Acute alveolar osteitis: Difference between revisions
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Revision as of 05:22, 29 March 2014
Background
- Osteomyelitis of alveolar bone d/t premature loss of healing clot after tooth extraction
Diagnosis
- Occurs 2-4d after tooth extraction
- Initial post-extraction pain subsides followed by sudden/severe pain at extraction site
- Physical exam often unremarkable
Differential Diagnosis
Dentoalveolar Injuries
Odontogenic Infections
- Acute alveolar osteitis (dry socket)
- Acute necrotizing ulcerative gingivitis (trench mouth)
- Dental abscess
- Periapical abscess
- Periodontal abscess
- Ludwig's angina
- Pulpitis (dental caries)
- Pericoronitis
- Peritonsillar abscess (PTA)
- Retropharyngeal abscess
- Vincent's angina - tonsillitis and pharyngitis
Other
Treatment
- Analgesia
- Often requires dental block
- Irrigate and suction
- Pack with ribbon gauze soaked with eugenol or local anesthetic
- Penicillin VK 500mg PO QID OR clindamycin 300mg PO QID
- Referral to dentist within 24hr
Source
- EBmedicine: Acute Dental Emergencies in Emergency Medicine
- Tintinalli