Infected Socket
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A post extraction complication due to infection of the clot due to contamination (infected socket). The condition is painful and if not managed well could lead to osteomyelitis.
Clinical presentation
- Severe painful socket 2–4days after tooth extraction
- Fever
- Necrotic blood clot in the socket
- Swollen gingiva around the socket
- Sometimes there may be lymphadenopathy and trismus (inability to open the mouth)
Non-pharmacological Treatment
Socket debridement under local anesthesia with lignocaine 2% and irrigate with hydrogen peroxide 3% followed with copious amounts of normal saline. The procedure of irrigation is repeated the 2nd and 3rd day and where necessary can be extended to the 4th day if pain persists.
Pharmacological Treatment
Patient is instructed to rinse with 3% hydrogen peroxide or 2% povidone iodine 3–4 times a day. Antibiotics should be prescribed to prevent progression to osteomyelitis:
A: amoxicillin (PO) 500mg 8hourly for 5–7days
OR
B: azithromycin (PO) 500mg 24hourly for 3days
AND
A: metronidazole (PO) 400mg 8hourly for 5days
Investigation
- Periapical X-ray of the socket may be necessary when there is limited improvement despite treatment