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

• Published in: Special care in dentistry Vol. 44; no. 4; pp. 1171 - 1181
• Main Authors: Boyer, Taylor L., Solanki, Pooja, McGregor, Jessina C., Wilson, Geneva M., Gibson, Gretchen, Jurasic, M. Marianne, Evans, Charlesnika T., Suda, Katie J.
• Format: Journal Article
• Language: English
• Published: United States Wiley Subscription Services, Inc 01-07-2024
• Subjects: alveolar osteitis; antibiotic prophylaxis; Antibiotics; Complex patients; dentistry; Disease prevention; extraction; Infections; Mental disorders; Minority & ethnic groups; Oral infection; Prophylaxis; Risk factors; Teeth; United States > US; Alaska; antibiotic prophylaxis; extraction; oral infection; alveolar osteitis; dentistry
• ISSN: 0275-1879; 1754-4505; 1754-4505
• DOI: 10.1111/scd.12965

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.