Tooth extraction pain

What do you need help with?

• Reasons you might need a tooth extraction

• Managing pain after your tooth extraction

• Relieving tooth extraction pain at home

• Is there a risk of infection from a tooth extraction?

• Tooth extraction aftercare: What to do after surgery

• Managing dry socket

Impacted tooth: Tooth ‘impaction’ is when a tooth (usually a wisdom tooth) gets stuck in the gums or jaw. This can cause pain and swelling, or damage to neighbouring teeth.

Tooth decay: The build-up of bacteria known as plaque and tartar on your teeth can cause irreparable damage – leading to pain and infection, and sometimes requiring the removal of the decayed teeth.

Gum disease: Gum disease, like tooth decay, comes from a build-up of bad bacteria in the mouth and can cause further complications (such as tooth decay, infection, swelling, bad breath and receding gums).

Overcrowding: Sometimes teeth come in when the jaw is still too small. This overcrowding of too many teeth in one place can cause teeth to become crooked, sometimes so much so it requires the removal of one or more of them.

Injury: Accidents and trauma to the face can easily damage your teeth. If this happens, and the damage is severe enough, the broken teeth may need to come out so as to not cause further harm.

Learn more: Tooth extractions

Will a tooth extraction hurt?

You may experience some discomfort during tooth extraction surgery. However, anaesthetic is used to numb the area to minimise the chance that you will feel pain. That said, you will likely start to feel pain after the tooth extraction and for a number of days.

What level of pain is ‘normal’?

After tooth extraction surgery, it’s common to feel throbbing in the extraction area (known as the ‘socket’) as well as sensitivity. This is perfectly normal, and your dentist will likely prescribe some pain relief to help you minimise discomfort.

The amount of pain and length of recovery time depend on which tooth was extracted. For example, an impacted wisdom tooth is likely to require a complicated extraction, which may cause a higher degree of lasting pain.

When to see a dentist: 

• Severe, worsening or sudden pain.

• Continued pain after three days.

• You can see the exposed (dry) socket (see below).

• Noticeable bad breath.

• Pain spreading to your temple, neck, eye or ear.
  

If you experience these symptoms, call Kowhai Dental on 09 430 0707 or book an appointment online as soon as you can so we can help.

How long does tooth extraction pain last?

Tooth extraction pain should peak early, within 24-48 hours, and then start to fade in the following days. The healing process as a whole can take weeks, although it shouldn’t hurt after the first week.

What to expect right after tooth extraction surgery

Within the first couple of hours, you may not feel any pain at all, because the local anaesthesia used to numb your mouth during surgery could still be in effect. You might experience some tingling as it wears off.

What to expect within 24 hours

Tooth extraction pain tends to peak within the first 24 hours. This is where the wound is at its most fresh, and the healing process has only just started. It’s also likely you’ll experience bleeding during this time.

Activities which cause more blood to rush to the head, such as lying down or strenuous activity, may make this pain worse. This can make the pain worse at night, which we’ll talk more about below.

What to expect within 2-3 days

You will probably still have feelings of throbbing pain or the occasional ache at your tooth extraction site during the following few days.

The degree of pain and the length of time it lasts will depend in part on your body (and how well you look after your mouth during this period). Even if it doesn’t actively throb, the surgery site will be very sensitive and probably uncomfortable.

Some bleeding may also occur during this time.

What to expect within a week

In most cases, the aches and pains of a tooth extraction start to wind down after three days. There will still be a hole at the site – that’ll take a few weeks and maybe months to close – but the pain should lessen.

Bleeding should ideally have stopped by this point, although there might be a touch of swelling in the area making it sensitive. You’ll probably still feel a bit uncomfortable in that part of your mouth.

If you’re experiencing a lot of regular pain at this point, you may wish to consider contacting your dentist for further advice.

What to expect after one week

From this point on it’s up to you and your mouth. Your blood clot should be fully formed, the swelling gone down, and the pain reduced. You’ll still have an empty socket which is healing, but with some proper care and good cleaning it shouldn’t cause you too much, if any, bother.

How long should I take off work for a tooth extraction?

You’ll likely find you can return to basic light duties within 24 hours, so long as they aren’t too strenuous – driving, admin work on a computer, gentle walks, etc. should be OK.

At minimum you’ll want the first 24 hours off work, but talk to your dentist to see if they recommend that you take an additional day to recover from your particular surgery.

How can I make my tooth extraction heal faster?

The key things to think about for a successful healing process after tooth extraction surgery are:

1. Avoid strenuous actions which might dislodge the blood clot within that first week.

2. Don’t disturb the wound while it’s healing.

3. Keep your gauze in place as long as your dentist tells you to.

4. Be careful with what you eat and drink.

For more detailed information, scroll down to read our tooth extraction aftercare tips.

Common types of pain (and other discomforts) after a tooth extraction

1. Throbbing pain

What is it? Throbbing pain is experienced in a sort of rhythm or repetitive pulse, usually more of a deep, dull pain than a sharp one.

What to do about it: Throbbing pain is very normal after a tooth extraction and will typically die down within a few days. If it’s very uncomfortable, you will likely be able to take over-the-counter pain medication to treat it, but talk to your dentist first. See our tips on reducing pain below.

When to see a dentist: If it gets worse rather than better, or doesn’t go away within a few days.

2. Eye pain

What is it? If you experience eye pain after tooth extraction surgery, it’s probably not that your eyes are damaged but rather that the pain in your mouth is radiating up to feel like it’s behind your eyes.

What to do about it: Pain which is so severe it is radiating up into the eyes may be a sign of a greater problem, such as dry socket or an infection. 

When to see a dentist: Contact your dentist immediately to get their advice.

3. Sinus pain

What is it? Sinus pain may be caused by a tooth extraction in the upper mouth - your sinuses and upper teeth are, after all, in very close proximity. Pain or discomfort in the sinuses could be a side effect of the swelling and inflammation, or a greater problem; in some cases, removing an upper tooth can open a hole to the sinuses, risking further complications.

What to do about it: If your pain is being caused by swelling or discomfort in the tooth extraction site, it should go down within three days. Simple pain medication or a cold compress may also help. If the pain doesn’t go away, gets worse, or you’re just worried and need advice, you’d be best checking in with your dentist and speaking with them about your symptoms.

When to see a dentist: If the pain doesn’t go away after three days, or gets worse.

4. Ear pain or blocked ear

What is it? A sensation of pain, blockage, buzzing or ringing, or mild hearing loss in the ear following a tooth extraction. 

All the different components in your head are connected, so when one is affected they can all feel some kind of impact. In the case of your ears, because a tooth removal can inflame the muscles and cause swelling in the jaw, this can put pressure on your ears (which aren’t that far away!).

What to do about it: The feeling should go away as the swelling comes down, within a few days of your surgery. If it doesn’t, or it gets worse, it may be a sign that something else is wrong, for example an infection. 

When to see a dentist: If the feeling doesn’t go away within a few days, or gets worse.

5. Sore throat, jaw or neck

What is it? Tooth extraction surgery can inflame the muscles of the mouth and cause swelling, which puts pressure on all the other neighbouring parts of the face. This also affects the throat, jaw and neck. Muscle discomfort, feelings of pressure and nerve compression are all possible symptoms.

What to do about it: Like many problems associated with tooth removal, the symptoms should go away within a few days. Take it easy, stay hydrated, and follow your dentist’s post-surgical care advice. If your symptoms worsen, it could be a sign of a greater problem and, therefore, you may wish to talk to your dentist.

Additionally, if you feel like your neck or throat pain is coming from swollen lymph nodes, this could be a sign of infection.

When to see a dentist: If the pain doesn’t go away, gets worse, or you feel a swelling of the lymph nodes.

6. Upset stomach

What is it? Nausea is a common symptom among patients waking up from sedation. Usually this will go away within a few hours. Some people also feel nauseous for a number of days, up to a week, following tooth surgery, which is typically caused not by the healing process but rather side effects of medication or dehydration.

What to do about it: Give yourself 24 hours of taking things easy and see how you feel, and try to stay hydrated. If the problem persists and you’re confident you’re drinking enough water, it may instead be a side effect of your medications.

When to see a dentist: If the problem just won’t go away, you may want to see your dentist for advice. Depending on the medications you’re on, it may also require a trip to the GP.

7. Bad breath

What is it? Bad breath after a tooth extraction may have quite a few causes. Dry mouth and post-surgical bleeding are common, and will likely go away with time.

Poor oral hygiene may also cause bad breath after surgery due to a buildup of bacteria or food particles. That build-up of bacteria can also cause an infection, which is very serious.

What to do about it: Stay hydrated and give yourself a few days to recover. After the first 24 hours have passed, try to get back into the routine of cleaning your teeth properly, albeit carefully around the extraction site. Hydration and good oral hygiene are two of the best defences against post-surgical bad breath.

When to see a dentist: If the problem seems like it’s getting worse, or it’s been a couple of days and you’ve noticed no change, look for other signs of infection in the mouth or talk to your dentist for advice.

If you find that the throbbing and sensitivity of your extraction site is too uncomfortable, there are some steps you can take at home:

• Over-the-counter medication such as ibuprofen can help manage aches, as well as swelling and inflammation.Hold a cold compress (such as an ice pack wrapped in a towel) to the side of your cheek to further help with swelling.

• When the swelling has gone down, a warm compress may be soothing.

• Prop your head up with pillows when lying down.

• Eat soft, cold foods for the first couple of days.

• Swish your mouth with salt water four to five times a day, for five days following your surgery. But, wait at least one day before starting.

• To speed up your recovery, be sure to follow your dentist’s aftercare instructions carefully and don’t overexert yourself.

Yes, as with all types of surgery, there is a degree of infection risk within the first few days. However, it is easily avoided with proper aftercare.

Common signs of tooth extraction site infection:

• Discharge, e.g. pus.

• Increased swelling.

• Bleeding that lasts more than 24 hours.

• Persistent fever.

• Difficulty opening your mouth.

• Acute bad breath.

What does a socket look like when healing?

Within the first day after your tooth extraction, a blood clot should form inside the socket to protect the open wound and prevent bleeding. You should then see a gelatinous tissue form over the blood clot (known as ‘granulation tissue’), which is your body’s way of protecting the clot while the jaw bone heals.

It will take several weeks for the bone to fully heal. However, most people feel more or less back to normal within a few days.

What to do: Immediately after surgery

Immediately after surgery, the local anaesthetic will be wearing off and a blood clot will be trying to form. The biggest things to consider here are helping the blood clot and taking it easy so you don’t cause yourself pain.

• Bite on the gauze pad your dentist gives you for at least an hour after the surgery.

• Take prescribed pain relief as directed.

• Avoid brushing or rinsing for the next 24 hours.

• Try not to suck or spit – that means avoiding straws, avoiding smoking, and letting toothpaste fall out of your mouth – so you don’t spit it out. This is to ensure you do not accidentally dislodge the blood clot and increase the risk of dry socket (see below).

• Avoid hard, sharp, granular (i.e. seeds and crumbly foods) or hot foods. They can all cause pain, damage, or get stuck in the socket.

• Avoid chewing near the exposed socket.

• Avoid vigorous exercise.

Learn more: What to eat after tooth extraction

What to do: Up to three days after surgery

After 24 hours, up to three days, you’ll be in the most important period of healing for your extraction site. While you can start to brush your teeth again, you’ll still need to avoid activities that may harm the socket or dislodge the blood clot.

• Continue to avoid strenuous activity.

• Continue to avoid hard or granular foods, and try not to chew near the exposed socket.

• Start to brush and floss your teeth properly, but avoid brushing vigorously (especially around the extraction site). If you normally use an electric toothbrush, you may want to swap to a regular one for a few days.

• Keep the extraction site clean. Rinsing with salt water as described above can be of big help to keeping the extraction site clean while fighting inflammation.

• Continue to avoid sucking and spitting.

What to do: Beyond three days

From three days onwards you can start to slowly reintroduce your regular habits back into your life, depending on how your mouth feels.

You may wish to avoid hard or granular foods for a bit longer, as they can stab the wound and get stuck in the socket.

Start slow with exercise and slowly work up, so you understand what will or won’t cause pain. You may also find you need to keep propping your head up at night.

Learn more: How to brush your teeth after wisdom tooth removal

What is dry socket?

Dry socket is a painful condition that can happen following a tooth extraction. It occurs when a blood clot fails to develop, becomes dislodged or dissolves before the extraction wound has a chance to heal.

A blood clot is necessary for healing following an extraction because it protects the underlying bone and nerve endings in the empty socket. When the clot fails, the exposed nerve endings can cause severe pain not just in the socket, but radiating across the side of your face. It also increases the risk of infection.

 Learn more: Dry socket

Symptoms of dry socket

• Intense pain radiating from the socket to your ear, eye, temple or neck.

• A visible socket (partial or total loss of blood clot).

• Acute halitosis (bad breath).

• A deeply unpleasant taste in your mouth.

• Food or debris accumulating in the empty socket.

• Acute swelling around the socket.

• Slight fever.

What does dry socket look like?

It may not be possible to see a dry socket, especially if it’s far back in the mouth. However, if you are able to see the extraction site, ideally what you would see is a noticeable blood clot at its centre. If the socket appears white in colour, you may be viewing exposed bone – in which case, the clot has failed.

In the case of an infected dry socket, you may also notice black, green or yellow discolouration in and around the socket.

Dry socket must be treated by a dentist, as you will typically need the site cleaned, medicated and dressed. Your dentist may also prescribe pain relief relative to the severity of your pain.

What to expect during your consultation

When you come to see us for pain or dry socket following a dental extraction, we’ll examine the wound for signs of a blood clot, infection or debris.

If dry socket has occurred, your dentist will usually irrigate the wound to remove debris and apply a medicated dressing. This dressing often provides immediate relief and will likely need replacing every few days until recovery is complete.

Where dry socket hasn’t occurred, we may provide stronger pain relief to assist your comfortable recovery, or investigate further if we have cause for concern.

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