A clinical study of "dry socket".

A total of 1274 extractions carried out by the author resulted in a dry socket incidence of 2.6%. There was no sex predilection in the occurrence of dry socket. Incidence of dry socket formation was highest in the first and second molar region. Forceful infiltration of an extra 2 ml of local anesthetic into the tissues resulted in a higher incidence of dry socket; however this difference was not statistically significant. Dry sockets occurred more frequently in difficult extraction cases as compared to routine extractions; this difference was statistically significant. However, when 20 teeth in difficult extraction cases were removed by the open surgical method there were no cases of dry socket formation. Teeth removed principally due to a periodontal involvement did not give rise to a single case of dry socket. Treatment of dry socket with intra-alveolar dressings did reduce the pain; however, the healing time was invariably prolonged. The best results, in the form of reduction of pain and rapid healing, were obtained with the surgical method of reflection of a flap and debridement of the socket.