II. Complications

  1. Immediate Periosteitis
    1. Initial post-Tooth Extraction pain due to socket inflammation
    2. Occurs in the first day after extraction and improves with NSAIDs
  2. Dry Socket (Alveolar Periostitis)
    1. Onset 3-4 days after Tooth Extraction
    2. Blood clot is lost prematurely at the extraction site
    3. Painful, localized bone infection at the extraction site
  3. Prolonged bleeding
    1. Apply direct pressure to area by biting on gauze or tea bag (Tranexamic Acid)
    2. Surgical collagen foam may be used in refractory cases
      1. Insert foam in socket and Suture the socket closed over the top

III. Management: Dry Socket

  1. Anesthetize the area
    1. See Inferior Alveolar Block
    2. See Periapical Block (Supraperiosteal Dental Anesthesia)
  2. Protect the socket
    1. Flush the socket with saline
    2. Apply Dry Socket paste
  3. Course
    1. Expect pain improvement within 20 minutes of applying paste
    2. Paste typically lasts for 5 days, but reapplication may be needed sooner

IV. References

  1. Broderick and Deak (2015) Crit Dec Emerg Med 29(1): 2-8

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Ontology: Alveolar periostitis (C0013240)

Definition (MSH) A condition sometimes occurring after tooth extraction, particularly after traumatic extraction, resulting in a dry appearance of the exposed bone in the socket, due to disintegration or loss of the blood clot. It is basically a focal osteomyelitis without suppuration and is accompanied by severe pain (alveolalgia) and foul odor. (Dorland, 28th ed)
Concepts Disease or Syndrome (T047)
MSH D004368
ICD9 526.5
ICD10 K10.3 , M27.3
SnomedCT 196467004, 196466008, 196465007, 61804006, 251331003, 12033006
English Dry Socket, Dry Sockets, Socket, Dry, Sockets, Dry, Alveolitis of jaw NOS, Alveolar Osteitides, Alveolar Osteitis, Alveolar Periostitides, Alveolar Periostitis, Alveolitis Sicca Dolorosa, Alveolitis of jaws, Osteitides, Alveolar, Osteitis, Alveolar, Periostitides, Alveolar, Periostitis, Alveolar, Dry socket NOS, alveolitis of jaw (diagnosis), alveolitis of jaw, dry socket alveolitis of jaw (diagnosis), dry socket alveolitis of jaw, Dry Socket [Disease/Finding], tooth dry socket, alveolar osteitis, dry socket, alveolitis sicca dolorosa, dry sockets, dry tooth socket, dry socket tooth, Alveolitis of jaw NOS (disorder), Dry tooth socket (disorder), periostitis alveolar, Alveolar periostitis (diagnosis), Alveolar osteitis, Alveolitis of jaw, Dry socket, Alveolitis sicca dolorosa, Dry tooth socket, Alveolar periostitis (disorder), Alveolitis of jaw (disorder), Alveolar periostitis, dry; socket, jaw; alveolitis, osteitis; alveolar, periostitis; alveolar, alveolar; osteitis, alveolar; periostitis, alveolitis; jaw, socket; dry, Alveolitis of jaw, NOS
Swedish Torr tandhåleinflammation
Dutch alveolitis van kaak, droge holte, alveolaire ostitis, droge holte NAO, alveolair; osteïtis, alveolair; periostitis, alveolitis; kaak, droog; tandkas, kaak; alveolitis, osteïtis; alveolair, periostitis; alveolair, tandkas; droog, Alveolitis van onderkaak en bovenkaak, Alveolaire osteitis, Alveolaire periostitis, Alveolitis, Alveolitis sicca dolorosa, Dry socket, Osteitis, alveolaire, Periostitis, alveolaire, Tandkasontsteking
French Alvéolite de la mâchoire, Alvéolite dentaire SAI, Alvéolite dentaire sèche, Alvéolite sèche, Alvéolite, Ostéite alvéolaire
German alveolare Osteitis, trockene Zahnalveole, trockene Zahnalveole NNB, Alveolitis des Kiefers, Alveolitis der Kiefer, Alveolitis sicca dolorosa, Trockene Alveole, Zahnfach, trockenes, Alveoläre Ostitis, Alveoläre Periostitis, Ostitis, alveoläre, Periostitis, alveoläre
Italian Cavità asciutta NAS, Alveolite della mascella, Cavità asciutta, Periostite alveolare, Alveolite secca dolorosa, Osteite alveolare, Alveolite post estrattiva
Portuguese Osteíte alveolar, Alveoalgia, Osteíte alveolar NE, Alveolite mandibular, Alveolite, Alveolite Seca Dolorosa, Alvéolo Seco, Osteite Alveolar, Periostite Alveolar
Spanish Alveolo seco, Alveolitis mandibular, Alveolo seco NEOM, Osteitis alveolar, Alveolo Seco, Osteítis Alveolar, alveolitis mandibular, SAI, alveolitis mandibular, SAI (trastorno), Alveolitis, alveolitis de mandíbula (trastorno), alveolitis de mandíbula, alveolitis seca dolorosa, manguito seco, osteítis alveolar, periostitis alveolar (trastorno), periostitis alveolar, Alveolitis Seca Dolorosa, Periostitis Alveolar
Japanese アゴノシソウエン, ドライ・ソケットNOS, 歯槽骨炎, シソウコツエン, 顎の歯槽炎, ドライソケット, ドライ・ソケット, ドライソケットNOS, 乾燥抜歯窩, 歯槽痛, ドライソケット, 感染抜歯窩
Czech suché zubní lůžko, Suchá zubní jamka NOS, Alveolární osteitida, Suchá zubní jamka, Alveolitida čelisti, alveolitis sicca, alveolární ostitis, suchá alveolitida
Finnish Poistokuopan tulehdus
Russian AL'VEOLIT LUNOCHKOVYI POSTEKSTRAKTSIONNYI, AL'VEOLALGIIA, SUKHAIA AL'VEOLA, АЛЬВЕОЛАЛГИЯ, АЛЬВЕОЛИТ ЛУНОЧКОВЫЙ ПОСТЭКСТРАКЦИОННЫЙ, СУХАЯ АЛЬВЕОЛА
Korean 턱의 치조염
Polish Zębodół suchy, Zębodół pusty, Bóle poekstrakcyjne, Suchy zębodół
Hungarian Állkapocs alveolitise, alveolaris osteitis, alveolaris osteitis k.m.n.
Norwegian Alveolitt

Ontology: Tooth Extraction (C0040440)

Definition (NCI) The surgical removal of a tooth from its bony socket.
Definition (MSH) The surgical removal of a tooth. (Dorland, 28th ed)
Definition (CSP) surgical removal of a tooth.
Concepts Therapeutic or Preventive Procedure (T061)
MSH D014081
ICD9 23.1
ICD10 458
SnomedCT 173284006, 307290002, 149005001, 173290005, 149003008, 148999009, 55162003
English Extraction, Tooth, Extractions, Tooth, Tooth Extractions, Extraction of tooth, S/R - Surg removal of tooth, S/R - Surgical removal of tooth, SR - Surgical removal of tooth, Extraction of Tooth, Surgical extraction of tooth, Surgical removal of tooth NOS, Xsurg - Surg removal of tooth, Xsurg - Surgical removal of tooth, Tooth removal NOS, tooth extraction (treatment), Tooth extraction NOS, tooth extraction, tooth removal, dental extraction, Extraction;tooth/teeth, dental extractions, extraction of tooth, exodontia, extracted tooth, tooth extractions, Tooth removal NOS (procedure), Surgical removal of tooth NOS (procedure), Surgical removal of tooth (procedure), Extraction of tooth (procedure), Teeth--Extraction, Exodontia procedure, Extn - Extraction of tooth, Extract tooth, Removal of tooth, X - Extraction of tooth, Xtn - Extraction of tooth, Exodontia, Tooth extraction, Tooth extraction (procedure), Tooth extraction, NOS, Exodontia procedure, NOS, Tooth Extraction, Surgical removal of tooth, Extraction of tooth NOS, tooth/teeth extraction
Italian Estrazione dentaria, Estrazione dentaria NAS, Estrazione dentale
Dutch tandextractie NAO, tandextractie, Extractie, tabd-, Tandextractie
French Extraction dentaire SAI, Extraction de dent, Avulsion de dent, Avulsion dentaire, Extraction dentaire
German Zahnextraktion NNB, Extraktion, Zahn-, Zahnextraktion
Portuguese Extracção dentária NE, Extracção dentária, Extração Dentária
Spanish Extracción dental NEOM, Extracción Dental, extracción de un diente, extracción de diente (procedimiento), extracción dental (procedimiento), extracción de diente, extracción dental, extracción quirúrgica de diente, SAI (procedimiento), remoción quirúrgica de diente, extracción quirúrgica de diente, SAI, extracción dental, SAI, extracción dental, SAI (procedimiento), remoción quirúrgica de diente (procedimiento), extracción quirúrgica de diente, Tooth removal NOS, Extracción Dentaria, procedimiento de exodoncia, Extracción dental
Japanese 抜歯NOS, 抜歯, バッシ, バッシNOS
Swedish Tandutdragning
Finnish Hampaanpoisto
Russian UDALENIE ZUBOV, ZUBOV EKSTRAKTSIIA, ЗУБОВ ЭКСТРАКЦИЯ, УДАЛЕНИЕ ЗУБОВ
Czech Extrakce zubu, Extrakce zubu NOS, extrakce zubů, zuby - extrakce
Croatian ZUB, EKSTRAKCIJA
Polish Usunięcie zęba, Ekstrakcja zęba
Hungarian Foghúzás, Foghúzás k.m.n.
Norwegian Tannuttrekking, Tannekstraksjon, Uttrekking av tenner