Alveolar osteitis

Editor-In-Chief: Prab R Tumpati, MD
Obesity, Sleep & Internal medicine
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W8MD medical weight loss NYC and sleep center NYC

Alveolar osteitis
Synonyms	Dry socket
Pronounce	N/A
Specialty	N/A
Symptoms	Severe pain, bad breath, unpleasant taste
Complications	Delayed healing, infection
Onset	1-3 days after tooth extraction
Duration	5-10 days
Types	N/A
Causes	Dislodgement of blood clot, bacterial infection
Risks	Smoking, oral contraceptive use, traumatic extraction
Diagnosis	Clinical examination
Differential diagnosis	Osteomyelitis, Pericoronitis, Trigeminal neuralgia
Prevention	Avoid smoking, follow post-extraction care instructions
Treatment	Pain management, medicated dressings
Medication	N/A
Prognosis	N/A
Frequency	1-5% of routine extractions, up to 30% of impacted mandibular third molars
Deaths	N/A

Alveolar osteitis

Alveolar Osteitis

Alveolar osteitis, commonly known as dry socket, is a painful dental condition that can occur after a tooth extraction, particularly the extraction of mandibular third molars (wisdom teeth). It is characterized by the inflammation of the alveolar bone and the loss of the blood clot that normally forms in the socket after a tooth is removed.

Pathophysiology

After a tooth extraction, a blood clot forms in the socket to protect the underlying bone and nerves as the area heals. In alveolar osteitis, this blood clot is dislodged or dissolves before the wound has healed, exposing the bone and nerves to air, food, and fluids. This exposure can lead to severe pain and delayed healing. The exact cause of the clot loss is not fully understood, but several factors may contribute, including:

• Bacterial infection
• Trauma to the extraction site
• Poor oral hygiene
• Smoking or tobacco use
• Use of oral contraceptives

Symptoms

The primary symptom of alveolar osteitis is severe pain that typically begins 1 to 3 days after the tooth extraction. The pain may radiate to the ear, eye, temple, or neck on the same side as the extraction. Other symptoms may include:

• Bad breath or a foul taste in the mouth
• Visible bone in the socket
• Swelling of the gums or face

Diagnosis

Diagnosis of alveolar osteitis is primarily clinical, based on the patient's symptoms and examination of the extraction site. The dentist or oral surgeon will look for signs of an empty socket with exposed bone and may note the absence of a blood clot.

Treatment

Treatment of alveolar osteitis focuses on pain management and promoting healing. Common treatments include:

• Flushing the socket to remove debris
• Packing the socket with medicated dressings
• Prescribing pain relief medications
• Advising on proper oral hygiene and care

Prevention

Preventive measures can reduce the risk of developing alveolar osteitis. These include:

• Following post-extraction care instructions carefully
• Avoiding smoking and tobacco use
• Maintaining good oral hygiene
• Avoiding vigorous rinsing or spitting for the first 24 hours after extraction

Related Pages

• Tooth extraction
• Wisdom teeth
• Oral surgery
• Dental pain