Prevalence of Dry Socket (Alveolar Osteitis) Following Tooth Extraction in Diabetic Patients: A Cross-Sectional Study

Background: Dry socket (alveolar osteitis) is one of the most common and painful complications after tooth extraction. Diabetic patients are particularly vulnerable due to impaired wound healing, microvascular compromise, and increased susceptibility to infection. Objective: To determine the prevalence of dry socket and identify associated demographic, metabolic, behavioral, and surgical risk factors among diabetic patients undergoing tooth extraction. Methodology: This hospital-based descriptive cross-sectional study was conducted at a Tertiary Care Hospital of Karachi from August 2024 to March 2025, included 105 diabetic patients undergoing simple or surgical tooth extraction. Results: Dry socket developed in 21 patients, giving a prevalence of 20%. Affected patients were older (56.3 ± 8.7 vs 51.9 ± 9.5 years) with longer diabetes duration (11.4 ± 3.8 vs 8.1 ± 3.9 years) and higher HbA1c levels (9.6 ± 1.1% vs 8.1 ± 1.2%). Uncontrolled glycemia was present in 90.5% of cases. Smoking (57.1%), poor oral hygiene (47.6%), and poor postoperative compliance (52.4%) were significantly associated. Surgical extraction (57.1%), mandibular posterior teeth (71.4%), longer operative time (27.4 ± 6.1 minutes), traumatic procedures, and preoperative infection increased risk. Patients with dry socket reported higher pain scores (8.6 ± 0.9) and longer healing times (9.8 ± 2.1 days), with most requiring additional visits. Conclusion: Dry socket is common among diabetic patients and is strongly associated with poor glycemic control, adverse oral hygiene habits, and traumatic surgical factors. Optimising metabolic control and minimising operative trauma may significantly reduce postoperative complications.