Survey on the management of Alveolar Osteitis ( Dry Sockets) in South Africa

Abstract

Exodontia remains one of the most regularly done procedures in dentistry in South Africa (SA) and alveolar osteitis (AO) is considered one of the most common complications associated with exodontia. Despite the extensive research done on this clinical entity, the management of AO still remains controversial. Various management protocols have been suggested in the literature, varying from prophylactic to symptomatic management of AO (Blum,2002). However, none of these management protocols have to date shown any conclusive evidence on the effectiveness and benefit over another protocol. The author was of the opinion that general dental practitioners (GDPs) in South Africa generally use preventative and treatment protocols based on what they were taught at their alumni dental schools or use protocols modified from their own clinical experience in practice. The aim of this study was to assess which treatment protocols are routinely used by GDPs in South Africa for the management of AO and suggest a scientifically sound treatment protocol for AO. The study was done in the form of a questionnaire and the participants were randomly selected from the Health Professions Council's register. The results showed that most of the GDPs in South Africa continued to use the same treatment protocol as their alumni dental school. They were of the opinion that these protocols were still clinically the most effective. Despite the plethora of intra-alveolar medicaments available, Alvogyl®still remains the medicament of choice of GDPs. As there is no evidence in the scientific literature that suggests that one intra-alveolar medicament or antibiotic is more effective than the other, the author does not encourage the use of the medicaments or antibiotics in the treatment of AO. However, by following simple measures such as improving patients' oral hygiene and using a pre-operative 0.2% chlorhexidine mouth rinse, the incidence of AO can be reduced significantly.