The patient developed severe pain three days after a lower right second molar extraction. Which condition is most likely diagnosed?

Localized osteitis, commonly known as dry socket, is a condition that can occur after the extraction of a tooth, particularly lower molars. This condition is characterized by severe pain, which typically begins a few days after the extraction, often around the third day, as the blood clot that should have formed in the socket dissolves or dislodges prematurely. The underlying bone becomes exposed and sensitive, leading to significant discomfort.

In this scenario, the timing of the onset of severe pain is crucial. The fact that the pain developed three days post-extraction aligns with the typical time frame for localized osteitis to manifest, distinguishing it from other potential post-extraction complications that may present differently or within a different time frame.

Localized osteitis is also often accompanied by specific clinical signs such as a foul odor and a visible lack of granulation tissue in the socket, further leading to its diagnosis. Understanding the factors leading to this condition, including improper aftercare, smoking, and certain medications, enhances the importance of post-operative instructions in preventing it.

In contrast, other conditions, such as oroantral fistula and retained root, would generally have different presentations, timelines, and symptoms. Reactionary hemorrhage usually occurs immediately following the extraction or shortly thereafter