Dry Sockets - How to Prevent and Manage Them? Oral Surgery Complications - GF010

When did they change the ingredients of Alvogyl?!
It’s the return of Oral Surgeon and sensible man Dr. Chris Waith - this time to answer our Oral Surgery Complication questions starting with Dry Sockets , how to Prevent and Manage Them?
00:00 Introduction
3:54 How can we prevent dry sockets?
10:43 Can Suturing Help?
15:39 Managing Dry Sockets
19:09 Role of Irrigation and Dressing?
Next up: OAC and Tuberosity Fracture
www.protrusive.co.uk/dry-sockets
Chris' Oral Surgery Courses: theoralsurgerycourse.co.uk/
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[@aakashm1]

Thanks for the episode. In patient's who are already on stronger painkillers such as zapain or co-codamol would you still recommend that they follow the ibuprofen + paracetamol regimen?

[@REGEDENTAG]

Thanks for this episode. Did you try surgical-grade hyaluronic acid gel? Helps preserve socket (stabilize blood clot), bacteriostatic, while reducing swelling and pain.

[@protrusive]

Thanks! Will take a look in to this - have not used it before :)

[@Saifdaoud]

Just a quick pharmaceutical tip more the. 400mg ibuprofen is useless for pain you only need 200 or 400 or pain reliever more than that is not needed , and thanks for this great podcast ❤

[@protrusive]

thank you!

[@zerposh]

Jaz u should recive a nobel prize

[@ebonysmith2949]

Any tips on how to stimulate bleeding in the socket if it doesn't happen naturally after the extraction?

[@drjazgulati]

I usually stick a curved end if Mitchell's inside the anaesthetised socket and and agigitate/scrape - usually by the time I have curreted a socket to remove debris, bleeding will be promoted. Hope that helps!

[@chriswaith9595]

I work just like Jaz has described. I’d use a Mitchell’s, a Lucas curette or even a dental excavator, trying to agitate the side of the sockets to remove any debris and promote some bleeding. I know some implant colleagues who go as far as to use a rose head in a handpiece to promote some bleeding (although I wouldn’t routinely).

[@furbyinthemicrowave5344]

In 20 years of practice I basically only place Alvogyl gently into the socket and obviously only antibiotics if there is a post op infection which is rare.
I have had only one patient get no relief from Alvogyl and they had multiple comorbidities.
Otherwise Alvogyl gives relief within 30 minutes.
Also let your patient know that they have had a surgical procedure and have an open wound that needs time to heal so some post op pain should be expected.

[@protrusive]

agreed - unfortunately in the UK (unsure of rest of world) alvogyl no longer exists: www.nature.com/articles/s41415-020-2073-x