Incidence of Dry Socket after Extraction among Al-Bayan University Dental Clinic Patients, 2022
Dr Omer Abdoun*
*Correspondence to: Dr Omer Abdoun, Assistant Professor, Department of Oral and Maxillofacial Surgery, University of Khartoum.
Copyright.
© 2025 Dr Omer Abdoun This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Received: 26 July 2025
Published: 01 Aug 2025
DOI: https://doi.org/10.5281/zenodo.16793956
Abstract
Background: Dry socket, also known as alveolar osteitis, is a commonly encountered complication following dental extractions. The condition can be defined as: "postoperative pain in and around the extraction site, which increases in severity any time between one and three days after extraction, accompanied by a partially or totally disintegrated blood clot within the alveolar socket, with or without halitosis". Dry socket is one of the most common complaints the patient suffers following dental extraction. It is more frequent following mandibular third molar extraction. The literature shows variation in its incidence. Petri and Wilson (1992) reported a 0% incidence while Erickson et al. (1960) reported an incidence of 35%.
Method: An observational descriptive retrospective intuitional – based study was conducted from November 2021 to April 2022. A total of 9 patients with dry socket were included in this study from AL-Bayan Dental Clinic, Khartoum, Sudan. Data was collected using data collecting sheets. The data was entered and analyzed using SPSS version 23.
Results: In this study, 9 patients had dry socket after extraction. Males (55.6%) were more than females (44.4%). The commonest age group was found to be 20-30 years (55.6%). (22.2%) of dry socket patients were diabetic, while (11.1%) were hypertensive. The commonest occupation was student (55.6%), followed by both employee and free worker (22.2%). Regarding location of dry socket, (33.3%) were found in the upper 6th , (33.3%) in the upper 7th, while (22.2%) were found in the lower 6th and (11.1%) in the lower 7th. (22.2%) from participants with dry socket were smokers. (11.1%) from participants with dry socket were current snuff dippers. (11.1%) of participants with dry socket used to drink alcohol. The commonest type of extraction was simple (66.7%), followed by multiple (33.3%). Only one individual (11.1%) had a complication during extraction and it was trauma. Post-operatively, (22.2%) of patients touched the area with their tongues, while (11.1%) drunk hot drinks. The majority of patients with dry socket presented after 1-2 days (88.9%), followed by 3-4 days (11.1%). All of patients with dry socket (100%) had irrigation with normal saline, debridement and used gel. The majority (77.8%) improved after only one session, while (22.2%) improved after 2 sessions.
Conclusion: As overall, the incidence of dry socket in our study was lower than the incidence in the previous done studies, with the upper 6th and 7th teeth being the most common location for dry socket. Risk factors included: female gender, DM, smoking, trauma during extraction and not following post-operative instructions. Treatment with normal saline irrigation, debridement and eugenol dressings allowed relief of the symptoms
Background
Dry socket, also known as alveolar osteitis, is a commonly encountered complication following dental extractions. The condition can be defined as: "postoperative pain in and around the extraction site, which increases in severity any time between one and three days after extraction, accompanied by a partially or totally disintegrated blood clot within the alveolar socket, with or without halitosis". (1)
Dry socket is one of the most common complaints the patient suffers following dental extraction. It is more frequent following mandibular third molar extraction. The literature shows variation in its incidence. Petri and Wilson (1992) reported a 0% incidence while Erickson et al. (1960) reported an incidence of 35%. (2)
The most prominent characteristic of dry socket is severe pain, which responds poorly to narcotic and over-the-counter analgesics, generally leading to loss of productivity. It often requires a few postoperative visits to the dental practice to manage the pain, making it costly to both the patient and society. (1)
Dry socket occurs due to the disintegration of the blood clot by fibrinolysis. Many factors contribute to the occurrence of dry socket. For example: low experience level of operator preoperative infection, sex, site of extraction, use of oral contraceptives, smoking, and use of local anesthetics with vasoconstrictor. (2)
Other possible risk factors include periodontal diseases and previous dry socket with past extractions. (3) Dry socket is a global phenomenon. The purpose of the study is to investigate the incidence of dry socket in recent times in a Sudan.
Problem statement:
Dry socket is one of the complications which may follow dental extractions. Whilst the exact pathogenesis is unknown, blood clot disintegration as a result of fibrinolysis remains the most acknowledged theory.
Justification:
Dry socket falls under the most common as well as serious complications. The occurrence of dry socket in dental clinical practice is very common, which may be due to systemic or chronic disease related to the patient health, that alters the patient immunity with respect to infection, there will be other local chances too for the occurrence of dry socket which include the habits of smoking cigarette, chewing pan masala, bad oral hygiene. So, we choose this topic because there is no data or research guideline in Sudanese population.
Objectives:
General objectives:
• To study the incidence of dry socket after extraction among Al-Bayan University dental clinic patients.
Specific Objectives:
• To define the socio-demographic characteristics of participants.
• To determine the predisposing factors for dry socket following extraction.
• To determine the distribution of dry socket by tooth type and location.
Methodology
Study Design
The study was conducted as an observational retrospective cross sectional institutional – based study.
Study Area
The study was conducted in Bayan University dental clinic, Khartoum state, Sudan.
Study Population
Patients attending to Bayan University dental clinic, Khartoum state, Sudan.
Inclusive Criteria
• Post-extraction patients.
• Patients who accept to participate in this study.
Exclusive Criteria
• Patients who didn’t undergo extraction.
• Patients who refuse to participate in this study.
Period of Study
December 2021 to April 2022.
Sample size:
Total coverage.
Data collection:
Data was collected using standardized data collection sheets.
Data collection tools:
The data was collected using structured data collection sheets based on socio-demographic information. The data collection sheets used included all the objectives of this study.
Ethical consideration:
It was sought from the research technical and ethical committee at the Faculty of Dentistry. The participants’ privacy and confidentiality were maintained.
Results
In this study, 9 patients had dry socket after extraction. Males (55.6%) were more than females (44.4%). The commonest age group was found to be 20-30 years (55.6%), followed by 31.40 years (33.3%). (22.2%) of dry socket patients were diabetic, while (11.1%) were hypertensive. The commonest occupation was student (55.6%), followed by both employee and free worker (22.2%).
Regarding location of dry socket, (33.3%) were found in the upper 6th , (33.3%) in the upper 7th, while (22.2%) were found in the lower 6th and (11.1%) in the lower 7th.
(22.2%) from participants with dry socket were smokers. (50%) smoked for 1 year, and (50%) smoked for more than 1 year. (100%) of smokers smoked 1-5 cigarettes per day.
(11.1%) from participants with dry socket were current snuff dippers. All of them (100%) dipped snuff for more than 1 year.
(11.1%) of participants with dry socket used to drink alcohol.
The commonest type of extraction was simple (66.7%), followed by multiple (33.3%).
Only one individual (11.1%) had a complication during extraction and it was trauma.
Post-operatively, (22.2%) of patients touched the area with their tongues, while (11.1%) drunk hot drinks.
The majority of patients with dry socket presented after 1-2 days (88.9%), followed by 3-4 days (11.1%).
All of patients with dry socket (100%) had irrigation with normal saline, debridement and used gel. The majority (77.8%) improved after only one session, while (22.2%) improved after 2 sessions.
Tables 1 to 18,
Figures 1 to 18
(Please click here to view all tables and figures.)
Conclusion
As overall, the incidence of dry socket in our study was lower than the incidence in the previous done studies, with the upper 6th and 7th teeth being the most common location for dry socket. Risk factors included: female gender, DM, smoking, trauma during extraction and not following post-operative instructions. Treatment with normal saline irrigation, debridement and eugenol dressings allowed relief of the symptoms.
References:
1. MUDALI, Vaneshree and MAHOMED, Ozayr. Incidence and predisposing factors for dry socket following extraction of permanent teeth at a regional hospital in Kwa-Zulu Natal. S. Afr. dent. j. [online]. 2016, vol.71, n.4 [cited 2022-03-06], pp.166-169.
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4. M.D.Ashok Kumar, S.Gheena. (2015). Incidence of Dry Socket after Third Molar Extraction. Saveetha Dental College & Hospitals,Chennai.
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6. Ya-Wei Chen1,2, Lin-Yang ChiID3, Oscar Kuang-Sheng Lee. (2021). Revisit incidence of complications after impacted mandibular third molar extraction: A nationwide population-based cohort study. School of Dental Medicine, University of Pennsylvania, Philadelphia, PA, United States of America..