Abstract
BACKGROUND: Dry socket is a common post-extraction complication, characterized by the exposure of bone surfaces to the oral environment, leading to severe pain and potential infection. This study investigates the relationship between oral microbial composition and dry socket incidence in tooth extraction patients. METHODS: From 87 patients (56 normal healing, 31 dry socket), 321 microbial samples were collected at pre-, med-, and post-extraction stages from saliva and the extraction sites, and all information was documented. All samples underwent 16S rDNA sequencing and amplicon analysis. RESULTS: Dry socket patients exhibited distinct oral microbial diversity and composition. Prevotella, Fusobacterium, and Haemophilus strongly associated with the occurrence of dry socket. The microbial profiles in saliva revealed clearer temporal changes and healing/dry socket distinctions. The microbial network in the saliva of patients with dry socket exhibited key node/edge differences between med/post stages. Random forest analysis using pre-extraction saliva microbes to predict post-extraction symptoms, achieving a 75% accuracy rate in identifying the healthy group. CONCLUSION: Haemophilus and Fusobacterium were key microbes in dry socket development and prediction. Functional changes caused by alterations in microbial composition and structure might have been the reason for the different symptoms observed after tooth extraction.