Post-extraction complications
Recognise haemorrhage, dry socket, infection, oroantral communication and nerve disturbance. Document examination and a management plan.
Understand
Dry socket is painful delayed healing without the same features as spreading infection. Bleeding, infection, retained root, oroantral communication and nerve change need different responses.
Assess
Take a timeline, inspect the socket, assess systemic signs, haemostasis, sinus symptoms and sensory distribution. Distinguish expected discomfort from deterioration.
Apply
Treat the identified problem, provide appropriate analgesia and safety-netting. Persistent bleeding, fever, spreading swelling or progressive neurological symptoms require escalation.
Key distinctions
Dry socket often presents with severe pain after a delay and loss or breakdown of clot, without necessarily having purulence or systemic illness. Persistent active bleeding, oroantral communication and neurosensory change demand different examination and action. Aftercare should explain expected bleeding and pain, how to apply pressure and which changes require urgent help.
Think through a case
Four days after extraction, a patient has severe local pain but no fever or spreading swelling. Examine for dry socket while still considering retained infection or other causes.
The distinction to remember
Do not manage all post-extraction pain with antibiotics. Diagnose the complication first.
Test your recall
What feature suggests an oroantral communication?
Show answer
Air or fluid movement between the mouth and nose after a maxillary extraction.