From the Guidelines
The treatment for dry socket (alveolar osteitis) should prioritize the use of L-PRF membranes to seal the socket entrance and promote healing, as recommended in the most recent study from 2025 1. The goal of treatment is to manage pain, promote healing, and prevent further infection.
- Irrigation of the socket with saline solution to remove debris and bacteria is a crucial step.
- Covering the socket with a double layer of L-PRF membranes, as described in the 2025 study 1, can help seal the socket entrance and prevent epithelium and/or connective tissue growth underneath the membranes.
- De-epithelialization of the gingival borders along the socket, as mentioned in the 2025 study 1, may also be considered to remove the pocket epithelium.
- Pain control can be achieved with ibuprofen (400-600mg every 6 hours) or acetaminophen (500-1000mg every 6 hours), with prescription-strength analgesics like hydrocodone/acetaminophen sometimes needed for severe pain.
- Chlorhexidine 0.12% mouth rinse used twice daily can help prevent further infection.
- Patients should maintain good oral hygiene but avoid vigorous rinsing or touching the extraction site.
- Warm salt water rinses (1/2 teaspoon salt in 8 ounces warm water) several times daily after the first 24 hours can help with healing. The use of L-PRF membranes, as recommended in the most recent study 1, is a key component of the treatment, and its implementation can lead to improved outcomes in terms of morbidity, mortality, and quality of life.
From the Research
Definition and Overview of Dry Socket
- Dry socket, also known as alveolar osteitis, is a painful and common post-operative complication following exodontia 2.
- It is characterized by a post-extraction socket that exhibits exposed bone that is not covered by a blood clot or healing epithelium 3.
Treatment of Dry Socket
- The treatment of dry socket aims to relieve patient's pain and promote alveolar mucosa healing 4.
- Curettage and irrigation should be carried out in dry socket, as well as another therapy such as LLLT, zinc oxide eugenol, or plasma rich in growth factors, which show better results in pain remission and alveolar mucosa healing 4.
- Traditional options of treatment are directed toward palliative care, such as the irrigation of the surgical site, avoiding curetting the extraction socket, and packing with a zinc oxide-eugenol paste on iodoform gauze to relieve acute pain episodes 5.
- New agents in the market, such as PRGF and GECB, can accelerate the healing of the socket 5.
Prevention of Dry Socket
- The prevention methods include avoiding smoking before and after surgery and a traumatic surgery 5.
- The use of antibiotics, such as azithromycin, can be considered to prevent dry socket 5.
- Other preventive measures, such as chlorhexidine rinse or gel, can be effective in reducing the incidence of dry socket 5.
- Assessment of alveolar bone exposure must be a factor to consider in future research 4.