Dry Socket, also known as dento-alveolar osteitis,
alveolar osteitis, alveolitis, focal osteomyelitis without
suppuration, alveolalgia, alveolitis sicca dolorosa and
alveolar periostitis, is a well-recognised complication
of tooth extraction.
It is characterised by increasingly severe pain in and around
the extraction site usually starting on the 2 – 4 post-
operative day and can last for 10 – 40 days.
The pain radiates typically to the ear. The normal post-
extraction blood clot is absent from the tooth socket; the
bony walls of the socket are bare and exquisitely sensitive
to even gentle probing. Bad breath and an unpleasant
taste in the mouth are invariably present.
The condition probably arises as a result of a complex
interaction between surgical trauma, local bacterial infection
and various systemic factors.
The incidence rate probably lies somewhere between 3 -
20% of all extractions with lower pre-molar and molar
sockets most commonly involved.
|Prevention & Management of
- Extraction of ‘wisdom teeth’ especially impacted
- Traumatic & difficult extractions.
- Oral / depot contraception.
- Immunosuppressant drugs such as steroids,
cyclosporine & methotrexate.
- Active / recent history of Acute Ulcerative Gingivitis
(‘Trench Mouth’) or Pericoronitis (infection /
inflammation around the crown of a tooth) associated
with the tooth to be extracted.
- Smoking (> 20 cigarettes per day).
- Increased bone density either locally or generally (eg.
Paget’s Disease & Osteopetrosis).
- Previous history of ‘dry sockets’ following extractions.
|Last Updated 5th December 2014