Acute alveolar osteitis: Difference between revisions
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*Amsterdam JT: Oral Medicine, in Marx JA, Hockberger RS, Walls RM, et al (eds): Rosen’s Emergency Medicine: Concepts and Clinical Practice, ed 8. St. Louis, Mosby, Inc., 2013, (Ch) 70: p 901. Chapter 70. | |||
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Revision as of 17:43, 17 August 2015
Background
- Osteomyelitis of alveolar bone d/t premature loss of healing clot after tooth extraction
Clinical Features
- Exposed bone with no clot in extraction site
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
Diagnosis
- Occurs 2-4d after tooth extraction
- Initial post-extraction pain subsides followed by sudden/severe pain at extraction site
- Physical exam often unremarkable
Management
- Analgesia (often requires dental block)
- Irrigate and suction
- Pack with iodoform ribbon gauze soaked with eugenol (oil of cloves) or local anesthetic
- Penicillin VK 500mg PO QID OR clindamycin 300mg PO QID
Disposition
- Discharge with dental follow-up within 24 hours
See Also
References
- Amsterdam JT: Oral Medicine, in Marx JA, Hockberger RS, Walls RM, et al (eds): Rosen’s Emergency Medicine: Concepts and Clinical Practice, ed 8. St. Louis, Mosby, Inc., 2013, (Ch) 70: p 901. Chapter 70.