Landero Dental Clinic

30/06/2026

Dry Socket

🔹 Also called alveolar osteitis / alveolitis sicca dolorosa
🔹 Loss/disintegration of extraction socket clot → exposed bone

Pathogenesis
🔹 Due to fibrinolysis of clot
🔹 Plasmin dissolves fibrin clot
🔹 Severe pain + foul odor, but usually no pus

Risk factors
🔹 Traumatic/difficult extraction
🔹 Especially impacted mandibular 3rd molar
🔹 Women, smokers
🔹 Oral contraceptives (estrogen ↑ fibrinolysis)
🔹 Also seen with Paget disease or post-radiotherapy

Clinical features
🔹 Starts day 2–3 after extraction
🔹 Lasts about 7–10 days
🔹 Severe throbbing pain radiating to ear/neck
🔹 Bad odor / bad taste
🔹 Empty dry socket with exposed necrotic bone
🔹 May have low-grade fever and ipsilateral nodes

Management
🔹 Palliative only
🔹 Gentle irrigation
🔹 Obtundent dressing: ZOE or iodoform gauze
🔹 Change dressing until pain subsides

Prevention
🔹 Atraumatic extraction technique is most important
🔹 Routine socket antibiotics not routinely recommended

High-yield pearl
🔹 Post-extraction day 2–3 severe pain + empty socket + foul odor + no pus = dry socket

26/06/2026

𝗕𝗮𝗸𝗶𝘁 𝘄𝗮𝗹𝗮𝗻𝗴 𝗳𝗶𝘅𝗲𝗱 𝗽𝗿𝗶𝗰𝗲 𝗮𝗻𝗴 𝗺𝗴𝗮 𝗱𝗲𝗻𝘁𝗮𝗹 𝗽𝗿𝗼𝗰𝗲𝗱𝘂𝗿𝗲𝘀? 💸

After all, kung pareho namang “bunot,” “pasta,” o “root canal,” bakit minsan magkakaiba ang presyo?

The simple answer is: 𝘽𝙚𝙘𝙖𝙪𝙨𝙚 𝙣𝙤 𝙩𝙬𝙤 𝙙𝙚𝙣𝙩𝙖𝙡 𝙘𝙖𝙨𝙚𝙨 𝙖𝙧𝙚 𝙚𝙭𝙖𝙘𝙩𝙡𝙮 𝙩𝙝𝙚 𝙨𝙖𝙢𝙚. 💯

Just because two patients need the same procedure doesn’t mean the treatment will have the same level of difficulty.

For example, a tooth extraction can be very simple for one patient.

Pero sa ibang pasyente, the tooth might be badly broken, impacted, infected, or positioned in a way that requires more time, more instruments, and a more complex approach.

Pareho silang extraction.

Pero magkaiba ang condition.

Magkaiba rin ang treatment requirements.

That’s why dental fees are not based solely on the name of the procedure.

They’re also influenced by:

🦷 The condition of the tooth and surrounding tissues
🦷 The complexity of the case
🦷 The materials that will be used
🦷 The instruments and equipment required
🦷 The time needed to complete the treatment
🦷 The clinical expertise needed to achieve a safe and predictable result

Sa dentistry, hindi siya parang restaurant menu na may iisang price para sa lahat. 👎

Every smile is unique.

Every patient has different needs.

And every treatment plan is customized based on what is actually happening inside the mouth.

That’s why a proper consultation is important.

Because before we can determine the most appropriate treatment—and its corresponding fee—we first need to evaluate your specific dental condition.

At the end of the day, you’re not just paying for the procedure itself.

You’re also paying for the diagnosis, treatment planning, sterilization protocols, quality materials, professional expertise, and the care needed to achieve the best possible outcome.

✨ Because in dentistry, one fixed price simply cannot fit every patient.

21/06/2026

☕🦷 The timing of brushing may matter more than many people realize.

Coffee contains acids that temporarily soften the outer surface of teeth. Brushing immediately afterward can increase enamel wear over time, especially when this becomes a daily habit. Dental professionals often recommend brushing before coffee, as removing plaque first makes it harder for stains to attach to tooth surfaces.

After drinking coffee, a simple rinse with water can help wash away acids and pigments while saliva naturally restores a healthier pH in the mouth. If brushing is needed, waiting about 30 minutes allows the enamel surface time to recover.

A small adjustment in a morning routine may help protect enamel, reduce staining, and support long-term oral health.

06/05/2026

Ludwig Angina

🔹 Rapidly spreading bilateral cellulitis of submandibular, sublingual, and submental spaces
🔹 Usually from mandibular 2nd/3rd molar infection
🔹 Cellulitis → hard diffuse swelling, not localized abscess

Clinical
🔹 Bull neck
🔹 Woody/board-like induration
🔹 Elevated, posteriorly displaced tongue
🔹 Dysphagia, odynophagia, drooling
🔹 Hot potato voice, trismus
🔹 Fever, tachycardia, malaise

Main danger
🔹 Airway obstruction = most serious complication
🔹 Death usually from asphyxiation

Management
🔹 Airway first
🔹 Hospitalize
🔹 IV broad-spectrum antibiotics
🔹 Incision and drainage / decompression
🔹 Remove source: extract or treat offending tooth

High-yield pearl
🔹 Bilateral board-like submandibular swelling + tongue elevation = Ludwig angina

06/05/2026

🩸 “The socket won’t stop bleeding… what now?” 😰

Post-extraction bleeding management every dentist MUST master

You’ve done a clean extraction… everything looked perfect…
And then 💥 the patient calls—“Doctor, it’s still bleeding!”

Let’s break down the exact stepwise approach—the way examiners LOVE and clinics DEMAND 👇

🥇 STEP 1: DIRECT PRESSURE (FIRST LINE – NEVER MISS THIS)

👉 This solves most cases

Place a sterile gauze over socket

Ask patient to bite firmly for 30–60 minutes

Slightly moistened gauze works better (helps clot formation)

🧠 Why?
Pressure = vessel compression + clot stabilization

💡 If bleeding stops here → you’re done. Don’t over-treat.

🥈 STEP 2: INSPECT THE SOCKET

👉 If bleeding persists, don’t blindly pack—look first

Remove the existing clot

Irrigate gently

Identify source:

🦴 Bone (oozing)

💉 Soft tissue tear

⚠️ Foreign body / root fragment

🧠 Why?
You can’t fix what you don’t identify.

🥉 STEP 3: LOCAL HEMOSTATIC MEASURES

👉 Now we actively control bleeding

🧪 Place inside socket:

Gelfoam

Surgicel (oxidized cellulose)

Collagen plug

Topical thrombin

🧠 These act as a scaffold → clot formation → stabilization

🧵 STEP 4: SUTURING (EXAM FAVORITE)

👉 Figure-of-8 suture = GOLD STANDARD

Compresses socket

Holds clot in place

Provides mechanical stability

💡 If you remember ONE suture for exams → this is it

💊 STEP 5: PHARMACOLOGIC SUPPORT

👉 Especially important in medically compromised patients

Tranexamic acid (TXA)

Mouthwash OR gauze soaked in TXA

Prevents clot breakdown (antifibrinolytic)

⚠️ Avoid unnecessary NSAIDs in bleeding-prone patients

🚨 STEP 6: THINK SYSTEMIC (BIG EXAM TRAP)

👉 Bleeding not stopping? Don’t keep packing blindly

Check for:

💊 Drugs:

Warfarin

DOACs (Apixaban, Rivaroxaban)

Aspirin / Clopidogrel

🩸 Disorders:

Hemophilia A

Von Willebrand disease

👉 Investigations:

INR (ideal

05/05/2026