I would like to thank Dr. Lindner for his consideration of my article. While I am not aware of any studies that associate dental waterline biofilm with the incidence of alveolar osteitis, I am in complete agreement with him that dental unit water should not be used for the lavage of extraction sites in oral surgery.
I did not address that aspect of the procedure in my article because I hardly ever irrigate the socket using this protocol, and I had not changed the agent I use for irrigation in developing it. It has been my experience that, when the socket is packed with an absorbable gelatin sponge as a scaffold on which the clot will form, and the wound is sutured shut, it is virtually impossible for the clot to be lost.
In those rare instances that I do irrigate, it is done using a disinfectant oral rinse, as mentioned in the article. I use either Peridex (Zila Pharmaceuticals Inc., Phoenix; 0.12 percent chlorhexidine gluconate) or TheraSol (OralSolutions Inc., Strongsville, Ohio; 0.3 percent alkyl dimethyl amine oxide/alkyl dimethyl glycine) .
Thank you for this opportunity to reply to Dr. Lindner’s discerning remarks in JADA.
