Dry+Socket+Protocol

Increased Risk

 * 1) Smoking
 * 2) Old age
 * 3) Mandibular Extractions
 * 4) Female (especially if they are on birth control)
 * 5) Alcohol
 * 6) Steroid
 * 7) Use of straws

Prevention

 * 1) Quick(Within 10mins per tooth) and atraumatic extraction

Diagnosis

 * 1) Take room temperature fluid (doesn't matter what i.e.. chlorhexidine, saline) and use a mono jet syringe and irrigate. Are not looking for back pressure but want to make sure that the irritant comes out clean and there are no food particles etc... ( DO NOT ANESTHETIZE )
 * 2) If patient says the pain was excruciating then you are most likely working with a dry socket that needs to be packed. If there is little pain then you will want to discuss with patient about no treatment because treatment will prolong healing time
 * 3) If your patient has symptoms beyond 2 weeks you will want to investigate area with radiographs and/or flapping tissue. Look for anything that may cause ostemyelitis such as:
 * Pieces of tooth or bone
 * foreign bodies
 * immunocompromised patients

Treatment

 * 1) Patients that are stable and reliable
 * Take iodoform soaked gauzes and pack in socket
 * Remove within 48 hours (risk of toxic shock syndrome)
 * Piece of gauze must be large enough that it is obvious there is something packed
 * 1) Unreliable Patients (may never see again)
 * Pack with gel foam (will dissolve)

Note: Be sure to inform patient that the procedure you are performing will prolong the healing time. It does not fix the dry socket but will only alleviate pain.