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Acute alveolar osteitis
From WikEM
Contents
Background
- Also known as "Dry socket"
- Caused by premature loss of healing clot in the alveolar socket after tooth extraction[1]
- Occurs 2-4d after tooth extraction
- Initial post-extraction pain subsides followed by sudden/severe pain at extraction site
Clinical Features
- Postoperative pain at site of recent tooth extraction
Differential Diagnosis
Dentoalveolar Injuries
Odontogenic Infections
- Dental caries (pulpitis)
- Ludwig's angina
- Periapical abcess
- Periodontal abscess
- Peritonsillar Abscess (PTA)
- Retropharyngeal abscess
- Trench Mouth (Acute Necrotizing Ulcerative Gingivitis)
- Vincent's angina - tonsillitis and pharyngitis
- Acute alveolar osteitis
Other
- Scurvy
- Gingival hyperplasia
- Phenytoin
- Cyclosporine
- Nifedipine, Amlodipine
- Leukemia
Evaluation
- Clinical diagnosis
- Exposed bone with no clot in extraction site
Management
- Analgesia (often requires dental block)
- Irrigate and suction
- Pack with iodoform ribbon gauze soaked with eugenol (oil of cloves) or local anesthetic
- Penicillin VK 500mg PO QID OR clindamycin 300mg PO QID
Disposition
- Discharge with dental follow-up within 24 hours
See Also
References
- ↑ Kolokythas A, Olech E, Miloro M. Alveolar Osteitis: A Comprehensive Review of Concepts and Controversies. International Journal of Dentistry. 2010; 2010: 249073. doi:10.1155/2010/249073
Authors
Kevin Lu, Neil Young, Amanda Alberino, Ross Donaldson, Michael Holtz, Jordan Swartz, Claire
