
Surgery Clinic. The other questionnaire was completed for every patient who returned for a post-operative visit
and was diagnosed with dry socket during the study period.
Results: There were 838 dental extractions carried out in 469 patients. The overall prevalence of dry socket
was 4.8%. There was no statistically significant association between the development of dry socket and age,
sex, medical history, medications taken by the patient, indications for the extraction, extraction site, operator
experience, or the amount of local anesthesia and administration technique used. The prevalence of dry socket
following non-surgical extractions was 3.2%, while the prevalence following surgical extractions was 20.1%
(P< 0.002). The prevalence of dry socket following surgical and non-surgical extractions was significantly higher
in smokers (9.1%) than in non-smokers (3%) (P = 0.001), and a direct linear trend was observed between the
amount of smoking and the prevalence of dry socket (P = 0.034). The prevalence of dry socket was significantly
higher in the single extraction cases (7.3%) than in the multiple extraction cases (3.4%) (P = 0.018). The clinical
picture and management of dry socket at DTC/JUST were similar to previous reports in the literature. The
prevalence of dry socket, its clinical picture, and management at DTC/JUST are similar to those reported in
the literature.
Abstract
2
The Journal of Contemporary Dental Practice, Volume 8, No. 3, March 1, 2007
Introduction
Dry socket is one of the most common
complications of tooth extraction and is
characterized by severe pain starting usually
on the second or third day postoperatively. Its
prevalence has been reported to vary from 0%1
to more than 35%2
and is more common following
mandibular third molar extraction.
3-9 Patients
experience pain and may experience loss of
productivity. This makes the condition costly
to both patient and society, as 45% of patients
require multiple postoperative visits in the
process of managing this painful condition.
10
The exact pathogenesis of dry socket is not
well understood. However, disintegration of
the blood clot by fibrinolysis remains the most
widely accepted theory.11 Several contributing
factors have been reported to be associated with
an increased risk of dry socket. They include
traumatic extraction,
3-4,11 preoperative infection,
11-12
smoking,13 sex,
11,14
site of extraction,
8,14 use of
oral contraceptives,
15 use of local anesthetics
with vasoconstrictors,
16
inadequate postoperative
irrigation,
17 and low level of operator experience.
4,8
Several methods have been advocated to reduce
the incidence of dry socket including the use
of antiseptic mouthwashes18-20 antifibrinolytic
agents,
21 antibiotics,
22-23 steroids,
24 clot supporting
agents,
25
and other intra-alveolar dressings and
medicaments.
9,27-28
While this condition cannot be completely
treated as long as the exact etiology is not
firmly established, its management appears
to be simple and effective. It usually involves
reassurance of the patient, cleaning and
irrigation of the affected socket, and insertion of a
medicated pack.
2,25,29-30
This is the first study of dry socket at the Dental
Teaching Center of Jordan University of Science
and Technology (DTC/JUST) and in Jordan . Its
aims were to identify the prevalence and risk
factors as well as to describe the clinical picture
of this painful condition at this Jordanian dental
teaching center.
Methods and Materials
The DTC/JUST was the setting for the study.
This center is located in Irbid, in North Jordan,
and is involved in the training of undergraduate
and postgraduate dental students. It serves the
community of the city of Irbid and its neighboring
towns and villages, which have a total population
of approximately 750,000.
This prospective study was totally observational
without any interference with any of the clinical
procedures normally followed at DTC/JUST.
Description of the Sample
During the study period, 838 permanent tooth
extractions were carried out in 469 patients.
There were 225 (48.0%) male patients and 244
(52.0%) female patients. The age of patients
Conclusion: Smoking and surgical trauma are associated with an increased incidence of dry socket. Moreover,
patients who had single extractions were more likely to develop dry socket than those who had multiple
extractions in the same visi
