Since alveolar osteitis is not primarily an infection, there is not usually any pyrexia (fever) and cervical lymphadenitis (swollen glands in the neck), and only minimal edema (swelling) and erythema (redness) is present in the soft tissues surrounding the socket.

Signs may include:

- An empty socket, which is partially or totally devoid of blood clot. Exposed bone may be visible or the socket may be filled with food debris which reveals the exposed bone once it is removed. The exposed bone is extremely painful and sensitive to touch. Surrounding inflamed soft tissues may overlie the socket and hide the dry socket from casual examination.

- Denuded (bare) bone walls.

Symptoms may include:

- Dull, aching, throbbing pain in the area of the socket, which is moderate to severe and may radiate to other parts of the head such as the ear, eye, temple and neck. The pain normally starts on the second to fourth day after the extraction, and may last 10–40 days. The pain may be so strong that even strong analgesics do not relieve it.

- Intraoral halitosis (oral malodor).

- Bad taste in the mouth.

Since dry socket occurs exclusively following a dental extraction, it could be considered both a complication and an iatrogenic condition, but this does not take into account both the reason why the tooth required extraction (i.e., extraction may have been unavoidable due to significant pain and infection) and also the fact that many dry sockets are the result of poor compliance with postoperative instructions, notably refraining from smoking in the days immediately after the procedure.

The signs and symptoms depend upon the type of OM, and may include:

- Pain, which is severe, throbbing and deep seated.

- Initially fistula are not present.

- No dental pain, but headache or other facial pain, as in the descriptive former term "neuralgia-inducing" (cavitational osteonecrosis).

- Fibromyalgia.

- Chronic fatigue syndrome.

- Swelling. External swelling is initially due to inflammatory edema with accompanying erythema (redness), heat and tenderness, and then later may be due to sub-periosteal pus accumulation. Eventually, subperiosteal bone formation may give a firm swelling.

- Trismus (difficulty opening the mouth), which may be present in some cases and is caused by edema in the muscles.

- Dysphagia (difficulty swallowing), which may be present in some cases and is caused by edema in the muscles.

- Cervical lymphadenitis (swelling of the lymph nodes in the neck).

- Aesthesia or paresthesia (altered sensation such as numbness or pins and needles) in the distribution of the mental nerve.

- Fever which may be present in the acute phase and is high and intermittent

- Malaise (general feeling of being unwell) which may be present in the acute phase

- Anorexia (loss of appetite).

- Leukocytosis (elevated numbers of white blood cells) which may be present in the acute phase

- Elevated erythrocyte sedimentation rate and C reactive protein are sometimes present.

- An obvious cause in the mouth (usually) such as a decayed tooth.

- Teeth that are tender to percussion, which may develop as the condition progresses

- Loosening of teeth, which may develop as the condition progresses.

- Pus may later be visible, which exudes from around the necks of teeth, from an open socket, or from other sites within the mouth or on the skin over the involved bone.

- Fetid odor.

Unlike acute OM in the long bones, acute OM in the jaws gives only a moderate systemic reaction and the person remains surprisingly well. Acute OM of the jaws may give a similar appearance to a typical odontogenic infection, but cellulitis does not tend to spread from the periosteal envelope of the involved bone. If the infection is not controlled, the process becomes chronic and systemic symptoms are usually present, including draining fistulas, loosening of teeth and sequestra formation. Untreated chronic osteomyelitis tends to feature occasional acute exacerbations.

Impacted wisdom teeth without a communication to the mouth, that have no pathology associated with the tooth and have not caused tooth resorption on the blocking tooth rarely have symptoms. In fact, only 12% of impacted wisdom teeth are associated with pathology.

When wisdom teeth communicate with the mouth, the most common symptom is localized pain, swelling and bleeding of the tissue overlying the tooth. This tissue is called the operculum and the disorder called pericoronitis which means inflammation around the crown of the tooth. Low grade chronic periodontitis commonly occurs on either the wisdom tooth or the second molar, causing less obvious symptoms such as bad breath and bleeding from the gums. The teeth can also remain asymptomatic (pain free), even with disease. As the teeth near the mouth during normal development, people sometimes report mild pressure of other symptoms similar to teething.

The term asymptomatic means that the person has no symptoms. The term asymptomatic should not be equated with absence of disease. Most diseases have no symptoms early in the disease process. A pain free or asymptomatic tooth can still be infected for many years before pain symptoms develop.

This type of classification is based on the amount of impacted tooth that is covered with the mandibular ramus. It is known as the Pell and Gregory classification, classes 1, 2, and 3.

Most commonly used classification system with respect to treatment planning. Depending on the angulation the tooth might be classified as:

- Mesioangular

- Horizontal

- Vertical

- Distoangular

- Palatal

- Buccal

- Lingual

All teeth are classified as either developing, erupted (into the mouth), embedded (failure to erupt despite lack of blockage from another tooth) or impacted. An impacted tooth is one that fails to erupt due to blockage from another tooth.

Wisdom teeth develop between the ages of 14 and 25, with 50% of root formation completed by age 16 and 95% of all teeth erupted by the age of 25. However, tooth movement can continue beyond the age of 25.

Impacted wisdom teeth are classified by the direction and depth of impaction, the amount of available space for tooth eruption. and the amount of soft tissue or bone (or both) that covers them. The classification structure helps clinicians estimate the risks for impaction, infections and complications associated with wisdom teeth removal. Wisdom teeth are also classified by the presence (or absence) of symptoms and disease.

One review found that 11% of teeth will have evidence of disease and are symptomatic, 0.6% will be symptomatic but have no disease, 51% will be asymptomatic but have disease present and 37% will be asymptomatic and have no disease.

Impacted wisdom teeth are often described by the direction of their impaction (forward tilting, or mesioangular being the most common), the depth of impaction and the age of the patient as well as other factors such as pre-existing infection or the presence of pathology. Of these predictors, age correlates best with extraction difficulty and complications during wisdom teeth removal rather than the orientation of the impaction.

Another classification system often taught in U.S. dental schools is known as "Pell and Gregory Classification". This system includes a horizontal and vertical component to classify the location of third molars (predominately applicable to mandibular third molars): the third molar's relationship to the occlusal plane being the vertical or "x-component" and to the anterior border of the ramus being the horizontal or "y-component". Vertically, Class A impaction is one in which the occlusal surface of the impacted tooth is level or nearly level with the occlusal plane and the cervical line of the adjacent second molar.

The classification is similar to the classification of OM generally, according to the length of time the inflammation has been present and whether there is suppuration (the formation of pus). "Acute osteomyelitis" is loosely defined as OM which has been present for less than one month and "chronic osteomyelitis" is the term used for when the condition lasts for more than one month. Suppurative osteomyelitis of the jaws is uncommon in developed regions, and more common in developing countries. In Europe and the United States, most cases follow dental infections or mandibular fractures. There have been many reported cases occurring in Africa which are coexistent with acute necrotizing ulcerative gingivitis or cancrum oris.

In the pre-antibiotic era, acute OM of the jaws was more extensive. Massive, diffuse infections commonly involved the whole side of the mandible, or the whole of one side and the opposite side as far as the mental foramen. Localized osteomyelitis tended to be described as either "vertical", where a short segment of the body of the mandible from the alveolar crest to the lower border was involved, and "alveolar", where a segment of alveolar bone down to the level of the inferior alveolar canal would sequestrate, including the sockets of several teeth. Treatment with antibiotics has significantly altered the natural history of OM of the jaws. Today, however, the condition is often a hidden infection, due in part to not being visible on most dental X-rays. In addition, some schools of dentistry do not recognize "silent" OM of the jaws—occurrence of the condition without visually obvious manifestations—in their curriculum. In addition, as circulation is intrinsically diminished in jawbones, antibiotics are frequently ineffective.

Gingival and periodontal pockets are dental terms indicating the presence of an abnormal depth of the gingival sulcus near the point at which the gingival tissue contacts the tooth.

Apical abscesses can spread to involve periodontal pockets around a tooth, and periodontal pockets cause eventual pulp necrosis via accessory canals or the apical foramen at the bottom of the tooth. Such lesions are termed periodontic-endodontic lesions, and they may be acutely painful, sharing similar signs and symptoms with a periodontal abscess, or they may cause mild pain or no pain at all if they are chronic and free-draining. Successful root canal therapy is required before periodonal treatment is attempted. Generally, the long-term prognosis of perio-endo lesions is poor.

Cracked tooth syndrome refers to a highly variable set of pain-sensitivity symptoms that may accompany a tooth fracture, usually sporadic, sharp pain that occurs during biting or with release of biting pressure, or relieved by releasing pressure on the tooth. The term is falling into disfavor and has given way to the more generalized description of fractures and cracks of the tooth, which allows for the wide variations in signs, symptoms, and prognosis for traumatized teeth. A fracture of a tooth can involve the enamel, dentin, and/or pulp, and can be orientated horizontally or vertically. Fractured or cracked teeth can cause pain via several mechanisms, including dentin hypersensitivity, pulpitis (reversible or irreversible), or periodontal pain. Accordingly, there is no single test or combination of symptoms that accurately diagnose a fracture or crack, although when pain can be stimulated by causing separation of the cusps of the tooth, it's highly suggestive of the disorder. Vertical fractures can be very difficult to identify because the crack can rarely be probed or seen on radiographs, as the fracture runs in the plane of conventional films (similar to how the split between two adjacent panes of glass is invisible when facing them).

When toothache results from dental trauma (regardless of the exact pulpal or periodontal diagnosis), the treatment and prognosis is dependent on the extent of damage to the tooth, the stage of development of the tooth, the degree of displacement or, when the tooth is avulsed, the time out of the socket and the starting health of the tooth and bone. Because of the high variation in treatment and prognosis, dentists often use trauma guides to help determine prognosis and direct treatment decisions.

The prognosis for a cracked tooth varies with the extent of the fracture. Those cracks that are irritating the pulp but do not extend through the pulp chamber can be amenable to stabilizing dental restorations such as a crown or composite resin. Should the fracture extend though the pulp chamber and into the root, the prognosis of the tooth is hopeless.

Condensing osteitis is a periapical inflammatory disease that results from a reaction to a dental related infection. This causes more bone production rather than bone destruction in the area (most common site is near the root apices of premolars and molars). The lesion appears as a radiopacity in the periapical area hence the sclerotic reaction. The sclerotic reaction results from good patient immunity and a low degree of virulence of the offending bacteria. The associated tooth may be carious or contains a large restoration, and is usually associated with a non-vital tooth.

A reaction to past trauma or infection but it's difficult to rule out in some cases.

Focal radiodensity of the jaw which is NOT inflammatory, dysplastic, neoplastic or a manifestation of a systemic disease.

This is common and affects 5% of the population, usually seen in teens and those in their 20's. Typically asymptomatic and is an incidental finding on a radiograph. found anywhere in the jaw, most commonly in the mandibular premolar-molar region. The shape ranges from round to linear streaks to occasional angular forms.

Infection of periapical tissues of a high immunity host by organisms of low virulence which leads to a localized bony reaction to a low grade inflammatory stimulus.

As the original sulcular depth increases and the apical migration of the junctional epithelium has simultaneously occurred, the pocket is now lined by pocket epithelium (PE) instead of junctional epithelium (JE). To have a true periodontal pocket, a probing measurement of 4 mm or more must be clinically evidenced. In this state, much of the gingival fibers that initially attached the gingival tissue to the tooth have been irreversibly destroyed. The depth of the periodontal pockets must be recorded in the patient record for proper monitoring of periodontal disease. Unlike in clinically healthy situations, parts of the sulcular epithelium can sometimes be seen in periodontally involved gingival tissue if air is blown into the periodontal pocket, exposing the newly denuded roots of the tooth. A periodontal pocket can become an infected space and may result in an abscess formation with a papule on the gingival surface. Incision and drainage of the abscess may be necessary, as well as systemic antibiotics; placement of local antimicrobial delivery systems within the periodontal pocket to reduce localized infections may also be considered.

It is classified as supra bony and infra bony based on its depth in relation to alveolar bone.

Intraoral dental sinus (also termed a parulis and commonly, a gumboil) is an oral lesion characterized by a soft erythematous papule (red spot) that develops on the alveolar process in association with a non-vital tooth and accompanying dental abscess. A parulis is made up of inflamed granulation tissue.

Less commonly, dental infections drain onto the surface of the skin, forming a cutaneous sinus of dental origin.

This condition is often resolved by endodontic treatment and does not have indication for antibiotic use. This is a common mistake among health professionals.

The cause is usually pressure from the flange of a denture which causes chronic irritation and a hyperplastic response in the soft tissues. Women during pregnancy can also present with an epulis, which will resolve after birth. Fibroepithelial polyps, pedunculated lesions of the palate beneath an upper denture, are associated with this condition. A cobble-stone appearance similar to an epulis fissuratum in a patient without dentures can be diagnostic of Crohn's disease. Epulis fissuratum can also appear around dental implants.

The median alveolar cyst is a rare cyst, occurring in the bony alveolus between the maxillary central incisors. It is distinguished from a periapical cyst by the fact that adjacent teeth are vital.

The lesion is usually painless. The usual appearance is of two excess tissue folds in alveolar vestibule/buccal sulcus, with the flange of the denture fitting in between the two folds. It may occur in either the maxillary or mandibular sulci, although the latter is more usual. Anterior locations are more common than posterior. Less commonly there may be a single fold, and the lesion may appear on the lingual surface of the mandibular alveolar ridge.

The swelling is firm and fibrous, with a smooth, pink surface. The surface may also show ulceration or erythema. The size of the lesion varies from less than 1 cm to involving the entire length of the sulcus.

Buccal exostoses are considered different entities to osteomas (e.g. seen in Gardner syndrome), even though the two lesions are histopathologically identical.

Why buccal exostoses form is unclear, but it may involve bruxism (tooth clenching and grinding), and genetic factors. Typically they first appear in early adulthood.

Gingival cyst of adult is a rare condition. The incidence is less than 0.5%. It is formed from the rests of dental lamina. It is found in the soft tissues on the buccal and labial portions of the jaw. It usually occurs on the facial gingiva as a single small flesh colored swelling, sometimes with a bluish hue due to the cystic fluid. Sometimes, it may occur in cluster, either unilaterally or bilaterally or on the lingual surface of the alveolar process. It is most commonly seen in the canine and premolar regions of the mandible, and are sometimes confused with lateral periodontal cysts. It is not normally problematic, but when it grows larger, it can cause some discomfort. It can be removed by simple surgical excision. They are developed late in life, generally up to the sixth decade of age.

Osteitis is inflammation of bone. More specifically, it can refer to one of the following conditions:

- Osteomyelitis, or "infectious osteitis", mainly "bacterial osteitis")

- Alveolar osteitis or "dry socket"

- Condensing osteitis (or Osteitis condensans)

- Osteitis deformans (or Paget's disease of bone)

- Osteitis fibrosa cystica (or Osteitis fibrosa, or Von Recklinghausen's disease of bone)

- Osteitis pubis

- Radiation osteitis

- Osteitis condensans ilii

- Panosteitis, a long bone condition in large breed dogs

- In horses, pedal osteitis is frequently confused with laminitis.

Peripheral giant-cell granulomas appear microscopically as a large number of multinucleated giant cells, which can have up to dozens of nuclei. Additionally, there are mesenchymal cells that are ovoid and spindle-shaped. Near the borders of the lesion, deposits of hemosiderin and hemorrhage is often found. In 50% of cases, ulcerations are present.