II. Epidemiology

  1. Complicates 5-20% of Tooth Extractions

III. Pathophysiology

  1. Blood clot is lost prematurely at the extraction site
  2. Painful, localized Bone Infection at the extraction site

IV. Risk Factors

  1. Posterior mandibular teeth
  2. Advanced age
  3. Tobacco Smoking
  4. Poor Oral Hygiene

V. Symptoms

  1. Precautions
    1. Trismus is not typically present
      1. Consider alternative diagnosis (e.g. dental abscess)
  2. Severe Dental Pain
    1. Onset 3-4 days after Tooth Extraction (delayed beyond typical post-extraction pain)
    2. Not relieved with Acetaminophen and NSAIDS
  3. Halitosis

VI. Management

  1. Anesthetize the area
    1. See Inferior Alveolar Block
    2. See Periapical Block (Supraperiosteal Dental Anesthesia)
  2. Protect the socket
    1. Flush the socket with saline
    2. Apply Dry Socket paste
  3. Course
    1. Expect pain improvement within 20 minutes of applying paste
    2. Paste typically lasts for 5 days, but reapplication may be needed sooner
  4. Additional Measures
    1. Analgesics
    2. Antibiotics may be indicated

VII. References

  1. Broderick and Deak (2015) Crit Dec Emerg Med 29(1): 2-8

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Related Studies

Ontology: Alveolar periostitis (C0013240)

Definition (MSH) A condition sometimes occurring after tooth extraction, particularly after traumatic extraction, resulting in a dry appearance of the exposed bone in the socket, due to disintegration or loss of the blood clot. It is basically a focal osteomyelitis without suppuration and is accompanied by severe pain (alveolalgia) and foul odor. (Dorland, 28th ed)
Concepts Disease or Syndrome (T047)
MSH D004368
ICD9 526.5
ICD10 K10.3 , M27.3
SnomedCT 196467004, 196466008, 196465007, 61804006, 251331003, 12033006
English Dry Socket, Dry Sockets, Socket, Dry, Sockets, Dry, Alveolitis of jaw NOS, Alveolar Osteitides, Alveolar Osteitis, Alveolar Periostitides, Alveolar Periostitis, Alveolitis Sicca Dolorosa, Alveolitis of jaws, Osteitides, Alveolar, Osteitis, Alveolar, Periostitides, Alveolar, Periostitis, Alveolar, Dry socket NOS, alveolitis of jaw (diagnosis), alveolitis of jaw, dry socket alveolitis of jaw (diagnosis), dry socket alveolitis of jaw, Dry Socket [Disease/Finding], tooth dry socket, alveolar osteitis, dry socket, alveolitis sicca dolorosa, dry sockets, dry tooth socket, dry socket tooth, Alveolitis of jaw NOS (disorder), Dry tooth socket (disorder), periostitis alveolar, Alveolar periostitis (diagnosis), Alveolar osteitis, Alveolitis of jaw, Dry socket, Alveolitis sicca dolorosa, Dry tooth socket, Alveolar periostitis (disorder), Alveolitis of jaw (disorder), Alveolar periostitis, dry; socket, jaw; alveolitis, osteitis; alveolar, periostitis; alveolar, alveolar; osteitis, alveolar; periostitis, alveolitis; jaw, socket; dry, Alveolitis of jaw, NOS
Swedish Torr tandhåleinflammation
Dutch alveolitis van kaak, droge holte, alveolaire ostitis, droge holte NAO, alveolair; osteïtis, alveolair; periostitis, alveolitis; kaak, droog; tandkas, kaak; alveolitis, osteïtis; alveolair, periostitis; alveolair, tandkas; droog, Alveolitis van onderkaak en bovenkaak, Alveolaire osteitis, Alveolaire periostitis, Alveolitis, Alveolitis sicca dolorosa, Dry socket, Osteitis, alveolaire, Periostitis, alveolaire, Tandkasontsteking
French Alvéolite de la mâchoire, Alvéolite dentaire SAI, Alvéolite dentaire sèche, Alvéolite sèche, Alvéolite, Ostéite alvéolaire
German alveolare Osteitis, trockene Zahnalveole, trockene Zahnalveole NNB, Alveolitis des Kiefers, Alveolitis der Kiefer, Alveolitis sicca dolorosa, Trockene Alveole, Zahnfach, trockenes, Alveoläre Ostitis, Alveoläre Periostitis, Ostitis, alveoläre, Periostitis, alveoläre
Italian Cavità asciutta NAS, Alveolite della mascella, Cavità asciutta, Periostite alveolare, Alveolite secca dolorosa, Osteite alveolare, Alveolite post estrattiva
Portuguese Osteíte alveolar, Alveoalgia, Osteíte alveolar NE, Alveolite mandibular, Alveolite, Alveolite Seca Dolorosa, Alvéolo Seco, Osteite Alveolar, Periostite Alveolar
Spanish Alveolo seco, Alveolitis mandibular, Alveolo seco NEOM, Osteitis alveolar, Alveolo Seco, Osteítis Alveolar, alveolitis mandibular, SAI, alveolitis mandibular, SAI (trastorno), Alveolitis, alveolitis de mandíbula (trastorno), alveolitis de mandíbula, alveolitis seca dolorosa, manguito seco, osteítis alveolar, periostitis alveolar (trastorno), periostitis alveolar, Alveolitis Seca Dolorosa, Periostitis Alveolar
Japanese アゴノシソウエン, ドライ・ソケットNOS, 歯槽骨炎, シソウコツエン, 顎の歯槽炎, ドライソケット, ドライ・ソケット, ドライソケットNOS, 乾燥抜歯窩, 歯槽痛, ドライソケット, 感染抜歯窩
Czech suché zubní lůžko, Suchá zubní jamka NOS, Alveolární osteitida, Suchá zubní jamka, Alveolitida čelisti, alveolitis sicca, alveolární ostitis, suchá alveolitida
Finnish Poistokuopan tulehdus
Russian AL'VEOLIT LUNOCHKOVYI POSTEKSTRAKTSIONNYI, AL'VEOLALGIIA, SUKHAIA AL'VEOLA, АЛЬВЕОЛАЛГИЯ, АЛЬВЕОЛИТ ЛУНОЧКОВЫЙ ПОСТЭКСТРАКЦИОННЫЙ, СУХАЯ АЛЬВЕОЛА
Korean 턱의 치조염
Polish Zębodół suchy, Zębodół pusty, Bóle poekstrakcyjne, Suchy zębodół
Hungarian Állkapocs alveolitise, alveolaris osteitis, alveolaris osteitis k.m.n.
Norwegian Alveolitt