New Paradigm in Explaining Dry Socket: Case Studies

Dry socket is considered as the most common complication following tooth extraction. It is mainly manifested by severe irradiating pain that start 1 to 4 days after dental extraction with a denuded socket. Although many risk factors are associated with it, no clear and direct cause has been described to explain its etiopathogenesis. Here, we suggest a new pathogenesis and management of Dry socket based on new microbiological and clinical findings from 11 clinical cases.

We present a series of 6 Dry socket cases from which alveolar swabs have been taken for microbial exploration. Materials from the 6 cases were subjected to bacterial culture and susceptibility testing. Microbiological results showed the presence of Pseudomonas aeruginosa in 4 samples. Furthermore, the antibiogram showed sensitivity to ciprofloxacin.

Then, a serial of 11 cases resistant to local management, were treated by ciprofloxacin that was prescribed at 500 mg 3 times per day for 5 days. After taking antibiotics,9 patients experienced complete relief in 12 to 24 hours. In addition to earlier laboratory data, this clinical outcome lends greater credence to the idea that an infectious mechanism contributes to the pathophysiology of Dry socket.