Dental extractions are performed very frequently, although like any treatment, they may involve some risk.
Alveolitis is a postoperative complication derived from an extraction, and although it does not have a high incidence in the general population, there are certain factors that increase the likelihood of suffering it.
In this article, we will explain exactly what alveolitis consists of, as well as the best way to treat and prevent it.
What is alveolitis and why does it occur?
Dental alveolitis is a localized, reversible infection that can occur 24 to 72 hours after a tooth has been extracted.
Although this complication does not necessarily occur, it occurs more frequently in people who have had a retained wisdom tooth extracted.
According to the Revista Española de Cirugía Oral y Maxilofacial (Spanish Journal of Oral and Maxillofacial Surgery), after an exodontia, a blood clot usually forms in the cavity left by the tooth: the alveolus.
This is the cavity in which each of the teeth is housed.
The clot serves as protection, but if it does not form or breaks up after it has formed, after three days, the alveolus is exposed.
The disintegration of the clot occurs due to the lack of blood vessels in the process of alveolitis.
The alveolus becomes more vulnerable to attack by bacteria or any external agent, causing pain and inflammation in the tissue.
This is why alveolitis is characterized by severe pain in the alveolus that forces the patient to go immediately to a dental clinic.
Incidence of dental alveolitis in the population
Alveolitis is the most common complication of tooth extraction.
In fact, according to data published in the European Journal of Odontostomatology, the incidence varies from 1 to 4%.
However, in the case of a wisdom tooth, this percentage ranges from 20 to 30%, i.e. ten times more than in other extractions.
Parts of the tooth
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ALVEOLAR BONE
What types of dental alveolitis are there?
Within alveolitis, we can distinguish between two types according to their symptoms.
Dry alveolitis
In this type of infection, the alveolus is empty and open, that is, there is no blood clot.
Therefore, the bone in the cavity is visible to the naked eye and generates a very sharp pain that intensifies when chewing.
Wet alveolitis
In the case of wet alveolitis, on the other hand, the alveolus does have an accumulation of blood, which is usually very dark in color.
When a person suffers from this type of infection, the pain is not as severe.
Smoking, age and the use of oral contraceptives are risk factors for developing dry alveolitis.
What are the symptoms?
Patients who develop alveolitis experience a very localized affliction, particularly in the area where the extraction has taken place.
At first, they feel a slight discomfort, and then they experience a slight improvement, but then a worsening with acute pain.
Dry alveolitis appears between the second and fourth day after the intervention, so its diagnosis is not immediate.
Other symptoms that accompany this process are a bad taste in the mouth and halitosis.
How do I know if the pain I have is “normal”?
After the extraction of a tooth or molar, it is normal to feel a certain degree of pain or discomfort in the wound produced during the intervention.
To know if the pain you feel is “normal”, you should take into account two aspects:
They are tolerable with the use of analgesic medication prescribed by the surgeon who has carried out the exodontia.
They occur during the first 48 hours and diminish as the days go by.
However, if this pain is not controllable with analgesic medication – for example, it does not allow the patient to sleep – and increases after 48 hours, there is a possibility that alveolitis has developed.
Can dental alveolitis be prevented?
As with other oral conditions, the best weapon against dry socket disease is prevention.
Therefore, when trying to prevent it, it is important to know the risk factors that can trigger it.
This information will help us to follow appropriate habits both before and after tooth or molar extraction.
But, in addition, it will also be useful to understand the need to transmit to the dentist who performs the extraction certain aspects about our situation or life habits.
Choose a good dentist
Since the dentist’s experience plays a fundamental role, we recommend that you look for a professional who is very experienced in performing dental extractions.
Alveolitis risk factors
Age and sex of the patient
An older person is more likely to develop dental alveolitis than a younger patient.
In addition, women may have a greater predisposition to develop it, as indicated by a study published in the Electronic Medical Journal.
To carry it out, different doctors analyzed 140 patients who presented alveolitis after an extraction.
The age group 35 to 59 years accounted for 5.72 % and 60 % were women.
Difficulty of extraction
The chances of developing alveolitis increase when it is necessary to perform a surgery in which a lot of tissue has to be manipulated, rather than a simple extraction.
Hence, surgery to extract impacted or impacted teeth involves a higher risk for the patient.
Retained wisdom tooth
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IMPACTED WISDOM TOOTH
A report published in The Journal of Contemporary Dental Practice states that surgical intervention increases the chances of suffering this complication.
The data obtained in the study is based on 838 extractions performed on 469 patients.
The findings indicate that the prevalence of dry socket after simple extractions was 3.2%, while the prevalence after surgical extractions was 20.1%.
Surgical trauma
Increased trauma during extraction surgery hinders and delays alveolar healing.
This damage to the area may be associated with the inexperience of the dentist or surgeon.
A professional with many extractions behind him/her knows how to perform the intervention causing the least possible trauma.
Previous infections
A person who has had periodontal diseases -periodontitis-, as well as other infectious processes such as pericoronaritis, has a greater predisposition to have alveolitis.
Use of oral contraceptives
Oral contraceptives have numerous side effects for women who take them.
Despite the fact that their hormonal load has been reduced, their intake is still associated with various complications related to dental treatments.
This is indicated by the Spanish Society of Implants, whose researchers assure that they favor the appearance of alveolitis, periodontal problems and alterations in the healing of the mucosa.
This is due to the fact that the composition of contraceptive pills hinders the correct formation of the blood clot.
Lack of hygiene
Poor oral hygiene leads to numerous oral diseases, including dental alveolitis.
Although dentists give general advice, there are specific guidelines for after an extraction.
You can rinse your mouth gently and brush your teeth, but avoid the damaged area for the first 24 hours.
Even so, each surgeon will give specific instructions for each person.
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Smoking
Tobacco smoke contains a large amount of polluting and harmful components that damage our oral and general health.
It delays the healing and the healing process of the alveolus, even in cases of simple exodontia, and smoke prevents the correct formation of the clot.
Therefore, it is advisable to eliminate, or at least reduce, cigarette smoking before and after surgery.
Wisdom tooth extraction
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EXTRACTION OF A TOOTH
Treatments against dry or wet alveolitis
As we have previously indicated, the acute pain caused by alveolitis makes it almost impossible not to go to a dental clinic.
Once there, it will be the professional who will diagnose this complication in order to proceed to clean the alveolus with serum.
In this way, he will sanitize the area and eliminate any residue that has remained lodged.
In addition, it will be necessary to prescribe medication: analgesics to combat pain, antibiotics to cure the infection and anti-inflammatory drugs to reduce swelling.
After treatment at the dental clinic, the dentist may also prescribe the use of a chlorhexidine mouthwash.
The entire healing process usually takes about 10 to 15 days.
As you can see, alveolitis does not present serious complications, but it is an annoying and painful process whose healing requires treatment and waiting a few days.
This is why prevention remains the best weapon to fight against this uncomfortable oral condition.
You will be interested in ” What is the treatment for a dental phlegmon?
Bibliographic references
At DrAW Clinic we are guided by editorial guidelines that ensure the veracity of all the information we publish. If you would like to know more about how we ensure that our content is up-to-date and properly supported, we encourage you to read our editorial commitment.
Vergara Buenaventura, A. Spanish Journal of Oral and Maxillofacial Surgery. Dry alveolitis: a review of the literature. 2014. Vol. 36. No. 4. pages 169-173. (https://www.elsevier.es/es-revista-revista-espanola-cirugia-oral-maxilofacial-300-articulo-alveolitis-seca-una-revision-literatura-S1130055814000604)
European Journal of Odontostomatology. Systemic review: complications in 3rd molar extractions. 2014. (http://www.redoe.com/ver.php?id=146)
Leon. V, Hernández, C., Gómez, I., Clausell, M., Porras, D. Electronic Medical Journal. Frequency of dental alveolitis and factors that characterize it. 2016. vol.38 no.1 Matanzas Jan.-Feb.
