Dry Socket: A Prospective Study of Prevalent Risk Factors in a Nigerian Population

Purpose: To identify major risk factors for developing dry socket in some Nigerians, and to formulate a nonpharmacologic protocol for its effective prevention. Patients and Methods: Patients presenting with dry socket at the Oral Surgery Clinic of the Obafemi Awolowo University Teaching Hospital, Ile-Ife, Osun State, Nigeria, over an 18-month period were studied. Biographic data, preoperative diagnoses, teeth extracted, oral hygiene status, and history relevant to the extractions and presentations of dry socket were documented. Procedures were classified as traumatic or atraumatic. Data were analyzed using SPSS version 11.0 (SPSS Inc, Chicago, IL) with simple descriptive statistics and the χ2 test, as appropriate. P ≤ .05 was considered significant. Results: Sixty-eight extraction sockets in 65 patients (46 females and 19 males) with a mean age of 33.48 (±SD 13.5) years were studied. All extracted teeth were posterior (17 maxillary, and 51 mandibular). Preoperative diagnoses were mainly of acute apical periodontitis secondary to carious lesion (30/68), chronic apical periodontitis (18/68), and chronic pulpitis (15/68). The use of an oral contraceptive was elicited in 25% of the females, and extractions were performed between days 1 and 22 of their menstrual cycle. Extraction was traumatic in 66.2% of cases. A ranking of the elicited risk factors suggests that a previously infected posterior tooth involves an equal risk in both genders. Poor oral hygiene and traumatic extraction in a mandibular tooth were prominent in males, whereas extractions performed between days 1 and 22 of the menstrual cycle were significant in females. Conclusion: Control of preoperative infection, insistence on good oral hygiene, avoidance of trauma, and avoidance of surgery on days 1 to 22 of the menstrual cycle in nonmenopausal women may reduce the incidence of dry socket in the study population. © 2008 American Association of Oral and Maxillofacial Surgeons.