What is alveolitis?

Last updated on: 5 Aug, 2026

Tooth extraction is one of the most common procedures in dental practice. In most cases, the wound heals without complications, but sometimes recovery does not proceed as expected. One of the most common complications following tooth extraction is alveolitis – a painful inflammatory condition affecting the bone socket (alveolus) left after the tooth has been removed. 

The condition occurs in around 2–5% of extractions, but when lower wisdom teeth are removed, the percentage can rise significantly. Knowing the most common causes of alveolitis, the early signs and the appropriate measures to take is crucial for any patient who is due to have, or has already had, an extraction.

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What is alveolitis?

Alveolitis is an acute inflammation of the alveolus – the bony socket where the tooth was located before it was removed. Under normal circumstances, a blood clot forms in this cavity after extraction, serving a protective role. It covers the exposed bone and nerve endings, shielding them from bacteria and mechanical impact, and creating conditions for normal healing. 

When this clot fails to form, dissolves prematurely or is dislodged, the bone remains exposed and unprotected. This leads to severe pain, bacterial invasion and a delay in the healing process.

There are two main types of this complication. In dry alveolitis (alveolar osteitis), the alveolus is empty, with no clot, and the bone is covered with a brownish necrotic coating. There is no suppuration, but the pain is intense and throbbing. 

In wet alveolitis, a purulent discharge mixed with blood and a strongly unpleasant odour is observed in the alveolus. This variant is associated with a more pronounced infection and may be accompanied by a fever.

Causes

The causes of alveolitis are complex and often involve several risk factors occurring simultaneously. Understanding these helps both the patient and the dentist to take timely preventive measures.

Infections

The presence of an infection following extraction is one of the leading causes of complications. If a granuloma, periodontitis or other inflammation already exists in the area of the tooth prior to extraction, bacteria can spread into the alveolus and prevent the formation of a blood clot. 

Gum diseases such as periodontitis also increase the risk, as the bacterial environment in the oral cavity is more aggressive. Infection can also occur during the procedure itself, even under sterile conditions, because the oral cavity naturally contains numerous microorganisms.

Trauma during surgical procedures

Traumatic extraction is another serious risk factor. When the extraction has been complex, for example when removing impacted wisdom teeth or severely decayed teeth, the alveolar wall may be damaged. 

Damage to the bone disrupts the normal blood supply and hinders the formation of a proper blood clot. Root remnants, bone fragments or necrotic tissue in the alveolus can also trigger an inflammatory reaction.

Other predisposing factors

The link between smoking and alveolitis is well documented. Nicotine constricts blood vessels, which disrupts the blood supply to the wound. The suction caused by smoking can physically dislodge the clot. 

In addition to smoking, the risk increases with poor oral hygiene, chronic conditions (such as diabetes, which reduces immune defence), and the use of oral contraceptives. Aggressive mouth rinsing and drinking through a straw in the first few hours after the procedure can also lead to the clot being dislodged.

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Symptoms of alveolitis

Monitoring for symptoms of alveolitis is important for a timely visit to the dentist. The condition has characteristic manifestations that differ from the usual discomfort following extraction. 

Here are the main clinical signs of alveolitis:

• Pain and discomfort associated with alveolitis – pain is the primary symptom. It appears between 2 and 4 days after the extraction and is significantly more severe than normal post-operative pain. Typically, rather than subsiding over time, it intensifies; it may be throbbing and spread to the ear, temple or neck.
• Swelling and inflammation – the soft tissues surrounding the alveolus become red and swollen. The regional lymph nodes may be enlarged and tender to the touch. In cases of wet alveolitis, purulent discharge may be observed from the wound.
• Other clinical manifestations – an empty and dry alveolus with visible bone and a brownish coating, bad breath (halitosis) and a bad taste in the mouth. In more severe cases, a rise in body temperature and general malaise may occur.

If these symptoms appear, you should consult your dentist immediately so that an accurate diagnosis can be made and treatment can begin.

Diagnosis and treatment

The diagnosis of alveolitis is based on a clinical examination and assessment of the condition of the alveolus. The dentist assesses the presence or absence of a blood clot, the condition of the bone and the surrounding soft tissues. If necessary, an X-ray is ordered to rule out other complications – root remnants, bone fragments or deep-seated infection.

The treatment of alveolitis involves several steps. First, the alveolar socket is thoroughly irrigated with saline solution to remove food debris and necrotic tissue. A medicated dressing or a swab soaked in medication may then be placed to provide rapid relief. 

It is also important to debride the wound – removing any existing clot – and subsequently prescribe appropriate pain relief. 

Antibiotic treatment is indicated in cases of widespread infection, fever, or in patients with a compromised immune system. Rinsing with antiseptic solutions can also be carried out at home. As an adjunctive therapy for alveolitis, laser therapy is sometimes used to accelerate healing.

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What are the best practices for prevention?

Prevention of alveolitis begins even before the extraction itself. If there is active inflammation in the area of the tooth, the dentist can treat it before the procedure. 

A modern method for preventing alveolitis is the placement of a PRF membrane – a clot prepared from the patient’s own blood, which is placed in the alveolus and significantly reduces the risk of complications. At the Dentatime clinic, PRF therapy is actively used as part of surgical and restorative procedures.

After the procedure, it is important to strictly follow the post-extraction recommendations: avoid smoking for at least 48 hours, do not rinse your mouth vigorously, do not drink through a straw, and eat soft foods for the first few days. Post-operative care also includes careful oral hygiene. 

Clean your teeth with a soft-bristled brush, taking care not to disturb the wound area. Take the prescribed medication and follow your dentist’s instructions. These simple measures promote normal healing and significantly reduce the risk of complications from alveolitis.

What are the risks of untreated alveolitis?

Untreated alveolitis carries serious risks. Prolonged inflammation and the exposed bone surface create conditions for infection to penetrate deeper, which can lead to osteomyelitis – a severe inflammation of the jawbone. Furthermore, the untreated condition leads to delayed recovery, chronic pain and prolonged discomfort. 

In rarer cases, the infection may spread to surrounding tissues and cause an abscess. This is why, at the slightest suspicion of a complication, it is essential to seek dental care promptly.

Conclusion

Alveolitis is an unpleasant but treatable complication following a tooth extraction. Early recognition of symptoms and a prompt visit to the dentist are crucial for a speedy recovery. 

Adhering to post-operative care and the treating dentist’s instructions is the best guarantee of a smooth recovery. If you have any questions or experience unusual pain following extraction, consult a dental specialist for professional diagnosis and care.

Frequently asked questions

Can alveolitis be treated at home?

Self-treatment is not recommended. Relieving pain with painkillers is a temporary measure, but professional cleaning and treatment of the socket by a dentist is necessary.

Does taking oral contraceptives increase the risk of alveolitis?

Yes, elevated oestrogen levels can affect blood clotting and hinder the formation of a stable clot, which increases the risk of dry socket.

Is it normal to have a slight taste of blood in the mouth in the first few hours after a tooth extraction?

Yes, slight bleeding and a taste of blood in the first few hours are completely normal. Press the gauze pad against the site for about 30 minutes and avoid rinsing your mouth so as not to disturb the clot.