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)
- Unpleasant taste or odour from the affected area
- Swelling (occasionally)
Initial management
Recommend optimal analgesia (see Appendix 2).
Advise the patient to avoid smoking and maintain good oral hygiene.
Advise the patient to seek urgent dental care.
Subsequent care
Consider:
- Irrigating with saline*.
- Applying a suitable material to dress the socket, e.g. Alvogyl.
Do not prescribe antibiotics unless there are signs of spreading infection, systemic infection, or for an immunocompromised patient.
* Note that chlorhexidine has been reported as a very rare but potentially serious cause of allergic reaction when used for dry socket irrigation. As there is no evidence in favour of its use for treatment of dry socket, it is not recommended.