Dry socked following third molar extraction: Incidence and predisposing factors

Aim: Dry socket is a common complication following extraction of third molar. The aim of this study was to assess dry socket incidence at Schwartz-Arad Day-Care Surgical center performed by one surgeon (DSA) and to explore predisposing factors for dry socket development. Methods: A retrospective cohort study was conducted on 660 consecutive patients who were referred to the center for extraction of third molars between 2001-2010. The study included 290 men and 369 women (one unknown) aged 12.4-77.2 years (mean 29.3±11.7 years). All patients were administered antibiotic and glucocorticoids prophylaxis followed by 5 days antibiotic and 3 days glucocorticoids, postoperatively. Mouth-wash with 0.5% chlorhexidine for 1–2 minutes prior to extraction was done. Data regarding patient health and smoking habits was collected, as well as radiologic data: tooth impaction and position classified. Results: Out of 1171 extracted third molars, dry socket was diagnosed in 79 (6.7%). The ratio men:women was 1:1.3. Preliminary data shows statistically significant increased dry socket incidence in mandible compare to maxilla (9.2% and 0.6%, respectively), older patients compare to younger (averaged age 31.5 and 26.9 years, respectively), smokers compare to non-smokers (13.3% and 3.3%, respectively), and retromolar space less than 5mm compare to more than 5mm (6.7% and 27.2%, respectively). Conclusion: Data shows decreased dry socket development following third molar extraction at DSA when compared to literature values, possibly due to the pre- and postoperative protocol used. Common predisposing factors of dry socket are gender, age, smoking, tooth site, and retromoral space less than 5mm.