Hormone levels could predict postextraction dry socket

Investigators may have uncovered a link between sex hormone fluctuations and the pathogenesis of alveolar osteitis following dental extractions.

In a narrative review published in Advances in Oral and Maxillofacial Surgery, the investigators used the PubMed and Google Scholar databases to identify clinical studies, reviews and experimental studies focused on sex hormone variations and the incidence of post-dental extraction alveolar osteitis published between 2018 and 2025.

The data revealed that exposure to higher levels of estrogen — particularly during the ovulatory phase of the menstrual cycle — was correlated with a higher prevalence of alveolar osteitis. As a result, the complication was more commonly observed among women compared with men, particularly those who used combined oral contraceptives. The investigators hypothesized that the greater fibrinolytic activity seen during periods of high estrogen levels could lead to the early dissolution of the alveolar blood clot, thereby exposing the alveolar bone and nerves and impairing wound healing.

In a news article from Oral Health reporting on the findings, experts noted that addressing sex-based disparities in the incidence of postextraction alveolar osteitis may involve more effective surgical techniques and the administration of low-dose oral contraceptives.

The findings suggested that clinicians should weigh menstrual cycle timing and oral contraceptive use to prevent postextraction complications.

Read more: Advances in Oral and Maxillofacial Surgery

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