dental disorders
Postextraction Problems
Postextraction alveolitis (dry socket)
Postextraction alveolitis is pain emanating from bare bone if the socket’s clot lyses. Although this condition is self-limited, it is quite painful and usually requires some type of intervention. It is much more common among people who smoke or use oral contraceptives and occurs mainly after removal of mandibular molars, usually wisdom teeth. Typically, the pain begins on the 2nd or 3rd postoperative day, is referred to the ear, and lasts from a few days to many weeks. The socket should be rinsed with saline or 0.12%chlorhexidineand some type of palliative material placed. A longstanding option has been a 1- to 2-inch iodoform gauze strip saturated in eugenol (an analgesic) or coated with an anesthetic ointment, such aslidocaine2.5% ortetracaine0.5%, placed in the socket. The gauze is changed every 1 to 3 days until symptoms do not return after the gauze is left out for a few hours. More recently, a commercially available mixture of butamben (an anesthetic), eugenol, and iodoform (antimicrobial) has become more commonly used. Although not resorbable, this mixture washes out of the socket spontaneously after a few days. These procedures typically eliminate the need for systemic analgesics, although nonsteroidal anti-inflammatory drugs (NSAIDs) may be given if additional pain relief is needed. Patients should follow up with a dentist in 24 hours. 