Frenectomía Infantil: ¿Cuándo Está Indicada y Cómo Afecta al Desarrollo del Habla?

El frenillo es una estructura de tejido conectivo que puede encontrarse en la lengua (frenillo lingual), el labio superior (frenillo labial) o inferior.

📌 Artículo Recomendado:

Vídeo 🔽 Frenectomía lingual en bebés - Cirugía paso a paso ... Compartimos con uds. el procedimiento quirúrgico de la frenectomia realizado a un bebé. Una cirugía sencilla que no implica mayor riesgo al paciente

Cuando su inserción es anormal o restrictiva, puede afectar funciones orales esenciales como la lactancia, masticación, fonación y la higiene oral. En tales casos, puede considerarse la realización de una frenectomía, una cirugía ambulatoria común en odontopediatría.

Enlaces Patrocinados

✅ ¿Qué es la frenectomía infantil?
La frenectomía es un procedimiento quirúrgico que consiste en la remoción o modificación del frenillo oral. En niños, las indicaciones más comunes incluyen:

° Frenillo lingual corto (anquiloglosia)
° Frenillo labial superior bajo que interfiere con la succión, el cepillado o provoca diastemas
° Alteraciones en el habla relacionadas con restricciones de movilidad lingual
° Problemas durante la lactancia materna.

✅ Diagnóstico: Evaluación Clínica y Funcional
El diagnóstico se basa en la evaluación clínica de la forma, inserción y movilidad del frenillo, así como en la funcionalidad oral. Los protocolos más usados incluyen:

° Hazelbaker Assessment Tool for Lingual Frenulum Function (HATLFF)
° Escala de Coryllos para anquiloglosia
° Evaluación por fonoaudiólogo si hay dificultades fonéticas

Los signos clínicos incluyen:

° Dificultad para elevar o protruir la lengua
° Fatiga al comer o hablar
° Imposibilidad de hacer sonidos como la "r", "l", "t" o "d"

✅ ¿Cómo afecta al desarrollo del habla?
Estudios recientes han mostrado que un frenillo lingual restrictivo puede contribuir a retrasos o distorsiones en el desarrollo fonético y fonológico, especialmente en la producción de consonantes alveolares y linguales. Sin embargo, no todos los niños con anquiloglosia desarrollan problemas del habla.
Una evaluación multidisciplinaria es fundamental para determinar si la alteración funcional del frenillo afecta significativamente la articulación y requiere tratamiento quirúrgico.

📌 Artículo Recomendado:

Artículo Odontológico 🔽 Patología de los Frenillos Bucales ... Los frenillos bucales son bandas de tejido conectivo fibroso, muscular o mixto, recubiertas de una membrana mucosa situada en la línea media y de origen congénito

✅ Procedimiento quirúrgico: Frenectomía paso a paso

1. Evaluación preoperatoria
° Historia clínica
° Consentimiento informado
° Evaluación de la función lingual y labial

2. Anestesia local
° Aplicación tópica seguida de infiltración anestésica
° En bebés, puede realizarse sin anestesia infiltrativa si el procedimiento es corto y superficial

3. Técnica quirúrgica
° Se realiza con bisturí frío, electrobisturí o láser
° Incisión en el frenillo
° Hemostasia inmediata
° En el caso del láser, se evita el uso de suturas

4. Postoperatorio
° Ejercicios orales (estiramientos, protrusión)
° Control del dolor con analgésicos
° Seguimiento con fonoaudiólogo si el caso lo requiere.

💬 Discusión
La frenectomía infantil debe estar sustentada en un diagnóstico funcional, no solo anatómico. Aunque muchos padres buscan este procedimiento como solución para problemas del habla o lactancia, la evidencia sugiere que no todos los casos requieren intervención quirúrgica inmediata.
Estudios como el de Francis et al. (2021) muestran mejoras en la alimentación y el lenguaje después de la frenectomía, especialmente cuando se acompaña de terapia miofuncional. No obstante, aún se debate la eficacia universal del procedimiento en todos los casos de anquiloglosia.

💡 Conclusión
La frenectomía infantil es un procedimiento seguro y efectivo cuando está correctamente indicado. Su impacto positivo en la lactancia y el habla está respaldado por estudios recientes, pero no debe realizarse de manera indiscriminada. Una evaluación multidisciplinaria entre odontopediatra, otorrinolaringólogo y fonoaudiólogo garantiza un tratamiento individualizado y exitoso.

📌 Artículo Recomendado:

Vídeo 🔽 Manejo de anquiloglosia en bebés - Protocolo de evaluación ... Esta anormalidad es relativamente común en recién nacidos, y crea dificultad en el amamantamiento y limita los movimientos de la lengua. En caso no sea tratado puede generar problemas de apiñamiento

📚 Referencias bibliográficas

✔ Francis, D. O., Chinnadurai, S., Morad, A., Epstein, R. A., Kohanim, S., Krishnaswami, S., ... & Sathe, N. A. (2021). Treatments for ankyloglossia and ankyloglossia with concomitant lip-tie: a systematic review. Pediatrics, 147(1), e20200345. https://doi.org/10.1542/peds.2020-0345

✔ Ghaheri, B. A., Cole, M., Fausel, S. C., Chuop, M., & Mace, J. C. (2017). Breastfeeding improvement following tongue-tie and lip-tie release: A prospective cohort study. Laryngoscope Investigative Otolaryngology, 2(5), 137–144. https://doi.org/10.1002/lio2.77

✔ O'Shea, J. E., Foster, J. P., O'Donnell, C. P., Breathnach, D., Jacobs, S. E., Todd, D. A., & Davis, P. G. (2017). Frenotomy for tongue-tie in newborn infants. Cochrane Database of Systematic Reviews, 3, CD011065. https://doi.org/10.1002/14651858.CD011065.pub2

✔ Buryk, M., Bloom, D., & Shope, T. (2011). Efficacy of neonatal release of ankyloglossia: a randomized trial. Pediatrics, 128(2), 280-288. https://doi.org/10.1542/peds.2011-0077

📌 Más artículos recomendados 

► Anquiloglosia en el lactante. Diagnóstico, consecuencias y tratamientos
► ¿Qué es el frenillo lingual corto? Frenectomia en niños
► Tratamiento quirúrgico del frenillo lingual corto en niños

White Spot Lesions in Orthodontics: Causes, Prevention, and Treatment Options

White spot lesions (WSLs) are a common clinical challenge during and after orthodontic treatment with fixed appliances. They are early indicators of enamel demineralization and can significantly affect the esthetic outcomes of orthodontic care.

📌 Recommended Article :

Video 🔽 What are the causes of white spots on teeth? ... It can occur in both primary and permanent dentition, and a professional evaluation is necessary to determine what is the cause of the white spots and perform an appropriate treatment

This article explores the definition, characteristics, etiology, prevention, and treatment options for WSLs based on the most recent scientific literature.

Advertisement

✅ Definition and Characteristics
White spot lesions are defined as subsurface enamel porosities caused by the demineralization of hydroxyapatite crystals, which appear as opaque, chalky white areas on the smooth surfaces of teeth (Gorelick et al., 1982). Unlike caries cavities, WSLs represent a non-cavitated stage of enamel decay that is often reversible with timely intervention (Featherstone, 2004).
These lesions are typically seen on the buccal surfaces of anterior teeth, especially around orthodontic brackets, and can become permanent esthetic defects if left untreated.

📌 Recommended Article :

Video 🔽 Use of Silver Diamine Fluoride (SDF) - General Guide on its application ... We share a complete guide on the benefits, advantages, and procedure for the application of Silver Diamino fluoride (SDF) in the treatment of cavities and dental sensitivity

✅ Etiology and Risk Factors
WSLs develop when dental plaque accumulates around orthodontic brackets and is not effectively removed. The cariogenic bacteria, particularly Streptococcus mutans and Lactobacillus, metabolize dietary sugars and produce acids that lower the pH in the biofilm, leading to enamel demineralization (ten Cate, 2001).

➤ Risk factors include:
° Poor oral hygiene during orthodontic treatment
° High carbohydrate/sugar diet
° Salivary flow or composition abnormalities
° Prolonged treatment time
° Lack of fluoride exposure

📌 Recommended Article :

PDF 🔽 Fluoride Varnish in the Prevention of Dental Caries in Children and Adolescents: A Systematic Review ... Fluoride varnish is easy to apply, offers greater absorption of minerals on the teeth, and is very safe, unlike other topical fluoride treatments (gels and rinses)

✅ Prevention Strategies
Effective prevention is crucial since early WSLs are reversible but can rapidly progress without intervention. Strategies include:

1. Oral Hygiene Education
Patient education remains the cornerstone. Brushing twice daily with fluoride toothpaste, interdental brushes, and electric toothbrushes has shown significant benefit (Derks et al., 2004).
2. Fluoride Use
Fluoride varnishes, mouth rinses, and high-fluoride toothpaste strengthen enamel and reduce WSL incidence. A randomized controlled trial found that 5% sodium fluoride varnish applied every 6 weeks significantly lowered WSL formation (Øgaard, 1994).
3. Sealants and Coatings
Resin sealants and glass ionomer coatings applied to tooth surfaces or brackets can form a physical barrier against plaque accumulation (Julien et al., 2006).
4. Diet Counseling
Minimizing acidic and sugary food intake is essential. Xylitol gum may also reduce bacterial load and stimulate salivary flow.

📌 Recommended Article :

Video 🔽 How we can manage orthodontic pain and discomfort? ... Another discomfort that is generated during treatment is pain, and this video gives you a series of recommendations to deal with that painful process

✅ Treatment Approaches
Once WSLs appear, timely and appropriate treatment can improve esthetics and prevent progression.

1. Remineralization Agents
° Fluoride therapies: High-fluoride toothpaste, varnishes, and gels promote remineralization.
° CPP-ACP (casein phosphopeptide–amorphous calcium phosphate): Enhances calcium and phosphate delivery to enamel (Bailey et al., 2009).
° Nano-hydroxyapatite: Biomimetic agent that integrates into enamel matrix (Huang et al., 2011).
2. Microabrasion
A minimally invasive technique using acidic and abrasive compounds to remove superficial enamel and improve lesion appearance (Croll, 1990).
3. Resin Infiltration (Icon®)
A novel approach using low-viscosity resin to infiltrate and mask lesions, improving esthetics and halting progression. Clinical studies report high patient satisfaction and long-term effectiveness (Paris et al., 2010).
4. Restorative Techniques
In advanced cases, composite resin restoration or veneers may be required to restore function and esthetics.

📌 Recommended Article :

PDF 🔽 Clear Aligners for Early Treatment of Anterior Crossbite - Indications and Benefits ... The detection and treatment of the anterior crossbite must be at an early age, in this way we stop the factors that trigger this malocclusion and avoid abnormal growth of the jaws

💬 Discussion
WSLs are a frequent but preventable side effect of fixed orthodontic appliances. The use of preventive strategies, such as patient education, fluoride application, and professional monitoring, is essential in reducing incidence. Emerging technologies like resin infiltration provide minimally invasive alternatives with promising results.
Current research focuses on biomimetic remineralizing agents and nanotechnology to enhance enamel repair. However, long-term studies are needed to validate their effectiveness in different populations and orthodontic conditions.

💡 Conclusion
White spot lesions represent a significant clinical concern in orthodontics. Through early diagnosis, preventive strategies, and minimally invasive treatments, dental professionals can mitigate their impact. Collaboration between orthodontists, general dentists, and patients is key to preserving enamel integrity and esthetic outcomes.

📌 Recommended Article :

Dental Article 🔽 How to Correct Harmful Oral Habits in Children That Affect Facial and Dental Development ... Certain harmful oral habits, such as thumb sucking, mouth breathing, or nail biting, can interfere with proper facial growth and tooth alignment

✅ Recommendations

° Reinforce oral hygiene at every orthodontic visit.
° Prescribe fluoride varnishes or high-fluoride toothpaste for at-risk patients.
° Consider applying sealants on high-risk teeth before bracket bonding.
° Introduce resin infiltration early for cosmetic management.
° Promote regular follow-up appointments post-debonding to monitor lesion progression.

📚 References

✔ Bailey, D. L., Adams, G. G., Tsao, C. E., Hyslop, A., Escobar, K., Manton, D. J., ... & Reynolds, E. C. (2009). Regression of post-orthodontic lesions by a remineralizing cream. Journal of Dental Research, 88(12), 1148-1153. https://doi.org/10.1177/0022034509347163

✔ Croll, T. P. (1990). Enamel microabrasion: observations after 10 years. Journal of the American Dental Association, 121(5), 548-550. https://doi.org/10.14219/jada.archive.1990.0172

✔ Derks, A., Katsaros, C., Frencken, J. E., van't Hof, M. A., Kuijpers-Jagtman, A. M. (2004). Caries-inhibiting effect of preventive measures during orthodontic treatment with fixed appliances: a systematic review. Caries Research, 38(5), 413-420. https://doi.org/10.1159/000079623

✔ Featherstone, J. D. B. (2004). The continuum of dental caries—evidence for a dynamic disease process. Journal of Dental Research, 83(Spec No C), C39-C42. https://doi.org/10.1177/154405910408301s08

✔ Gorelick, L., Geiger, A. M., & Gwinnett, A. J. (1982). Incidence of white spot formation after bonding and banding. American Journal of Orthodontics, 81(2), 93–98. https://doi.org/10.1016/0002-9416(82)90032-X

✔ Huang, S. B., Gao, S. S., Yu, H. Y. (2011). Effect of nano-hydroxyapatite concentration on remineralization of initial enamel lesion in vitro. Biomedical Materials, 4(3), 034104. https://doi.org/10.1088/1748-6041/4/3/034104

✔ Julien, K. C., Buschang, P. H., & Campbell, P. M. (2006). Prevalence of white spot lesion formation during orthodontic treatment. The Angle Orthodontist, 76(6), 1045–1050. https://doi.org/10.1043/0003-3219(2006)076[1045:POWSLF]2.0.CO;2

✔ Øgaard, B. (1994). Effectiveness of a fluoride-releasing orthodontic bonding material in the prevention of white spot lesions: a 9-month clinical study. American Journal of Orthodontics and Dentofacial Orthopedics, 106(6), 583–591. https://doi.org/10.1016/S0889-5406(94)70002-5

✔ Paris, S., Meyer-Lueckel, H., Mueller, J., Hummel, M., Kielbassa, A. M. (2010). Progression of sealed initial caries lesions: a randomized controlled clinical trial. Caries Research, 44(1), 67–71. https://doi.org/10.1159/000279324

✔ ten Cate, J. M. (2001). Review on fluoride, with special emphasis on calcium fluoride mechanisms in caries prevention. European Journal of Oral Sciences, 109(2), 207-212. https://doi.org/10.1034/j.1600-0722.2001.00006.x

📌 More Recommended Items

► What are impacted canines? - Treatment
► 6 signs that your child may need early orthodontic treatment
► Causes of Gum problems with braces

Dental Implants: What They Are, How They're Placed, and How Long They Last

Dental implants are one of the most effective and long-lasting solutions for replacing missing teeth. With modern technology and evidence-based protocols, implants offer a stable, aesthetic, and functional alternative for restoring smiles.

📌 Recommended Article :

Video 🔽 Prevention of peri-implantitis - 3D Video ... Prevention is the best way to avoid peri-implantitis, thus ensuring the permanence and stability of the dental implant. Let's see this interesting 3D video

This article explains what dental implants are, how they’re placed, how long they last, and how to care for them to ensure their long-term success.

Advertisement

✅ What Are Dental Implants?
A dental implant is a titanium post surgically inserted into the jawbone, acting as an artificial tooth root. Once healed, it serves as the base for a dental crown, bridge, or denture.
Titanium is biocompatible, meaning it integrates naturally with the bone through a process called osseointegration. This provides strong support for prosthetic teeth and helps preserve bone structure. According to recent clinical studies, dental implants have a success rate of over 95% (Moraschini et al., 2021).

✅ How Are Dental Implants Placed?
The implant process typically involves several steps and may take a few months to complete:

1. Initial Assessment:
A thorough dental exam, including 3D imaging, is done to evaluate bone volume and develop a treatment plan.
2. Surgical Placement:
Under local anesthesia, the implant is placed into the jawbone through a small incision. The procedure usually takes 30–60 minutes per implant.
3. Healing and Osseointegration:
Over the next 3–6 months, the bone heals and integrates with the implant, forming a stable foundation.
4. Abutment and Crown Placement:
Once osseointegration is complete, a connector (abutment) is attached to the implant, followed by a custom-made crown.

📌 Recommended Article :

Video 🔽 What is Peri-implantitis and how do we prevent it? 3D video ... Professional evaluation is important to determine peri-implantitis, but there are signs and symptoms that the patient may notice and that motivate him to see the specialist

✅ How Long Do Dental Implants Last?
On average, dental implants last 15 to 25 years, and many can last a lifetime with proper care. Several factors influence their longevity:

° Patient's overall health and oral hygiene
° Quality of surgical technique and materials
° Smoking and alcohol use
° Presence of chronic diseases (e.g., diabetes, osteoporosis)
° Regular dental checkups

A 2023 systematic review found a 94.6% implant survival rate after 10 years (Jung et al., 2023).

📌 Recommended Article :

Video 🔽 Dental Implants Post-Op Instructions ... Currently, surgical techniques ensure good results, but the patient must collaborate with the post-operative process

✅ Best Practices for Implant Maintenance
To keep your implants healthy and functional long-term, follow these essential recommendations:

° Brush twice a day with a soft-bristled toothbrush and use interdental brushes or floss.
° Schedule dental cleanings and checkups every 6 months or as advised.
° Avoid smoking, which increases the risk of peri-implantitis (inflammation around implants).
° Manage systemic conditions, especially diabetes and gum disease.
° Use a night guard if you grind your teeth (bruxism).

📌 Recommended Article :

Video 🔽 What's the Difference Between Dental Implants and Bridges? ... A correct evaluation by the dentist ensures a good rehabilitation, the most important thing is that we leave the dental office with a nice smile

💬 Discussion
Dental implants have transformed modern restorative dentistry. They provide unmatched function, aesthetics, and bone preservation when compared to traditional dentures or bridges. However, they require careful planning, maintenance, and patient commitment.
Potential complications such as bone loss, infection, or implant failure are preventable with proper hygiene, follow-up care, and a well-coordinated dental team. Patient education is critical to the long-term success of implant therapy.

💡 Conclusion Dental implants are a reliable and permanent solution for missing teeth. With a high success rate and natural appearance, they restore both function and confidence. Longevity depends on professional care, patient health, and consistent maintenance. When placed and maintained correctly, implants can last a lifetime.

📌 Recommended Article :

Video 🔽 Patient Prevention: Dental Implant Failures ... The patient must be informed before performing the surgery, about the care they should have after the surgical procedure, regarding their diet and hygiene, thus avoiding serious consequences

📚 References

✔ Jung, R. E., Zembic, A., Pjetursson, B. E., Zwahlen, M., & Thoma, D. S. (2023). Systematic review of the survival rate and incidence of biological, technical, and aesthetic complications of single crowns on implants reported in longitudinal studies with a follow-up of 10 years. Clinical Oral Implants Research, 34(1), 24–38. https://doi.org/10.1111/clr.13930

✔ Moraschini, V., Poubel, L. A. D. C., Ferreira, V. F., & Barboza, E. D. S. P. (2021). Evaluation of survival and success rates of dental implants reported in longitudinal studies with a follow-up period of at least 10 years: A systematic review. International Journal of Oral and Maxillofacial Surgery, 50(6), 767–777. https://doi.org/10.1016/j.ijom.2020.08.012

📌 More Recommended Items

► Step-by-Step Dental Implants: A Guide for Patients
► Common Complications of Dental Implants: Diagnosis and Treatment Guide
► Dental implant: What complications can there be after surgery?

Implantes dentales: qué son, cómo se colocan y cuánto duran

Los implantes dentales son una de las soluciones más avanzadas y duraderas para reemplazar dientes perdidos. Gracias a los avances tecnológicos y científicos, este tratamiento ha demostrado ser seguro, funcional y estéticamente satisfactorio tanto en jóvenes como en adultos mayores.

📌 Artículo Recomendado:

Vídeo 🔽 ¿Hay un límite de edad para colocarse un implante dental? ... Es importante que el implantólogo evalúe las condiciones de la cavidad bucal y el estado general del paciente, para determinar si es candidato para portar un implante dental

En este artículo se presenta una revisión clara y actualizada sobre qué son los implantes dentales, el procedimiento de colocación, su duración, y recomendaciones prácticas para su mantenimiento.

Enlaces Patrocinados

✅ ¿Qué son los implantes dentales?
Un implante dental es una estructura de titanio, biocompatible con el cuerpo humano, que se inserta quirúrgicamente en el hueso maxilar o mandibular. Actúa como raíz artificial sobre la cual se coloca posteriormente una corona dental, puente o prótesis removible.
Este tratamiento tiene como objetivo restaurar la función masticatoria, mejorar la estética facial y mantener la salud bucal. La tasa de éxito supera el 95%, según estudios clínicos recientes (Moraschini et al., 2021).

✅ ¿Cómo se colocan los implantes dentales?
El procedimiento de colocación de un implante dental consta de varias fases:

1. Evaluación clínica y radiográfica:
El odontólogo realiza un examen completo, incluyendo tomografías 3D, para evaluar el volumen óseo disponible y planificar la cirugía.
2. Colocación del implante:
Bajo anestesia local, se realiza una pequeña incisión en la encía para insertar el implante en el hueso. Este proceso suele durar entre 30 a 60 minutos.
3. Fase de osteointegración:
El implante se integra al hueso durante un periodo de 3 a 6 meses, permitiendo una fijación estable.
4. Colocación de la corona:
Una vez que el implante está firmemente integrado, se coloca un pilar (pilar protésico) y posteriormente la corona o prótesis dental.

✅ ¿Cuánto duran los implantes dentales?
La duración promedio de un implante dental es de 15 a 25 años, e incluso puede ser de por vida si se mantienen buenos hábitos de higiene y controles periódicos. Factores que influyen en su longevidad incluyen:

° Salud general y bucal del paciente
° Técnica quirúrgica empleada
° Calidad del implante y de la prótesis
° Higiene oral diaria
° Control de enfermedades periodontales y sistémicas (como diabetes)

Según un metaanálisis reciente, la tasa de supervivencia a 10 años es del 94.6% (Jung et al., 2023).

📌 Artículo Recomendado:

Vídeo 🔽 ¿Se pueden colocar implantes dentales en personas con enfermedad periodontal? ... Considerar la salud bucal antes de colocar un implante dental es importante porque así aseguramos un correcto postoperatorio y una buena estabilidad del implante dental

✅ Recomendaciones para el cuidado de los implantes

° Higiene bucal rigurosa: cepillado con cepillo suave y uso de hilo dental o cepillos interproximales.
° Visitas regulares al dentista: controles cada 6 meses o según indicación del profesional.
° Evitar el tabaco: el fumar disminuye la tasa de éxito y puede generar periimplantitis.
° Control de enfermedades sistémicas: especialmente diabetes y osteoporosis.
° Uso de férulas nocturnas si existe bruxismo.

💬 Discusión
Los implantes dentales han revolucionado la rehabilitación oral, ofreciendo soluciones altamente funcionales y estéticas. Sin embargo, no están exentos de complicaciones, como la pérdida ósea o la periimplantitis. La selección adecuada del paciente y un enfoque multidisciplinario son claves para el éxito a largo plazo.
La educación del paciente también cumple un rol fundamental. Informar adecuadamente sobre el procedimiento, los riesgos, beneficios y cuidados posteriores mejora la adherencia al tratamiento y los resultados.

📌 Artículo Recomendado:

Vídeo 🔽 ¿Existe el rechazo o alergia a los implantes dentales? ... Antes de colocar un implante se debe realizar una serie de exámenes que evalúan el estado de salud general del paciente, no solamente la salud bucal

💡 Conclusión
Los implantes dentales representan una opción segura, duradera y estética para la sustitución de dientes perdidos. Su éxito depende de múltiples factores, incluyendo la experiencia del profesional, el estado general del paciente y su compromiso con los cuidados postoperatorios. Con un enfoque integral y seguimiento adecuado, pueden ofrecer una solución de por vida.

📚 Referencias bibliográficas

✔ Jung, R. E., Zembic, A., Pjetursson, B. E., Zwahlen, M., & Thoma, D. S. (2023). Systematic review of the survival rate and incidence of biological, technical, and aesthetic complications of single crowns on implants reported in longitudinal studies with a follow-up of 10 years. Clinical Oral Implants Research, 34(1), 24–38. https://doi.org/10.1111/clr.13930

✔ Moraschini, V., Poubel, L. A. D. C., Ferreira, V. F., & Barboza, E. D. S. P. (2021). Evaluation of survival and success rates of dental implants reported in longitudinal studies with a follow-up period of at least 10 years: a systematic review. International Journal of Oral and Maxillofacial Surgery, 50(6), 767–777. https://doi.org/10.1016/j.ijom.2020.08.012

📌 Más artículos recomendados 

► Implantes dentales paso a paso: Guía para pacientes
► Cuidado Postoperatorio Tras un Implante Dental – Lo Que Debes Saber
► ¿Cuáles son las preocupaciones ante un implante dental?

How to Prevent Dry Socket After Tooth Extraction: Signs, Prevention, and Treatment Guide

Dry socket, or alveolar osteitis, is one of the most common and painful complications following tooth extraction—particularly of mandibular molars. It occurs when the post-extraction blood clot is dislodged or fails to form properly, exposing the underlying bone and nerves.

📌 Recommended Article :

Video 🔽 Tooth Extraction Aftercare Tips ... Before extracting a tooth, the dental surgeon must instruct the patient on pre and post operative care. These recommendations are intended to protect the wound and the healing process

Preventing dry socket is a key responsibility shared by both dental professionals and patients, involving proper surgical technique, patient education, and targeted pharmacological management.

Advertisement

✅ What Is Dry Socket?
Dry socket is a localized inflammation of the alveolar bone following the loss or breakdown of the blood clot in the socket. It typically occurs 2 to 5 days after extraction and results in intense pain, delayed healing, and possible infection.

📌 Recommended Article :

PDF 🔽 Guideline on Pediatric Oral Surgery ... Radiographs can include intraoral films and extraoral imaging if the area of interest extends beyond the dentoalveolar complex

✅ Signs and Symptoms
Key clinical features include:

° Severe, throbbing pain that radiates to the ear, jaw, or temple
° Empty-looking socket with exposed bone
° Foul odor or bad taste in the mouth
° Partial or total loss of the blood clot
° Swollen lymph nodes or low-grade fever (less commonly)

Radiographically, no bone destruction is observed, but clinically, the socket appears dry and inflamed.

📌 Recommended Article :

Video 🔽 How To Prevent A Dry Socket ... At the time that the surgical procedure is completed, the surgeon must instruct the patient on the care that must be taken to avoid an infectious process

✅ Risk Factors

° Smoking or tobacco use
° Poor oral hygiene
° Use of oral contraceptives
° Traumatic or complicated extractions
° Previous history of dry socket
° Improper post-op instructions or non-compliance

📌 Recommended Article :

Video 🔽 How is a palatine torus removed? - Step by Step ... The surgical procedure is ambulatory, under local anesthesia, and the postoperative period does not save any major complications as long as you follow the professional's instructions and recommendations

✅ In-Office Prevention Strategies

1. Atraumatic Surgical Technique
° Minimize trauma to the bone and surrounding soft tissue
° Use copious irrigation during extraction to avoid heat-induced bone damage (Bjørnland et al., 2010)
2. Socket Debridement and Saline Irrigation
° Gently irrigate the socket post-extraction to remove debris or bacteria
° Avoid aggressive curettage
3. Antimicrobial Agents
° Application of 0.12% chlorhexidine gel or rinse has shown significant efficacy in reducing dry socket incidence (López-Carriches et al., 2006)
4. Medicated Dressings (when needed)
° Use of eugenol-based pastes in high-risk patients can provide protection and antibacterial effect
5. Proper Suturing
° If appropriate, sutures help stabilize the clot and reduce risk of contamination

📌 Recommended Article :

Dental Article 🔽 Antibiotic Prophylaxis in Pediatric Dentistry: When and How to Use It Safely in 2025 ... Antibiotic prophylaxis in pediatric dentistry is a preventive measure used to avoid serious systemic infections, such as infective endocarditis, in children undergoing dental procedures.

✅ Home Care and Patient Instructions
Aftercare is critical in dry socket prevention. Patients should be instructed to:

° Avoid smoking or vaping for at least 72 hours
° Refrain from spitting, sucking through straws, or vigorous rinsing
° Eat soft, lukewarm foods and avoid hard, spicy, or crunchy foods
° Rinse gently with saline or chlorhexidine, starting 24 hours post-extraction
° Maintain proper oral hygiene, avoiding brushing directly on the surgical site

📌 Recommended Article :

Video 🔽 Post-extraction care for wisdom teeth - Tips and recommendations ... The procedure is outpatient, and the patient must comply with the pre- and post-operative recommendations. These recommendations aim to avoid some complications such as hemorrhages and alveolitis

✅ Pharmacological Support

1. Analgesics
° NSAIDs (e.g., ibuprofen 400–600 mg every 6–8 hours) are first-line for pain control
° For severe pain, acetaminophen + codeine or tramadol may be prescribed temporarily
2. Antibiotics
° Routine prophylactic antibiotics are not recommended unless the patient is immunocompromised or has systemic infection signs
° Topical antibiotics (e.g., tetracycline in socket) may help in high-risk cases (Halabi et al., 2021)
3. Antiseptics
° Chlorhexidine gluconate 0.12% as a rinse or gel pre- and post-operatively to reduce bacterial load

📌 Recommended Article :

PDF🔽 Manual of extraction techniques in pediatric dentistry - Step by step ... We share an article that shows us the anatomical considerations and the appropriate surgical technique when extracting teeth in pediatric patients

✅ Treatment of Established Dry Socket
Once dry socket develops, treatment focuses on symptom relief and promoting healing:

° Irrigation of the socket with warm saline to remove debris
° Application of medicated dressing, such as eugenol-containing pastes (e.g., Alvogyl)
° Pain control with systemic analgesics
° Follow-up visits every 24–48 hours to monitor healing and reapply dressing as needed

Dry socket typically resolves within 7–10 days with appropriate care.

📌 Recommended Article :

PDF/Video 🔽 What is frenectomy? Step by step surgical procedure ... We share complete information about frenectomy, effectiveness and the step-by-step procedure regarding a clinical case. In addition to the case of a laser frenectomy in pediatric patients

💬 Discussion
Dry socket is a painful yet preventable complication of dental extractions. Although its exact pathophysiology is not fully understood, current evidence supports that bacterial contamination, fibrinolytic activity, and patient behavior all contribute to clot breakdown. Research consistently shows that chlorhexidine use, atraumatic technique, and strong postoperative compliance significantly reduce the risk. Dental professionals must tailor prevention strategies based on individual risk factors, while empowering patients with clear post-op education.

💡 Conclusion
Dry socket prevention requires a combination of clinical precision and effective communication. Dentists should use atraumatic techniques, antiseptic protocols, and evidence-based pharmacological approaches. Patients, on the other hand, play a key role in avoiding risky behaviors post-extraction. Together, these efforts can dramatically reduce the incidence and severity of alveolar osteitis, improving patient comfort and recovery.

📚 References

✔ Bjørnland, T., Kvello, M., & Barkvoll, P. (2010). The effect of chlorhexidine rinse on the incidence of alveolar osteitis after third molar surgery: A prospective randomized study. Acta Odontologica Scandinavica, 68(5), 261–266. https://doi.org/10.3109/00016357.2010.494601

✔ Halabi, M., Barakat, H., Kaddoura, I., & Mahfouz, M. (2021). Prevention and treatment of dry socket: A systematic review. International Journal of Dentistry, 2021, 6631747. https://doi.org/10.1155/2021/6631747

✔ López-Carriches, C., Salido, M. P., & Blanco, C. A. (2006). Prevention of dry socket with chlorhexidine gel. Medicina Oral, Patología Oral y Cirugía Bucal, 11(5), E483–E488. https://www.medicinaoral.com/pubmed/medoralv11_i5_p483.pdf

📌 More Recommended Items

► What is pericoronitis? Causes, symptoms and treatment
► Ludwig's angina in a pediatric patient - Case report (diagnosis, symptoms and treatment)
► Ankyloglossia in infants - Diagnosis and surgical protocol