i recently asked a question about my 81 yr. old mom who developed a "dry socket" after a tooth extraction

Question

she has been to her dentist a number of times and yesterday he cleaned it out yet again, went deep into the socket, which required stiches. my question is this " does she need to be on antibiotics" everytime she returns from the dentist i am expecting her to be on something. he says that she doesn't need them. anyone out there that has had this problem and has taken antibiotics, and if so, did they help.

Answer 1

Dry sockets sometimes need antibiotics, but usually not. If she has any fever or swollen lymph glands near the site, then she may need to be on antibiotics, but otherwise, no. Treatment for dry socket is aimed at keeping the patient comfortable while they heal. The hole in the bone WILL grow new gum tissue to cover the bone and keep it from hurting. This usually takes about 7-10 days in a young, healthy person. Because your mother is older, it will take a bit longer. If she is diabetic (for instance), it will take longer still.

It sounds like she is kind of starting all over again and it may take another 2-3 weeks before she's done with it.

Answer 2

I do remember your 1st question, has she still been smoking? If so, she needs to really stop. I would also recommend a rinse of hydrogen perioxide (3%) mixed 50/50 with water. Rinse about 4 times a day. Or use an antiseptic mouth wash mixed 50/50 with water. She probably should be on antibiotics, but only a dentist can say for sure.

Here is some information from a website that may help:

Edited to add this addtional info:
Dry socket (alveolar osteitis) is an infection in your tooth socket after a tooth is extracted, so whoever says its not an infection is incorrect.

Call your dentist right away if you notice any symptoms of dry socket. Treatment for dry socket typically includes a gentle rinsing of the socket to remove debris. This is followed by packing the socket with Alvogyl. Its fibrous consistency allows for easy filling of the socket and good adherence during the entire healing process. The active ingredients of Alvogyl include:
• eugenol for analgesic action;
• butamben for anesthetic action; and
• iodoform for anti-microbial action.

Sometimes analgesics are also prescribed. You usually need to return to the dentist's office two to three times over a two-week time period for re-dressing and monitoring the healing. Fortunately, a dry socket is often self-healed over a longer time. In very rare situation where the dry socket can't heal itself, another operation may be needed. The procedure aims to make the socket bleed again and so that a new blood clot can be formed inside the post-extraction socket.

Hope this helps and good luck!

Answer 3

Dry socket, also termed alveolar osteitis is a well recognised complication of tooth extraction. It is characterised by increasingly severe pain in and around the extraction site, usually starting on the second or third post-operative day and which may last for between ten and forty days. The pain may radiate and typically pain in the ear is one of the symptoms of a dry socket in the mandible. The normal post-extraction blood clot is absent from the tooth socket(s), the bony walls of which are denuded and exquisitely sensitive to even gentle probing. Halitosis is invariably present. The condition probably arises as a result of a complex interaction between surgical trauma, local bacterial infection and various systemic factors.

There is great variation in reported incidence rates (1%-65%) between series usually due to inconsistency in diagnostic criteria, variation in microbial prophylaxis and study sample heterogeneity. The true incidence rate probably lies somewhere between 3% and 20% of all extractions with lower pre-molar and molar sockets most commonly involved.

TREATMENT

All patients with signs and symptoms suggestive of a possible dry socket should be reviewed immediately by the operating clinician.

If appropriate patients should be x-rayed to exclude the possibility of retained fragments of tooth or foreign body.

The affected socket(s) should be gently irrigated with 0.12% warmed chlorhexidine and all debris dislodged and aspirated. In extremely painful cases local anaesthesia may be required and in this instance regional nerve blocks should be employed wherever possible.

The socket should be lightly packed with a dressing that contains an obtundant for pain relief and a non-irritant antiseptic to inhibit bacterial and fungal growth. The dressing should prevent the accumulation of food debris and protect the exposed bone from local irritation. Ideally the dressing should resorb and should not excite a host inflammatory or foreign body response.

Appropriate analgesics should be prescribed. Members of the Non Steroidal Anti-inflammatory Group of drugs are recommended provided there are no individual medical contraindications for their use.

Patients' progress should be reviewed the following day but they should be informed to return sooner if problems worsen in the intervening period. Admission to hospital is rarely required.

. Analgesic efficacy should be reviewed and analgesic regimes altered appropriately. When it is considered that socket dressings are no longer required the patient can be instructed in home socket irrigation techniques using an appropriate appliance and 0.12% chlorhexidine.

Patients should be kept under review until they are pain free and socket healing is ensured

Answer 4

no AB needed for dry socket since it is not an infection
Tx is to rinse with warm saline preferably using a syringe to reach into the socket. if not improved, the dentist place Eugenol containing medication into the socket like alveogel which provides immediate relief