Exodontia is a frequently practiced dental procedure, providing patients with the relief of pain, and the prevention of spreading infection. Localised alveolar osteitis (LAO), more commonly known as dry socket, is a well-recognised potential post-extraction complication. LAO occurs when the protective fibrin clot fails to form, or is lost, causing an intense radiating pain for the patient, who may then require repeat visits to the dental setting for review and management of symptoms. It is therefore important for dental practitioners to have a good working knowledge of LAO risk factors to highlight those patients who may be at greater risk of developing this post-extraction complication.

This article undertakes a literature review conducted using PubMed and an inclusion criteria encompassing systematic reviews with meta-analysis, dental textbooks, randomised controlled trials, case-controlled trials, cohort studies and reviews.

LAO risk factors have been divided into physiological, clinical and lifestyle. Complex extraction sites, extraction of mandibular molars and smoking are consistently found to be associated with a greater risk of developing LAO throughout this literature review. Other potential risk factors for LAO are shown to have conflicting evidence in the literature reviewed, primarily due to limitations of data size and a lack of homogeneity across data sources.

An awareness of LAO risk factors is essential for informed consent prior to exodontia. This may be of particular consideration to the special care patient group, in order to minimise post-extraction risks and ensure optimal extraction site healing.

Key words: dry socket, localised alveolar osteitis, risk factors

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