Acute alveolar osteitis (dry socket)

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Background

  • Osteomyelitis of alveolar bone due to premature loss of healing clot after tooth extraction

Clinical Features

  • Exposed bone with no clot in extraction site

Differential Diagnosis

Dentoalveolar Injuries

Odontogenic Infections

Other

Evaluation

  • Occurs 2-4d after tooth extraction
  • Initial post-extraction pain subsides followed by sudden/severe pain at extraction site
  • Physical exam often unremarkable

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

Authors

Michael Holtz