A patient returns with pain 72 hours after extraction. What is the appropriate response?

• A. Tell them it's normal to still feel pain
• B. Irrigate and place eugenol-soaked gauze
• C. Open the wound and curette any remaining bone pieces
• D. Refer them to the emergency room

Answer: (B)

The correct approach is to irrigate and place eugenol-soaked gauze. After a dental extraction, it is common for patients to experience some level of discomfort, but persistent pain 72 hours post-extraction can indicate a complication such as dry socket or an infection.

Irrigation can help clean the extraction site and ensure that no food particles or debris are causing irritation. Adding eugenol-soaked gauze serves a dual purpose: eugenol has analgesic properties that can help alleviate pain, and placing gauze can protect the site while promoting healing. This approach addresses the patient's discomfort pragmatically while managing the potential for complications effectively.

Other responses do not appropriately address the patient's ongoing pain. Simply telling the patient that it's normal does not consider the possibility of complications that need attention. Opening the wound could potentially exacerbate the situation by introducing more bacteria or causing further trauma to the site. Referring the patient to the emergency room may be necessary in more severe cases, but immediate management of the extraction site is often more effective and appropriate in this context.