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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.
Pericoronitis is inflammation of the soft tissues surrounding the crown of a partially erupted tooth, [1] including the gingiva (gums) and the dental follicle. [2] The soft tissue covering a partially erupted tooth is known as an operculum, an area which can be difficult to access with normal oral hygiene methods.
This epulis contains giant cells and is usually found on the gum margin between teeth which are anterior to the permanent molars. [13]: 317 The development of a giant cell epulis may be related to the recent loss of baby teeth, extraction or trauma. [13]: 319 The swelling is round, soft and commonly maroon or purplish in colour.
Typically the tooth is lifted using an elevator, and using dental forceps, specific tooth movements are performed (e.g. rocking the tooth back and forth) expanding the tooth socket. Once the periodontal ligament is broken and the supporting alveolar bone has been adequately widened the tooth can be removed.
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.
Putting pressure or warmth on the tooth may induce extreme pain. The area may be sensitive to touch and possibly swollen as well. This swelling may be present at either the base of the tooth, the gum, and/or the cheek, and sometimes can be reduced by applying ice packs. An acute abscess may be painless but still have a swelling present on the gum.
After stabilizing the patient's airway, extracting the infected tooth will typically promote adequate drainage and the infection will resolve shortly thereafter. If the infection involves multiple primary spaces or any of the secondary spaces previously mentioned, then incision and drainage with culture-guided antibiotics may be indicated.
It is a type of dental abscess. A periodontal abscess occurs alongside a tooth, and is different from the more common [2] periapical abscess, which represents the spread of infection from a dead tooth (i.e. which has undergone pulpal necrosis). To reflect this, sometimes the term "lateral (periodontal) abscess" is used.
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