Chlorhexidine Versus Normal Saline Socket Irrigation for Prevention of Dry Socket After Lower Wisdom Tooth Extraction

Dry socket, also called alveolar osteitis, is a painful complication that can occur after tooth extraction, particularly following removal of impacted lower wisdom teeth. It occurs when the blood clot that normally forms in the extraction socket is lost or breaks down, resulting in pain and delayed healing. This study will compare two solutions used to irrigate the extraction socket immediately after removal of an impacted lower wisdom tooth: normal saline and chlorhexidine. The study will determine whether immediate socket irrigation with chlorhexidine reduces the frequency of dry socket compared with normal saline. A total of 174 eligible patients undergoing surgical extraction of impacted lower wisdom teeth will be randomly assigned to receive either normal saline or chlorhexidine for immediate post-extraction socket irrigation. Participants will not be informed which irrigation solution they receive. The extraction will be performed by a single surgeon, and postoperative assessment will be performed by a co-researcher. Participants will be assessed for signs and symptoms of dry socket on postoperative days 2, 3, and 5. The occurrence of dry socket will be determined using predefined clinical criteria, including pain, trismus, halitosis, gingival inflammation, exposed or bare bone, radiating pain, and ipsilateral lymphadenopathy. The study will compare the frequency of dry socket between the chlorhexidine and normal saline groups. The findings may help determine whether chlorhexidine is more effective than normal saline for reducing the occurrence of dry socket after surgical extraction of impacted lower wisdom teeth.