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The most common location of dry socket: in the socket of an extracted mandibular third molar (wisdom tooth). Since alveolar osteitis is not primarily an infection, there is not usually any pyrexia (fever) or cervical lymphadenitis (swollen glands in the neck), and only minimal edema (swelling) and erythema (redness) is present in the soft tissues surrounding the socket.
There is evidence that use of antibiotics before and/or after impacted wisdom tooth extraction reduces the risk of infections by 66%, and lowers incidence of dry socket by one third. For every 19 people who are treated with an antibiotic following impacted wisdom tooth removal, one infection is prevented. [19]
Socket preservation or alveolar ridge preservation is a procedure to reduce bone loss after tooth extraction. [ 1 ] [ 2 ] After tooth extraction, the jaw bone has a natural tendency to become narrow , and lose its original shape because the bone quickly resorbs , resulting in 30–60% loss in bone volume in the first six months. [ 3 ]
A Cochrane investigation found that the use of antibiotics either just before or just after surgery reduced the risk of infection, pain and dry socket after wisdom teeth are removed by oral surgeons, but that using antibiotics also causes more side effects for these patients. Nineteen patients needed to receive antibiotics to prevent one infection.
Wisdom teeth (often notated clinically as M3 for third molar) have long been identified as a source of problems and continue to be the most commonly impacted teeth in the human mouth. Impaction of the wisdom teeth results in a risk of periodontal disease and dental cavities. [29] Impacted wisdom teeth lead to pathology in 12% of cases. [30]
Historically, osteomyelitis of the jaws was a common complication of odontogenic infection (infections of the teeth). Before the antibiotic era, it was frequently a fatal condition. [1] Former and colloquial names include Osteonecrosis of the jaws (ONJ), cavitations, dry or wet socket, and NICO (Neuralgia-Inducing Cavitational osteonecrosis).
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After extraction of a tooth, the clot in the alveolus fills in with immature bone, which later is remodeled into mature secondary bone. Disturbance of the blood clot can cause alveolar osteitis, commonly referred to as "dry socket". With the partial or total loss of teeth, the alveolar process undergoes resorption.
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