Routine tooth extractions are relatively simple procedures with few complications. Through proper and adequate local anaesthetic, slight discomfort and pressure may be felt during the procedure but actual pain should not be felt at all.
Unfortunately it’s common for people to experience pain after a tooth extraction as the anaesthetic begins to wear out, but it’s important to understand that pain experienced after an extraction is part of the healing process.
However, while some pain may be part of the healing process, other pain may be a sign of a complication with your extraction, requiring further investigation.
The good news is that there are several tooth extraction aftercare techniques and tips that you can try at home that will alleviate the pain, and hopefully quicken the healing time.
So be sure to read the tips at the end of the article on how to reduce pain after a tooth extraction.
Why You May Feel Pain After a Tooth Extraction
Normal pain following a tooth extraction usually occurs a couple of hours after your tooth extraction when you return home. This is mostly because the local anaesthetic that the dentist used begins to wear off.
Normal Physiological Pain
When a tooth is extracted, a socket remains in the place where the tooth roots used to be embedded in bone. This socket fills up with blood that contains immunological and healing components.
Within 24 hours this socket fills up with blood that hardens and turns into a blood clot. This collection of blood causes an inflammation of the area and an increase of pressure that will lead to normal physiological pain.
Normally, this pain should recede within a couple of days. but here are a couple of reasons why pain might persist for more than several days:
Fractured root piece
Sometimes during an extraction (especially in teeth that have more than one root, or that are extremely curved) the tooth might break while it’s being extracted.
This break usually happens on the last part of the root that is attached to bone, causing a small “root tip” to be left behind when the whole tooth has been extracted.
If this is the case, painful inflammation might occur, and the small piece needs to be extracted again.
An X-ray is usually taken to confirm the presence or position of the fractured root piece.
Damage to bone
Not all extractions are the same – some extractions may take fewer than 10 minutes, while others may require oral surgery.
Complicated extractions (especially of lower molars and wisdom teeth) require more complicated dental work that will ultimately lead to more pain and a longer healing time.
When extracting a tooth, several procedures may be considered such as incisions, cutting bone, drilling through the bone, flap elevation, and suturing.
All these procedures are more invasive and will cause damage to bone. This will require healing and will lead you to experience more pain after the extraction.
If your tooth was infected quite heavily before the extraction, you can expect there to be more pain after it has been extracted.
This is because the bone due to the infection was extremely bitter and penetrable, and so the healing and rebuilding of this bone will take longer and therefore hurt more.
If your tooth was severely infected, your dentist may prescribe you an antibiotic after it has been extracted.
Dry socket (also known as alveolar osteitis) is a dental condition in which a blood clot fails to form in a tooth socket after an extraction.
Another common cause is that a blood clot can form but is dislodged (removed) from the socket.
Up to 5% of all dental extractions may undergo a dry socket (1).
When a blood clot fails to form, it leaves behind an empty and “dry socket”, causing the bone to become exposed. This situation is extremely painful and requires urgent professional dental care.
Treatment of dry-socket:
A dry socket is a very serious problem and cannot be dealt with at home.
It’s usually treated by application of a medical dressing consisting of analgesics and antibiotics directly inside the socket.
This dressing is usually replaced every several days until the symptoms have gone. The socket also needs to be fully irrigated to flush out any debris or foreign materials.
How to Reduce Tooth Extraction Pain
Choose your food carefully
During your healing period, it’s advisable to avoid any hard or hot foods and drinks (especially hot spicy food or soups).
These types of hot foods and drinks will slow the tooth socket from closing. Instead, opt for softer and colder meals that requires less chewing and will interfere less with your socket, which brings me to my next point…
That’s right, ice-cream, yogurt, or any soft and cold food or drink may help ease pain after an extraction.
This is because it causes vasoconstriction (narrowing) of the blood vessels that may have expanded during the extraction, and it helps in reducing any swelling and inflammation.
In addition to this, the frosty sensation of ice-cream even adds a beneficial numbing effect!
Ask your dentist to recommend you a pain killer that is safe for you take after your extraction.
You may not need to use one, but if you do feel a little pain a couple of hours after your extraction, you’ll be happy to have some just in case.
Your dentist will have talked to you about this, but do not take any aspirin or blood thinners unless directly stated otherwise by your dentist or doctor. Aspirin is a blood thinner and will make it harder for blood to clot and harder for a tooth socket to heal properly.
Tips for post-extraction care:
Don’t use a straw
Don’t use a straw or any beverages/foods that require sucking.
Sucking will cause a pressure drop in your oral cavity, dislodging any blood clots that have formed inside the tooth socket.
This will cause the tooth socket to take much longer to heal, and is in fact one of the primary causes of a dry socket.
Sorry heavy smokers, but in order to prevent further complications and ensure adequate healing of your extraction site, it’s very important not to smoke at least for 3 days after a tooth extraction.
Smoking contains many toxins that will actually directly affect the bone, and prevent the socket form closing up. It also contributes to dry socket formation.
You can apply an ice pack to the side of your face were the tooth was extracted.
Like ice-cream, the cold will help in reducing any swelling and inflammation and may help in reducing any pain.
To prevent burning of your skin, ice packs should be placed only for 15 minutes at a time.
Pain after tooth extraction: summary
A tooth extraction may indeed be an uncomfortable ordeal, both during the extraction procedure and afterwards.
But the most important is to have a positive attitude towards it, understand that mild pain is all part of the healing process and the more relaxed and understanding you are of your body, the quicker the healing process.
After a tooth extraction you should get some rest and a couple of days off, but if any pain becomes too much, so much so that you cannot focus on your daily activities or it keeps you up at night, especially with bleeding that doesn’t stop: immediately refer back to your dentist.