A re-audit to assess the incidence of alveolar osteitis within the Oral Surgery Department of a teaching hospital

Aim: Alveolar osteitis (AO) is one of the most common post-operative complications following tooth removal. It is associated with significant patient morbidity and an increase in post-operative visits. Thus, establishing the incidence of AO within the Oral Surgery Department of Bristol Dental Hospital and reviewing this in the light of the Cochrane systematic review, which suggests an incidence of 5% for routine extractions, is important. Material and Methods: This article shares the results of three audit cycles assessing the incidence of AO, comparing the findings and discussing them in terms of the relevant literature. Data were collected for a period of 1 month for all patients undergoing routine extractions under local anaesthetic performed by both staff and students. Results: One hundred and forty-four routine extractions were carried out on 89 patients during the audit period, with 55% of the extractions being performed by students and 45% by members of staff with varying levels of experience from DCT1 up to Associate Specialist. 4.8% (7/144) of patients returned with post-operative complications resulting in a diagnosis of AO. 71% of extractions resulting in AO were performed by students and this was identical to the incidence noted in a 2003 audit. 64% of AO occurred in mandibular teeth. Conclusion: Recent audits of AO incidence in the Oral Surgery Department of Bristol Dental Hospital indicate an acceptable level of occurrence, under the 5% target. The audits highlight operator experience and the location of the extraction site as contributing factors for the development of AO. This has implications for the clinical governance of the service, and students must be appropriately supervised to ensure high-quality patient care.