Acute alveolar osteitis

Revision as of 21:01, 2 December 2021 by Rossdonaldson1 (talk | contribs)
(diff) ← Older revision | Latest revision (diff) | Newer revision → (diff)


  • Osteomyelitis of exposed bone. 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

Acute alveolar osteitis of a socket after tooth extraction of all maxillary teeth; note lack of blood clot in socket and exposed alveolar bone.
The most common location of acute alveolar osteitis: in the socket of an extracted mandibular third molar (wisdom tooth).
Dry socket
  • Postoperative pain at site of recent tooth extraction

Differential Diagnosis

Dentoalveolar Injuries

Odontogenic Infections



  • Clinical diagnosis
  • Exposed bone with no clot in extraction site


  • Analgesia (often requires dental block)
  • Irrigate but socket should not be curetted and any residual clot should not be removed
  • Pack with iodoform ribbon gauze soaked with eugenol (oil of cloves) or local anesthetic
  • If available, may use commercially available "dry socket paste"
  • Penicillin VK 500mg PO QID OR clindamycin 300mg PO QID


  • Discharge with dental follow-up within 24 hours

See Also


  1. 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