Factors affecting incidence of dry socket: a prospective community-based study.

Dry socket, or alveolar osteitis, can occur because of the removal of teeth. No clear etiology has been acknowledged; however, numerous risk factors have been proposed and tested. We report on the results of a prospective, multicenter study of the incidence and factors affecting the occurrence of alveolar osteitis at the Royal Dental Hospital of Melbourne and Community Dental Clinics in Melbourne, Australia. Ethics approval was gained from the University of Melbourne and Dental Health Services Victoria. The data were analyzed in a descriptive fashion, and the factors affecting alveolar osteitis were assessed using logistic regression analysis. The incidence of alveolar osteitis was 2.3% of all teeth extracted, with 4.2% of all patients experiencing alveolar osteitis in a public dental setting. Multivariate analysis revealed operator experience, perioperative crown and root fractures, periodontal disease, posterior teeth, and, interestingly, the use of mental health medications to be significant independent risk factors for the development of alveolar osteitis. No alveolar osteitis was reported in patients taking antibiotics, the oral contraceptive pill, bisphosphonates, or oral steroid drugs. Smoking and extraction technique (either operative or nonoperative) were also not found to significantly affect the development of alveolar osteitis.