Alveolar osteitis (dry socket)
Brief description of the condition
Osteitis (inflammation) of a socket after a tooth is extracted, most common after molar extraction. Patients who smoke are more at risk of this condition.
Key signs and symptoms
- Pain (onset 24-48 hours after extraction; in vicinity of extraction site; tenderness of alveolar socket wall)
- Absence of a clot/soft tissue within the socket
- Unpleasant taste or odour from the affected area
- Swelling (occasionally)
Initial management
Recommend optimal analgesia (see Analgesia).
Advise the patient to avoid smoking, maintain good oral hygiene and rinse with salt water mouthwash (avoid rinsing on the day of the extraction).
Advise the patient to seek urgent dental care.
Subsequent care
Consider:
- Irrigating with saline*.
- Applying a suitable material to dress the socket (e.g. Alveogyl).34
- Using local anaesthetic to manage pain in severe cases.
Do not prescribe antibiotics unless there are signs of spreading infection, systemic infection, or judged appropriate for an immunocompromised patient.
Subsequent care
Consider:
- Irrigating with saline*.
- Applying a suitable material to dress the socket (e.g. Alveogyl).34
- Using local anaesthetic to manage pain in severe cases.
Do not prescribe antibiotics unless there are signs of spreading infection, systemic infection, or judged appropriate for an immunocompromised patient.