Alveolar osteitis
From Wikipedia, the free encyclopedia
In dentistry, a dry socket is a layman's term for alveolar osteitis, a disruption to the healing of the alveolar bone following extraction of the tooth.
Alveolar osteitis occurs when the blood clot at the site of a tooth extraction is disrupted prematurely. This leaves the alveolar bone unprotected and exposed to the oral environment. The socket can pack with food and bacteria. The pain typically commences 2-4 days following the extraction. This is often extremely unpleasant for the patient, as symptoms include extreme pain (sometimes worse than the toothache that indicated the extraction), a foul taste, bad breath, and swelling in the infected area. There may be lymph-node involvement.
Smokers have been shown to have a greatly increased risk of developing alveolar osteitis after tooth extraction. This is thought to be due to the decreased amount of oxygen available in the healing tissues as a result of carbon monoxide in tobacco smoke. It is advisable to avoid smoking following tooth extraction for at least 48 hours to reduce the risk of developing this "dry socket".
While this condition only seems to occur in 5-10% of extractions (primarily of the lower molar teeth) it seems that women are at higher risk than men for developing dry socket. Of the women that have developed it, the majority take an oral contraceptive. Dentists should recommend their female patients to have extractions during the last five days of their menstrual cycle to minimize chances of developing dry socket because the estrogen levels are lower during that part of the cycle.
Treatment for alveolar osteitis is mainly preventive. Dentists encourage maintaining good oral hygiene during the healing period. The blood clot should not be disturbed, and a warm salt water mouth rinse is often advised commencing 24 hours after the extraction. Once a patient develops dry socket, treatment is usually to debride (clean) the socket to remove any debris, and encourage new clot formation. This may be followed by packing the socket with some form of oral analgesic or anesthetic. Sometimes additional analgesics are prescribed. Gauze soaked in oil of cloves may also be placed in the socket to relieve toothache.
