Risk factors for oral infection and dry socket post-tooth extraction in medically complex patients in the absence of antibiotic prophylaxis: A case-control study.

Boyer TL, Solanki P, McGregor JC, Wilson GM, Gibson G, Jurasic MM, Evans CT, Suda KJ. Risk factors for oral infection and dry socket post-tooth extraction in medically complex patients in the absence of antibiotic prophylaxis: A case-control study. Special Care in Dentistry : Official Publication of The American Association of Hospital Dentists, The Academy of Dentistry For The Handicapped, and The American Society For Geriatric Dentistry. 2024 Feb 6.

Related HSR&D Project(s)

• IIR 17-039 – Improving Veteran Health by Increasing Dental Stewardship of Antibiotics and Opioids
• RCS 20-192 – Research Career Scientist Award

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Abstract:

INTRODUCTION: Dry socket and infection are complications of tooth extractions. The objective was to determine risk factors for post-extraction complications in patients without antibiotic prophylaxis stratified by early- and late-complications and complication type (oral infection and dry socket). METHODS: Retrospective, case (with complications)-control (without complications) study of patients (n  =  708) who had  1 extraction performed at any Veterans Health Administration facility between 2015-2019 and were not prescribed an antibiotic 30 days pre-extraction. RESULTS: Early complication cases (n  =  109) were more likely to be female [odds ratio (OR)  =  2.06; 95% confidence interval (CI):1.05-4.01], younger (OR  =  0.29; 95% CI:0.09-0.94 patients 80 years old, reference:18-44 years), Native American/Alaska Native (OR  =  21.11; 95% CI:2.33-191.41) and have fewer teeth extracted (OR  =  0.53 3+ teeth extracted; 95% CI:0.31-0.88, reference:1 tooth extracted). Late complication cases (n  =  67) were more likely to have a bipolar diagnosis (OR  =  2.98; 95% CI:1.04-8.57), history of implant placement (OR  =  8.27; 95% CI:1.63-41.82), and history of past smoking (OR  =  2.23; 95% CI:1.28-3.88). CONCLUSION: Predictors for post-extraction complications among patients who did not receive antibiotic prophylaxis were similar to prior work in cohorts who received prophylaxis. Unique factors identified in a medically complex population included being younger, Native American/Alaska Native, having mental health conditions, history of a dental implant, and fewer teeth extracted.