ORIGINAL ARTICLE Management of dry socket with low-level laser therapy Aqsa Kamal 1,2 & Basheer Salman 1 & Noor Hayatie AR 2 & A. R. Samsudin 1 Received: 8 April 2020 /Accepted: 3 June 2020 # Springer-Verlag GmbH Germany, part of Springer Nature 2020 Abstract Objective The aim of this study is to investigate the efficacy of delivering low-level laser therapy (LLLT) in the management of dry socket at University Dental Hospital Sharjah. Materials and method Forty-five patients with dry socket were divided into two treatment groups. Group I dry socket patients (n = 30) received conventional treatment while group II patients (n = 15) were irradiated with LLLT at a setting of 200-mW, 6-J, continuous-wave mode using an R02 tipless handpiece (Fotona Er:YAG, Europe), on the buccal, lingual, and middle surfaces of the socket for 30 s from a delivery distance of 1 cm. Pain score and quantification of granulation tissue in the socket were recorded at 0, 4, and 7 days post-dry socket treatment. Results Results showed that the LLLT-irradiated group II sockets showed a much lower VAS pain score of 1–2 as early as day 4, and a richer amount of granulation tissue compared to the conventional treated group I socket. The amount and rate of granulation tissue formation in the dry socket are inversely proportional to the pain score showing significant clinical effectiveness of LLLT on promoting the healing of the dry socket, with improvement in symptoms (P = .001). Conventionally treated dry sockets take at least 7 days to match the effective healing of an LLLT-irradiated dry socket. Conclusion LLLT irradiation influences biomodulation of dry socket healing by dampening inflammation, promoting vascular- ization, stimulating granulation, and controlling pain symptoms. Clinical relevance LLLT may be an additional effective tool for managing dry sockets in general dental practice. Keywords Dry socket . Low level laser therapy (LLLT) . Socket healing Introduction Oral wound healing is a process where the wound usually heals without disturbance or assistance [1]. However, one of the most common adverse conditions following tooth extrac- tion is “dry socket” or “alveolar osteitis,” which occurs in both healthy and medically compromised individuals [1, 2]. Dry socket is associated with intense pain, and the symptoms reached their maximum intensity at 12–48 h after surgery [1]. The socket is devoid of blood clot [3], resulting in the exposure of the bare alveolar bone. Dry socket commonly occurs from day 1 to day 3 post-extraction and is also charac- terized by halitosis and occasionally regional lymphadenitis [4]. The incidence of dry socket is 1–4% worldwide [2]. It is rampant following surgical extractions of the mandibular third molar [1]. Many risk factors are involved such as traumatic tooth extraction, oral contraceptives intake, smoking, bacterial infections, age, and the use of vasoconstrictor in local anesthesia. The most common treatment employed by dental practi- tioner dentists is curettage of the bare bone followed by irri- gation with chlorhexidine or saline and allowing the wound healing in its natural state. There are various other additional agents commonly ap- plied to dry socket that include hydrogen peroxide, alvogyl, zinc oxide eugenol, honey [5], turmeric [6], and clindamycin * A. R. Samsudin drabrani@sharjah.ac.ae Aqsa Kamal draqsakamal@student.usm.my Basheer Salman bsalman@sharjah.ac.ae Noor Hayatie AR norhayati@usm.my 1 College of Dental Medicine, University of Sharjah, Sharjah, United Arab Emirates 2 School of Dental Sciences, Universiti Sains Malaysia, George Town, Malaysia Clinical Oral Investigations https://doi.org/10.1007/s00784-020-03393-3