Beyond Extraction: A Strategic Approach to Managing Dry Socket in an Elderly Patient Following Canine Root Removal

While tooth extraction is a routine dental procedure, managing the aftermath, especially in elderly patients, demands heightened consideration. Comprehensive pre-and post-extraction evaluations are imperative. Alveolar osteitis, a common post-extraction complication, presents unique challenges. This condition, often referred to as dry socket, involves the exposure of bone within the socket, leading to heightened discomfort and delayed healing.

A 68-year-old male patient sought dental care for the extraction of retained dental root in the lower canines. Systemic evaluations, including normal blood pressure and glucose levels, were conducted. The extraction utilized a combination of topical, infiltration, and intraligamentary anesthesia to ensure a painless procedure. Post-extraction instructions and medication were provided. However, the patient returned five days later, reporting pain at the extraction site. Upon further inquiry, it was revealed that the patient had resumed smoking shortly after the extraction, contrary to the given instructions.

Intraoral examination disclosed a socket filled with food impaction, with alveolar bone exposed and minimal gingival inflammation. Aseptic techniques using povidone-iodine were employed, followed by curettage and irrigation with saline to remove debris. Subsequently, chlorhexidine was applied, and the patient received instructions along with a prescription for antibiotics, analgesics, and multivitamins to support healing.

Upon the patient's return seven days later, no complaints were reported, and the healing progress was satisfactory. This case emphasizes the importance of patient compliance with post-extraction instructions, especially in the elderly. Effective management of dry socket involves not only clinical intervention but also patient education to ensure optimal healing outcomes.

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