Risk Factors for Dry Socket After Mandibular Third Molar Extraction: A Prospective Cohort Study

Background Dry socket (DS) is one of the most distressing complications following tooth extraction, particularly after surgical removal of mandibular third molars. The etiology of DS remains unclear and involves a complex interplay of infection, immune responses, and multiple contributing factors. Therefore, the primary objective of this study was to investigate the risk factors associated with DS. Material and Methods This prospective, single-center, case-control study enrolled adult patients requiring mandibular third molar extraction. A series of questionnaires were administered to collect data on demographics, calculus index (CI), smoking habits, menstrual cycle, medication use, molar status, operative duration, as well as sleep duration and regularity. Associations were analyzed using the Chi-Square Test. Result The study included 579 mandibular third molars from 559 patients. Among these, 36 sites (6.2%) developed DS. Factors such as gender, CI, smoking habits, menstrual cycle, medication use, molar status, and operation duration were not significantly associated with DS. However, patients with insufficient and irregular sleep exhibited a significantly higher incidence of DS (P ≤ 0.01). Conclusions Sleep insufficiency and irregularity may be risk factors for DS, though the underlying physiological mechanisms require further investigation.