Alveolar osteitis, also known as dry socket, is commonly reported 1-5 days after a tooth extraction. Patients report severe pain at or near the socket from which the tooth was extracted. The pain may radiate, and halitosis may be noted.

The etiology is not completely understood, but alveolar osteitis is thought to be caused by early breakdown of the socket's blood clot, with total or partial loss of the clot. Loss of the blood clot may be due to premature fibrinolytic dissolution. In some cases, the clot does not form properly. The absence of a blood clot leaves the alveolar bone and the nerves of the socket exposed.

This condition is self-limiting. Resolution is within a few days of treatment. There are no expected complications from alveolar osteitis.

Conflicting reports exist, but females may be at greater risk. Tobacco use, oral contraceptive use, difficult extraction, poor oral hygiene, periodontal disease, pericoronitis, and previous alveolar osteitis are also risk factors for occurrence.

Alveolar osteitis occurs in approximately 1%-5% of all tooth extractions. Incidence is up to 30% for the mandibular third molars, the commonly extracted wisdom teeth.