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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]
Wisdom teeth become impacted when there is not enough room in the jaws to allow for all of the teeth to erupt into the mouth. Because the wisdom teeth are the last to erupt, due to insufficient room in the jaws to accommodate more teeth, the wisdom teeth become stuck in the jaws, i.e., impacted. There is a genetic predisposition to tooth impaction.
Tooth #5, the upper right second premolar, after extraction. The two single-headed arrows point to the CEJ, which is the line separating the crown (in this case, heavily decayed) and the roots. The double headed arrow (bottom right) shows the extent of the abscess that surrounds the apex of the palatal root.
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]
The development of lesions is most frequent after invasive dental procedures, such as extractions, and is also known to occur spontaneously. There may be no symptoms for weeks or months, until lesions with exposed bone appear. [5] Lesions are more common on the mandible than the maxilla. Pain and neuropathy [6] Erythema and suppuration; Bad breath
Alveolar osteitis is a complication of tooth extraction (especially lower wisdom teeth) in which the blood clot is not formed or is lost, leaving the socket where the tooth used to be empty, and bare bone is exposed to the mouth. [29] The pain is moderate to severe, and dull, aching, and throbbing in character.
Ludwig's angina (Latin: Angina ludovici) is a type of severe cellulitis involving the floor of the mouth [2] and is often caused by bacterial sources. [1] Early in the infection, the floor of the mouth raises due to swelling, leading to difficulty swallowing saliva.
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