Back to Basics - Alveolar Osteitis “Dry Socket”

Alveolar Osteitis  “Dry Socket” 


  • Follows tooth extraction (2-3 days later) 
  • Loss of post-procedure blood clot in socket
  • Associated risks pre-procedure tooth infection, poor oral hygiene, smoking, OCPs, using a straw
  • Higher incidence is mandibular posterior sockets 
  • Severe pain, halitosis, trismus 



  • Local dental anesthesia 

See a previous EM daily post for a refresher on Dental Blocks! Click here

  • NSAIDs > opiates 
  • Gentle irrigation w/ warm normal saline or chlorhexidine rinse 
  • Pack socket w/ dental paste (ie Coe-pak) to prevent exposure to air 
  • Dental referral in 24-48hrs 



1) Beaudreau, Ronald W.. "Oral and Dental Emergencies." Tintinalli’s Emergency Medicine: A Comprehensive Study Guide, 8e Eds. Judith E. Tintinalli, et al. New York, NY: McGraw-Hill, 2016

2) Fernandes, Gabriela Jude,B.D.S., M.S., and Hatton, Michael N,D.D.S., M.S. "Prevention of Alveolar Osteitis." New York State Dental Journal 82.1 (2016): 21-5. ProQuest. Web. 24 Nov. 2019.