Onset: 1-3 days after extraction of a molar, especially a third molar
Duration: 1-6 weeks
Features of delayed healing of the socket:
(1) empty socket with exposed bone without epitheliazation
(2) inflammation without suppuration
(3) tenderness to palpation
(4) a foul odor or necrotic granulation tissue may or may not be present
If a person with delayed healing of the socket has severe radiating pain (often to the ear), then the diagnosis is alveolar osteitis.
Differential diagnosis - infected socket with or without osteomyelitis:
(1) fever
(2) swelling and purulent discharge
(3) eventual diagnostic changes in X-rays
Recommendations of Swanson (1990) to prevent:
(1) preoperative mouthrinsing with 0.2% chlorhexidine gluconate
(2) lavage of the socket site after extraction with 175 mL of sterile normal saline
(3) dress the socket with gelatin sponge with tetracycline
