MDM - Dry Socket Syndrome

[##]-year-old [male/female] with [dental pain] with history and exam consistent with likely alveolar osteitis (dry socket syndrome) of the [location].

Initial considerations in this patient included anterior and acute alveolar osteitis (“dry socket”), dental fracture, subluxation, and avulsion, bleeding dental socket, and various dental infections among others.

Patient presented [## hours/days] from extraction of [describe tooth] with report of severe pain after initial improvement.  On exam the patient was noted to have evidence of dislodged clot [and exposed socket] at the extraction site.  The socket was gently irrigated and packed with iodoform gauze soaked in eugenol (oil of clove).  No evidence of purulent drainage from the extraction site, significant swelling of the gingiva, fever, or other findings suggestive of fever at this time.

Pain well controlled in the ED with [NSAIDs/opioids] prior to discharge.  Prior to discharge, we discussed return precautions for evidence of worsening infection, treatment with analgesics, [dry socket paste/Eugenol and] prophylactic initiation of antibiotics [Penicillin VK/Clindamycin], and follow up with Dental in 24-48 hours, and the patient demonstrated understanding and agreement.