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I don't know if many dentists/ dental students are aware of the relationship between the prevalence of oral contraceptives and dry socket/alveolitis/alveolar osteitis.
I was on call today.
A female patient that had had lower impacted wisdom teeth extracted on Friday, was not in so much pain until last night. Her pain was extending right up to the ear region. She told me that ingesting Ibuprofen or Vicoden was not alleviating the pain. According to past experience, when I get these emergency cases that ask me to personally call them, it is often to get another narcotic prescription 🙄 but based on the questions I asked, it was not the case. She had a sufficient supply of painkillers . I asked the patient if she was a smoker. She told me that she was a smoker but had not smoked ( so I hope 😡 ) . I also asked if she had been rinsing and spitting a lot in the first days post-exo , she told me she hadn't (then again she seemed rather upset by her pain and it seemed to me that she was unable to clearly pay attention to my questions). I will be seeing her in a few hours at the dental clinic as there is no oil of clove (which contains eugenol) in the emergency rooms any more (the nurses told me they used to have it in the ER supply but no longer do) 🙄 🙁
Based on something I read in the literature, out of curiousity, I asked the patient if she was taking any oral contraceptives. She told me that she was indeed taking oral contraceptives. In general, women (even those not taking the pill) seem to be more at risk for developing dry socket than men. It has to do with the amount of estrogen . As if God hasn't punished us women enough with the pains of child labor !!!!
🙁 Anyhow, apparently, use of oral contraceptives has been associated with a significant increase in the frequency of dry socket after extraction of mandibular molars.
Apparently in women who take birth control pills, the estrogen in the pills , increases the activity of the cell components that breakdown the mesh that the new tissues need to form a clot. Women who use birth control pills or have their teeth removed in the first 22 days of the menstrual cycle are twice as likely to develop dry socket after an extraction. It has been suggested that this risk is minimized by performing extractions during days 23 through 28 of the pill cycle when the estrogen levels are low or inactive. I don't know the date of the cycle on which the exos of this patient were done as she wasn't my patient.
Has anyone actually done exos on days 23-28 of the menstrual cycle for mandibular exos of female patients not on the pill or patients on the pill ? Maybe there should be some questions on future medical questionnaires which ask women of childbearing age what day of their cycle they are prior to considering extractions. I really wonder if there is some validity on the oral contraceptive-dry socket theory. It wasn't discussed in dental school. 😕
I was on call today.
A female patient that had had lower impacted wisdom teeth extracted on Friday, was not in so much pain until last night. Her pain was extending right up to the ear region. She told me that ingesting Ibuprofen or Vicoden was not alleviating the pain. According to past experience, when I get these emergency cases that ask me to personally call them, it is often to get another narcotic prescription 🙄 but based on the questions I asked, it was not the case. She had a sufficient supply of painkillers . I asked the patient if she was a smoker. She told me that she was a smoker but had not smoked ( so I hope 😡 ) . I also asked if she had been rinsing and spitting a lot in the first days post-exo , she told me she hadn't (then again she seemed rather upset by her pain and it seemed to me that she was unable to clearly pay attention to my questions). I will be seeing her in a few hours at the dental clinic as there is no oil of clove (which contains eugenol) in the emergency rooms any more (the nurses told me they used to have it in the ER supply but no longer do) 🙄 🙁 Based on something I read in the literature, out of curiousity, I asked the patient if she was taking any oral contraceptives. She told me that she was indeed taking oral contraceptives. In general, women (even those not taking the pill) seem to be more at risk for developing dry socket than men. It has to do with the amount of estrogen . As if God hasn't punished us women enough with the pains of child labor !!!!
🙁 Anyhow, apparently, use of oral contraceptives has been associated with a significant increase in the frequency of dry socket after extraction of mandibular molars. Apparently in women who take birth control pills, the estrogen in the pills , increases the activity of the cell components that breakdown the mesh that the new tissues need to form a clot. Women who use birth control pills or have their teeth removed in the first 22 days of the menstrual cycle are twice as likely to develop dry socket after an extraction. It has been suggested that this risk is minimized by performing extractions during days 23 through 28 of the pill cycle when the estrogen levels are low or inactive. I don't know the date of the cycle on which the exos of this patient were done as she wasn't my patient.
Has anyone actually done exos on days 23-28 of the menstrual cycle for mandibular exos of female patients not on the pill or patients on the pill ? Maybe there should be some questions on future medical questionnaires which ask women of childbearing age what day of their cycle they are prior to considering extractions. I really wonder if there is some validity on the oral contraceptive-dry socket theory. It wasn't discussed in dental school. 😕
