Viscous Lidocaine in the Treatment of Dry Socket

Alveolar osteitis is associated with up to 31% of impacted mandibular third molar extractions as well as an equally high number of surgical extractions. Many patients have described the pain as the worst they have ever experienced. Lidocaine jelly has been suggested to give immediate and long term pain relief and may have an antibacterial effect against common oral organisms. A study was performed at the University of Pennsylvania to assess analgesic effects and formulate a treatment protocol using topical viscous 2% lidocaine jelly in the socket two minutes before the placement of a dressing containing iodoform, bismuth subnitrate, benzocaine, and petrolatum.

The use of lidocaine resulted in a statistically significant decrease in pain perception as compared with an inactive jelly. Significant increases in pain relief were also seen in the test group. No negative side effects were found in either group.

Clinical Significance — Topical viscous 2% lidocaine jelly can be easily and effectively used in the dental office to lessen the pain of treatment for alveolar osteitis, especially in the period following dental instrumentation. It eliminates the risk of and need for a second nerve block to anesthetize buccal soft tissues.

‍Gerald S. Fine, D.D.S.

Practice limited to oral & maxillofacial surgery‍