Some amount of pain and discomfort is expected for few days after tooth extraction. Amount of pain which occurs after tooth extraction is dependent on procedure which is used for the extraction of the tooth and the degree of trauma to the adjacent tissues. Patient may experience pain for longer time after surgical tooth extraction as compared to simple tooth extraction. Pain which occurs after tooth extraction is not that severe which a patient can’t bear. Pain can be managed after tooth extraction with pain medicaments which are prescribed by the dentist or the oral surgeon. Pain will start regressing in few days after tooth extraction.

When to take first dose of pain pills after Tooth Extraction

After tooth extraction, the effect of anesthesia will be there for other few hours.  The first dose of the pain killer should be taken by the patient before the affect of numbness by the local anesthetic agent wears off.  Patient will experience sharp, intense pain after tooth extraction if the pain meds are not taken before the affect of anesthesia wears off. Pain killer taken by the patient will also take some time to become effective. To minimize the chances of nausea from the pain meds, patient should eat something to coat the stomach before taking the medicament.

Pain killer medicaments

They are to be taken by swallowing with water. Various pain meds available which can be taken by the patient with dentist consultation are:

In case of less mild pain situations, patient can take ibuprofen (Motrin or Advil) 400-800mg 4 hourly or can take acetaminophen (Tylenol) 500-1000mg 4 hourly.  If a patient is experiencing moderate pain, then codeine 15-60mg or hydrocodone 5-10mg may be taken by the patient. In case of very severe pain, oxycodone 2.5-10mg should be given to the patient. Patient should read and follow the directions for the use of pain medicament. Patient should know about the manner in which the pain medicament needs to be taken.  If a patient has any problem or question with the medicament, then he should discuss this with his pharmacist or his dentist. If a narcotic, such as codeine is given by the oral surgeon or the dentist, then it should be taken with foods as narcotic pain meds have a tendency to cause gastric problems. If a person is taking narcotics, then he should limit his activities and take rest as narcotics cause drowsiness. Patient should eat something before taking the pain meds. This will cause coating of the stomach and will reduce the chances of nausea or vomiting. Prescription pain meds are mostly given for 3-4 days. In case of complicated tooth extractions, they may be prescribed for longer time.

Pain during first 24 Hours after Tooth Extraction

Patient should expect some amount of pain and discomfort after tooth extraction. Pain which occurs is not that severe which can’t be managed by the patient. Patient can easily bear pain after tooth extraction with mild pain killers. Pain is significantly more during the first 12 hours after tooth extraction and will start regressing after that.

Tooth extraction socket area will be sore and tender when touched during the first 24 hours and the empty socket will be felt as irregular with the tongue. There might be some  swelling  at this stage.  Bleeding which occurs after tooth extraction will also subside within few hours and will stop in first 24 hours. In case of surgical tooth extraction or in wisdom tooth extraction, bleeding may persist for longer. In case of difficult wisdom teeth, oozing of blood till 3 days after tooth extraction is considered as normal. 

Bleeding after Tooth Extraction

During the first 24 hours after tooth extraction, patient should take soft and liquid diet and should avoid taking food from the side where tooth was extracted. Patient should avoid sucking anything with straw and should not spit too much during the first 24 hours. Patient should take rest and should avoid smoking and alcohol. Intermittent ice application can be done to reduce the swelling at this stage.

Tooth Extraction Pain after 24 Hours

Pain will start regressing after 24 hours after tooth extraction in case of both simple tooth extractions as well as surgical tooth extraction. There might be mild pain present after 24 hours of tooth extraction. Pain will keep regressing with time. There might be oozing of blood even after 24 hours in case of wisdom tooth extraction or in Surgical Tooth Extraction. This is considered as normal. To control the bleeding, patient can put a piece of gauze or can bite on tea bags. Swelling will be more than previous day in case of surgical tooth extraction. Patient may have to continue taking soft and liquid diet at this stage if it was a difficult tooth extraction and patient should not smoke. Smoking can create negative pressure which can further dislodge the clot. Patient should keep the socket area clean to avoid secondary infections. It is advised to do warm saline rinses 24 hours after the tooth extraction to reduce the swelling.

Tooth Extraction Pain after 2 Days

Significant pain seldom persists after 2 days of tooth extraction. If the patient experiences severe throbbing pain which is radiating, then it can be because of dry socket. In case of dry socket, the blood clot is dislodged. To treat dry socket, dressing is given to the patient. Only the pain meds and antibiotics will not be effective to treat the condition. In case of surgical tooth extraction, swelling becomes more pronounced.

Swelling reaches its peaks after 2 days and after that, swelling starts decreasing. If hard, bright red and hot swelling is present, then it suggests infection.  Slight bleeding may occur on third day after wisdom tooth extraction or some complicated tooth extraction. Patient can continue with warm saline rinses at this stage and should avoid smoking which causes delay in the healing.

Tooth Extraction Pain after 3 days

If a patient experiences severe throbbing pain after 3 days, then he should visit his dental surgeon or dentist. Pain can be because of dry socket which further delays the recovery of the socket. There should be no bleeding after 3days of tooth extraction. Swelling will start reducing after 3 days. Patient can continue with warm saline rinses at this stage and has to keep extraction socket area clean to avoid any secondary infection.

Tooth Extraction Pain after 5 days

After the fourth day, pain should subside more and more after every day. There is usually no swelling present after 5 days. Patient can continue with the warm saline rinses and should maintain good oral hygiene to avoid any secondary infection.

Tooth Extraction pain after 7 days – 10 days

There is usually no pain present at this stage. In case of surgical tooth extraction, if non-resorbable sutures or stitches are given by the oral surgeon, then they need to be removed by the oral surgeon. Removal of stitches is an entirely painless procedure and there is no need of giving the local anesthesia and numbing the area before removing the sutures. The sutures are snipped using a pair of tiny tweezers. The tweezers will pull out the sutures with almost no pain and takes only few seconds. The patient just feels a small pinch while stitches removal but there is no pain.

If pain is present beyond 7-10 days after tooth extraction, then patient should consult his dentist or oral surgeon.

Along with pain, swelling and bleeding, it is quite normal to have a low grade temperature for 7-10 days after surgical tooth extraction. Low grade temperature occurs as an immune response. Pain killers will help to moderate the temperature. If there is high temperature present that is >101 degrees Fahrenheit (38.3 Celsius), then it is indicative of infection.  

Pain is not a complication after tooth extraction. Some amount of pain and discomfort after tooth extraction is expected. Pain will be more in case of surgical tooth extraction as compared to simple tooth extraction and to avoid pain, patient should follow the instructions of his dentist and should take the pain meds as prescribed. Patient should follow all the do’s and don’ts after tooth extraction and should follow tooth extraction after care instructions to avoid worsening of pain. Patient should avoid spitting, sucking, drinking anything with straw for minimum of 24 hours after tooth extraction and should not smoke for minimum of 2 days after tooth extraction. They can create negative pressure and can cause dislodgement of clot and lead to dry socket.   
 

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Comments

  • An

    An 11 - August - 2015, at 23:39 PM

  • I had my left wisdom teeth extracted last week but i felt a lot of pain whereby they had dress the hole where the lower tooth came from but still next 5 lower teeth are painful. what could be the problem and what can i do?

  • mark

    mark 10 - August - 2015, at 14:39 PM

  • Had moler#3 extracted 3days agonow having pain in tooth behind the tooth I just had extracted. Is it normal to have pain in the tooth next to the tooth you had extracted?

  • sharon

    sharon 25 - April - 2015, at 07:05 AM

  • about 11 days ago I had a tooth extracted and an immediate implant placed. I am still in sever pain. What can be wrong?

  • NICOLE

    NICOLE 10 - April - 2015, at 16:46 PM

  • I had my #3(i believe) top molar extracted 6 days ago. It took him 40 minutes and having to drill my tooth into 3 pieces to be able to extract it and then he had to clip away a few sharp edges in the socket. the gums distal to that molar broke so my #2 is partially exposed at the moment. because of the discomfort ive been feeling and the fact that i smoke (no i did not smoke 2 days after the surgery which sucked but i slowly picked it back up gently )i started taking antibiotics to calm my parinoia of possible infection. today (day #6) i decided to try not taking my pain meds to see the level of discomfort i am having, and oh my. #2 feels very tender to the touch, the gums that are broken still have not reconnected and are a little swollen and the molar next to it is sensitive to cold and hot, its not a sharp pain im feeling, but a swollen tenderness and a little discomfort in my gums which makes it feel like my cheek hurts a little. My face doesnt swell but that part of my gums do every so often. Is this dry socket? ive heard its so painful id KNOW if it was, but i do not have dental insurance and am paying 2500$ worth of work already i fear going back in to pay for another office visit etc.

  • Niko

    Niko 26 - March - 2015, at 22:29 PM

  • 3 years ago a filling fell out and I ignored it, since it never caused me issues. (stupid). then a year later a major infection hit me and I was in agonizing pain for 2 weeks, after which the pain suddenly stopped (presumably killed the nerves), at which point I was finally able to get antibiotics, and the infection went away, but I was left with a small lump on my jaw. Very stupidly, I continued to ignore it, since the infection seemed to be gone. every few months a piece of the tooth would fall off. 2 weeks ago, a moderate amount of pain returned, and I finally decided it was time to cough up money for a dentist. What the dentist told me was not good. He told me that I had a massive infection that was at a critical level to break through into new territory. Much of my jawbone had already been deteriorated, and that it had to come out pronto or the infection may spread to other teeth, my jawbone, or worse, my blood, and that I may die in that case. the Xrays seemed to confirm to me what he was saying, as he told me that the black areas were infection, and it didnt look nice. He told me in a rating of urgency, it was a 9/10. He then told me about how his particular practice offers a membership for just 150$, and that my insurance would cover an extraction, but not the bone graft that he would certainly need to fill the socket and keep it from getting infected again, and that with his membership I could get that done for half the normal cost. It sounded good, even though I walked away from the appointment feeling like I had just been speaking to a used car salesman, and I was prescribed a course of antibiotics for a week. I made several calls to schedule appointments but the times couldnt work out, since I was starting a new job and couldnt afford to miss any days, and the times wouldnt work. At some point the scheduling professional told me Id need to pay up front to even make an appointment. When I told her I couldnt pay it right now, but that I would pay the fee when I came in for the procedure, she actually asked me how much I had in my account, and how much I could pay. Her changing requirements of how much I needed to pay to get an appointment even, again, made me feel like I was being scammed. After thinking it over and comparing prices, and finding that many dentists dont accept my insurance. I decided to give it a go. and scraping up the money for the procedure, and balancing scheduling with a new job Id just started, I was finally able to get in. But by the time Id gotten in, I felt strong hints that the infection had returned or never fully died off in the first place. I told the Dr this. I told the receptionst/dentist's assistant this. They told me dont worry about it, that as long as it wasnt too bad then it would be fine. They didnt do another xray to check for infection, they didnt even look at it again. I made it clear I had my hesitations. Eventually I went forward with it, cause after all, I needed this now or I might DIE, right? Well the procedure itself went ok. the Dr was professional and as gentle as could be expected for a tooth extraction. I left feeling like Id made the right choice, though the dentist left me with little more than an extra gauze pad to bite down on for the next while, and the advice not to use straws, or brush it too directly. Well now Im on day 5 after the extraction. I am on heavy pain meds now as I write this, because the pain was still quite bad or worse than it was. Even on these heavy pain meds Im still feeling pain 7/10. The blood clot appears to be intact, and the wound looks as healthy as I would guess it should look. There is a sharp piece of tooth that looks like the edge of the tooth was was to be extracted, sticking out of my gumline. I am aware that pieces of the bone graft solution could rise up and fall out, but this looks like a large piece of the side of my old tooth. I have a fever, and feel fairly sure that I a have a new infection, and that the hundreds of dollars I felt scammed into spending, did nothing for me, and that I will need to have it redone. Is this normal practice for a dentist? Is it normal to have a tooth extracted while it is possibly still affected by a large infection, even just a little bit? Am I overreacting? I am not the type to jump to lawsuits at all, but I am strongly considering legal actions for negligence and malpractice.

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