Prevalence, Clinical Picture, and Risk Factors of Dry Socket in a Jordanian Dental Teaching Center

Abstract

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. 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 visit. Citation Nusair YM, Younis MHA. Prevalence, Clinical Picture, and Risk Factors of Dry Socket in a Jordanian Dental Teaching Center. J Contemp Dent Pract 2007 March;(8)3:053-063.

Risk factors assessment for dry sockets: A logistic regression analysis study

“…Female predominance, as reported in previous literature was not a significant factor in our case [15]. The reason may be that unlike western societies where smoking habits are almost equally prevailing among both genders, very few female smokers are reported in Pakistan [26].…”

“…Majority of the literature supports the relationship between surgical trauma and dry socket [5,15]. Although no significant difference was observed between simple and surgical extractions, dry socket occurrence differed significantly between the extraction of impacted and non-impacted teeth.…”

“…The mandible in most previous studies is the most prevalent site for the dry socket attributed to difficult and traumatic extractions [15,24]. Our incidence of dry socket in mandible and maxilla is almost equal probably due to less number of surgical and traumatic extractions.…”

“…This difference could possibly be attributed to variations in the diagnostic criteria defined by different researchers. Also the present study considered the patient's age as unit of analysis whereas most other literature considered the number of extractions as the unit of interest without considering the age [15].…”

“…Some of these have been debated extensively and often interplay of factors is implicated. Predisposing factors include gender [10][11][12], tooth location [13], trauma to the alveolar socket [14], presence of a vasoconstrictor in local anaesthesia [15], smoking [16], oral contraceptive pills, menstruation, residual foreign bodies, root segments, ejection of saliva after extraction [17], systemic diseases [18], operator skill [14,19], difficulty of surgery, deeply impacted mandibular third molars [20], previous experience of dry socket and poor oral hygiene [21].…”