“DRY SOCKET” AND HORMONAL CHANGES
Smoking and Dry Sockets
As practicing Oral and Maxillofacial surgeons, we have known for years that a contributing factor for the development of alveolar osteitis-AO (colloquially called “dry socket”) is hormonal changes, such as the menstrual cycle. Since smoking has significantly reduced in my patient population, I have seen a significant reduction in the development of AO. The effect of proper oxygenation to the tissues is critical to proper healing. Nicotine is a vasoconstrictor (blood vessel constrictor) and can cause a decreased blood flow to the oral tissues. Carbon monoxide, a prominent component of cigarette smoke, is a potent oxygen depleter having 20 times the affinity to hemoglobin (part of your blood that carries oxygen) than oxygen-essentially depleting oxygen from the blood and tissues. So do not smoke!
Menstruation and Dry Sockets
During menstruation, the hormonal changes cause a fragility in the uterine lining allowing for these tissues to slough. Other lining tissues of the body may also be affected at the same time. Healing sites, such as extraction sockets, can show this during the menstrual cycle leading to the loss of the normal healing tissues. This results in the classic “open socket” with attendant discomfort and slow healing. The fact is, that we see this in very few patients and it is not clearly understood why it occurs in certain patients and not others. Obviously, there are other factors that contribute. I would not recommend putting off having wisdom teeth out just because of menstruation, but I would be aware of the risk especially if you have a history of tissue fragility such as oral sores during menstruation.
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J Oral Maxillofac Surg 71:1484-1489, 2013
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