Incidence of Dry Socket, Alveolar Infection, and Postoperative Pain Following the Extraction of Erupted Teeth

Abstract

The aim of this study was to determine the incidence of dry socket, alveolar infection, and postoperative pain following the routine extraction of erupted teeth. Using a questionnaire, this prospective cross-sectional study evaluated 357 consecutive surgeries in which 473 erupted teeth were extracted by dental students under rigorous control of microbiologic contaminants during a 22-month period. The subject sample consisted of 210 (58.8%) male patients ranging in age from 11 to 79 years (mean 41 +/- 16.3). The most prevalent self-reported ethnicity was Caucasian (78.2%). The questionnaire consisted of 60 questions directed to the patient and to the dental student who performed the surgical procedure. The questionnaires were completed before and within seven days after the surgery to obtain outcomes data. Forty-five questionnaires were excluded due to lack of information, inconsistencies, or lack of contact with the patient; however, none had indications of alveolar infection or dry socket. The data were analyzed using descriptive statistics, chi-square tests (x(2)), and an odds ratio (OR) as appropriate at the critical level of significance, set at p<0.05 (x(2)) or p<0.01 (x(2), with the Monte Carlo simulation). The observed incidence was 0.6% (two cases each) for both alveolar infection and dry socket. Higher pain levels and pain persisting longer than two days were observed with more traumatic surgeries, or associated with postoperative complications. Smoking was found to be statistically associated with the development of postoperative complications. The incidence of alveolar infection, dry socket, and severe pain were very low for the routine extraction of erupted teeth. Severe pain that persists for more than two days can represent a sign of a postoperative complication such as dry socket. Dental extraction is part of the dentists' daily work and intercurrences like dry socket, infection, and pain can occur. This manuscript reports the incidence of these occurrences and search for its predisposing factors.