Alveolitis

Alveolitis is an inflammatory condition of the alveolar bone and socket that can occur after tooth extraction, commonly referred to as dry socket. It typically involves disruption or loss of the blood clot that forms in the extraction site, leading to exposure of bone and surrounding tissue irritation.

Most cases arise a few days after extraction, usually within 2 to 4 days. Potential causes include failure of clot formation or retention, bacterial contamination, traumatic or difficult extractions, and inadequate socket protection. Risk factors include smoking, poor oral hygiene, complex or traumatic extractions, a history of dry socket, and, in some reports, hormonal factors.

Symptoms commonly include severe, throbbing pain that worsens over time, often accompanied by an empty-looking socket with exposed bone, foul breath or taste, mild swelling, and tenderness in the surrounding tissues. Diagnosis is clinical, based on symptoms and examination; imaging is not routinely required unless there is concern for other conditions such as osteomyelitis or a fractured jaw.

Management focuses on pain relief and promoting healing. This may involve irrigation or gentle debridement of the socket, placement of a medicated dressing (for example a zinc oxide–eugenol or similar dressing), and ongoing analgesia. Antibiotics are reserved for signs of infection, systemic illness, or high-risk situations. Patients are advised to maintain oral hygiene, avoid disturbing the clot, and follow up with their dental professional.

Prevention emphasizes atraumatic extraction techniques, adequate hemostasis, avoiding tobacco use for at least 48 to 72 hours, and adhering to postoperative care instructions such as gentle rinsing with saline or antiseptic mouthwash as advised.

Prognosis is generally favorable with appropriate care, with symptoms typically improving within one to two weeks. The condition is usually self-limited but can recur in susceptible individuals.