COVID-19 Influence on Mandibular Dry Socket Occurrence

Alveolar osteitis (AO), commonly known as dry socket, is a recognized complication following tooth extraction, particularly prevalent after mandibular third molar extractions. Given the global pandemic of coronavirus disease (COVID-19) and its implications for endothelial and hematologic changes, investigating its potential impact on dry socket risk in patients undergoing mandibular third molar extraction is crucial.

We reviewed patient records from individuals undergoing mandibular third molar extraction at Mashhad Dental School, Mashhad, Iran in 2022. Data included demographics, medical history, smoking status, and COVID-19 details such as history, hospitalization, and vaccination status.

Clinical examinations diagnosed alveolar osteitis, assessing for blood clot presence and local lymphadenitis. Out of 119 patients (82 females, 37 males), 49.6% developed dry socket post-extraction, with 94.1% having a history of COVID-19 and 32.7% requiring hospitalization due to the disease. 97.5% of patients were vaccinated against COVID-19. Additionally, 44.5% had systemic disease history, and 45.4% used related medications, with no observed associations with dry socket.

This study underscores the increased risk of dry socket following mandibular third molar extraction associated with corticosteroid use, oral contraceptive use, smoking, and COVID-19 hospitalization. Females exhibited a significantly higher risk compared to males. While no significant COVID-19 infection-dry socket link was found, the study highlights the need for further research, given the significant number of dry socket cases among COVID-19 patients and those hospitalized due to COVID-19.