Dry Socket Pathogenesis — ORE Part 1 MCQ

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EasyOral SurgeryDry Socket PathogenesisORE Part 1

Which pathological event most commonly underlies dry socket (alveolar osteitis) after mandibular third molar extraction?

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Correct answer: E — Breakdown or loss of the socket blood clot

**A is correct.** Alveolar osteitis is characterised by disintegration, premature loss, or failure of retention of the extraction-socket blood clot, resulting in exposed socket bone and severe post-extraction pain. Fibrinolysis is the accepted mechanism behind clot breakdown; smoking and disturbance of the socket clot are recognised associated factors. SDCEP describes dry socket as showing absence of clot or soft tissue in the socket and advises avoiding smoking and rinsing on the extraction day. **B** is not the primary pathological event, and *Staphylococcus aureus* is not the characteristic cause. **C**, **D**, and **E** are possible but distinct postoperative issues; none explains the defining clot loss of alveolar osteitis.

Reference: Scottish Dental Clinical Effectiveness Programme. Management of Acute Dental Problems: “Alveolar osteitis (dry socket)” (current webpage accessed July 2026). https://www.acutedentalproblems.sdcep.org.uk/guidance/management-of-oral-conditions/common-oral-conditions/alveolar-osteitis-dry-socket/