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Severe pain in an extraction socket after 3 days of extraction

 # A patient comes with severe pain in an extraction socket after 3 days of extraction. Which of the following drugs would you prescribe?
A. Amoxicillin
B. Metronidazole
C. Diclofenac
D. Tramadol



The correct answer is D. Tramadol.

Dry socket or alveolar osteitis is delayed healing but is not associated with an infection. This postoperative complication causes moderate to severe pain but is without the usual signs and symptoms of infection such as fever, swelling, and erythema. The term dry socket describes the appearance of the tooth extraction socket when the pain begins. In the usual clinical course, pain develops on the third or fourth day after removal of the tooth. Almost all dry sockets occur after the removal of lower molars.

The occurrence of a dry socket after a routine tooth extraction is rare (2% of extractions), but it is frequent after the removal of impacted mandibular third molars and other lower molars (20% of extractions in some series).

The treatment of alveolar osteitis is dictated by the single therapeutic goal of relieving the patient’s pain during the period of healing. If the patient receives no treatment, no sequela other than continued pain exists (treatment does not hasten healing).

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