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
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 for 3+ teeth; 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,…
How strong is the evidence?
Evidence Hub reads this as a case-control, done in people. Its evidence level is 4 of 5 (Low · observational). Observational designs can show an association but not prove cause. Reported size: 708 participants or records.
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