Pain after tooth extraction: how much does it hurt and how to relieve it?

Causes and duration of pain Mechanism of pain Localization Stages of healing Possible complications When to see a doctor What to do after removal What not to do How to reduce pain
Tooth extraction (removal) is a surgical intervention accompanied by damage to the periodontal tissues (gums, bone socket, mucous membrane). Pain after tooth extraction is a normal reaction of the body to surgery. Depending on the complexity of the clinical situation, the volume of the operation, after the procedure, when the effect of the anesthetic wears off (after 3-4 hours), the patient begins to feel aching pain in the injured area.

Why and how much does it hurt?

Pain occurs due to traumatic swelling of tissues and compression of nerve endings. The more complex and extensive the operation, the more intense the gum pain after tooth extraction. Normally, symptoms after extraction of an incisor or molar are as follows:

• Aching pain persists for 1-3 days
  , but subsides day by day;
• slight swelling, hematoma, redness around the removed unit (may increase for 2-3 days
  and then subside);
• formation of a blood clot in the wound;
• the appearance of a whitish coating (fibrin, which accelerates tissue healing).

This is a normal reaction to surgery. How much a tooth hurts after extraction depends on the complexity of the operation, the characteristics of the body, the patient’s pain threshold, the location of the dental unit in the row (after extraction of molars, the injury is more extensive and worries longer). Normally, discomfort lasts
3-5 days
, gradually subsides and disappears on its own.

Tissues are restored

about
10-14 days
. By this time, the mucous membrane has completely healed, new bone begins to form inside the hole, which will completely fill the defect in about six months.

The most difficult to treat and remove is the 3rd molar (figure eight, wisdom tooth). They have very curved, intertwined roots. A wisdom tooth is often completely unerupted (impacted), covered with mucous or bone, and incorrectly erupted (dystopic). The operation is hampered by difficult access to the figure eight. Therefore, healing after a complex 3rd molar extraction may take longer (about a month). But if pain and swelling have not begun to subside a week after the intervention, you need to consult a dentist.

Stages of decay development

There is no acute form of caries, so small changes are difficult to notice, they accumulate - and now a person cannot smile, only stumps of teeth remain. Therefore, it is important to undergo preventive examinations regularly. The dentist can identify the problem at the initial stage and can easily fix it.

1. Rotting begins at the spot stage. The color of part of the surface changes. Enamel demineralization begins. At this stage, treatment is quick and easy.
2. The superficial process of demineralization is increasing, but the pain syndrome has not yet manifested itself. The tooth can react to sweet, sour, cold, hot.
3. Middle stage The lesion reaches the enamel-dentin junction. Painful sensations occur periodically. Large areas are affected.
4. Deep damage The decay process affects the dentin surrounding the pulp. If this process is left unattended, pulpitis will develop. And this is far from the only problem.

Mechanism of pain

• Trauma to soft, hard periodontal tissues;
• damage (rupture) of the connective tissue holding the tooth;
• destruction of blood vessels and nerve endings;
• swelling of the injured gum, pressure on nearby areas, poor circulation;
• irradiation of pain along the nerve trunks to other parts of the maxillofacial areas.

Pain after extraction of any dental unit is a natural reaction of the body to the intervention. No matter how carefully the surgeon acts, the integrity of the vessels, nerves, and fibers is inevitably compromised. It is normal for the extracted tooth to hurt for no more than 2-3 days.

, after removing the figure eight, the gums may bother you
for about a week
. If after 7-10 days the discomfort does not disappear, but continues or increases, you need the help of a doctor.

Localization of pain

As a rule, painful sensations are localized in the area of ​​innervation of nerve endings injured during the intervention. Depending on where the hole is located, the pain can radiate to the throat, temple, or ear. Often, after tooth extraction, the neighboring tooth hurts. The most common reason is damage to soft tissues from instruments, which causes the gums around the wound to swell, begin to hurt, and the pain spreads further to neighboring units.

Incisors and canines usually have 1 root, which makes their removal the least traumatic. Chewing units have 2-3 or more roots, which complicates the operation and makes it more voluminous. The back teeth of the upper jaw border the bottom of the maxillary sinuses; after removal, the pain can radiate to the nasopharynx, cheek, orbit, and ear.

If after the removal of the lower tooth the jaw hurts, especially when it comes to multi-rooted chewing units (7, 8 teeth), this is normal. Usually such sensations go away within a few days. You need to go to the dentist if the pain does not subside after 5-7 days and is accompanied by other alarming symptoms.

Viruses

Viruses feed on the energy of cells, that is, they seem to de-energize them.

Viruses very clearly maintain territory, that is, each of them lays claim to a specific organ or system. Even different types of the same type of virus have their own localization. In the course of my medical work, I became convinced that your immune system is brought to the point of exhaustion (not to be confused with tension) by viruses and only viruses.

DNA viruses: pycnoviruses, iridoviruses, herpesviruses, adenoviruses, parvoviruses, hepadnaviruses, hepatitis B.

RNA viruses: paramyxoviruses, rhabdoviruses, arenaviruses, orthomyxoviruses, retroviruses, reoviruses, flaviviruses, calciviruses, hepatitis A, C, D, E, G.

Clinical manifestations: respiratory viral infections, pneumonia (pneumonia), maculopapular rashes on the skin and mucous membranes, blistering rashes, meningitis, encephalitis, hepatitis, diarrhea, conjunctivitis, genital lesions (herpes simplex virus, adenovirus, HIV), congenital and perinatal (postpartum) lesions (cytomegalovirus, herpes, rubella virus, enteroviruses, HIV).

Stages of socket healing

1. 2-3 hours
   after
   a blood clot (thrombus) forms
   in the socket . It serves as a barrier to pathogenic microorganisms, preventing them from entering the wound.
2. The next 2-3 days
   - the blood clot thickens, shrinks, the wound
   becomes covered with a whitish coating
   (fibrin film), the formation of granulation tissue begins inside the hole, the basis for the restoration of mucous membranes.
3. After 3-7 days
   , the thrombus lightens, becomes whitish, the connective tissue has practically filled the hole, swelling and pain are minimal or completely absent.
4. After 7-10 days
   , the hole has shrunk significantly,
   new bone begins to form
   , which will completely fill the defect after 4-6 months.
5. After 2 weeks
   ,
   the gums have completely healed
   .

Types of permanent fillings

• Metal seal. Advantages: long service life, inexpensive cost. Disadvantages: long hardening time, contrasting color with the color of the enamel.
• The cement filling can be phosphate or glass ionomer. Advantages: release of fluoride ions, which prevent the formation of caries. Disadvantages: fragility and short service life.
• Composite fillings are made from an epoxy mixture. Advantages: long service life. Disadvantages: long time to install the filling.
• Plastic fillings are made on the basis of acrylic acid. Advantages: high strength. Disadvantages: the formation of micropores in the filling, through which caries can penetrate.
• Ceramic inlays are used to restore a damaged tooth. Advantages: strength and reliability. Disadvantages: high cost and long installation time.

What are the possible complications?

The intensity of pain must be carefully monitored. Unpleasant sensations must subside, otherwise it indicates the development of pathology. The gums hurt especially painfully after difficult removal if inflammatory complications develop:

• Alveolitis is an inflammation of the bone socket and surrounding tissues. accompanied by acute, throbbing pain, redness, swelling, the formation of yellow, greenish, dark gray plaque, cloudy pus with a putrid odor. The cause of the complication is poor hygiene in the postoperative period, ignoring the drug therapy prescribed by the doctor.
• Dry socket - there is no blood clot in the socket, it is dry, empty, there is a yellowish-gray coating, a putrid odor. The reason is that the clot was not formed due to a blood clotting disorder; the clot was removed from the socket by the patient during hygiene, intensive rinsing, etc.
• Socket bleeding - may be associated with a blood clotting disorder, excessive damage to tissues, blood vessels, or a fracture of part of the alveoli.
• Facial neuralgia is a rare complication that occurs due to damage to the facial nerve during tooth extraction. Accompanied by numbness in the cheeks, tongue, lips.
• Periostitis is a purulent inflammation of the periosteum that develops for the same reasons as alveolitis. Accompanied by acute, diffuse pain that cannot be relieved with an analgesic. Swelling is pronounced, can spread to the neck, temperature is above 38℃, general intoxication of the body is observed (headache, weakness, etc.).
• Osteomyelitis is a purulent-necrotic lesion of the jaw bone, accompanied by throbbing pain radiating to the ear, temple, fever, swelling of the gums and oral mucosa, spasms of the masticatory muscles, deterioration in general well-being, and enlargement of the submandibular lymph nodes.

Cheek pain after tooth extraction is a very common symptom, the duration of which depends on the complexity of the intervention. Normally, aching pain completely subsides after 2-3 days

. The picture is completely different when complications develop. With inflammatory complications, purulent foci form in the tissues, and the risk of spread of purulent contents through the general bloodstream increases many times over. There is a high probability of phlegmon, abscess, and destruction of bone tissue. Serious surgery and long-term rehabilitation are inevitable.

Online consultation with a doctor

If you are concerned about the condition of your teeth and the symptoms described in this article: putrid odor, pain when biting, sensitivity of the enamel to cold, hot, sour, sweet, dark holes on the tooth, then it is best to undergo an examination and consultation with a dentist. Because these may be symptoms of deep caries, cysts, and other diseases. Bacteria or infection, entering the blood or lymph, affect healthy tissues, causing complications and illnesses. Which, if neglected, will lead to more expensive treatment:

• depulpation;
• dental restoration;
• deletion;
• dental implantation;
• prosthetics;
• treatment of adentia.

When do you need to see a dentist urgently?

• Severe, acute, throbbing pain that is not relieved by an analgesic, spreads across the face, radiates to the ear, neck;
• bleeding from the socket that does not stop, but rather intensifies;
• absence of a blood clot in the socket;
• bad breath;
• discharge of pus from the wound;
• the formation of yellow, dirty gray, green plaque on the wound;
• temperature rise above 38℃;
• numbness of a part of the face (gums, cheeks) for more than a day;
• pronounced swelling of the gums and cheeks, which does not decrease 2-3 days after extraction.

What can and should be done after tooth extraction

• 20-30 minutes after the intervention, carefully remove the cotton swab
  ;
• use cold compresses
  for 2-3 hours after the intervention (take a break every 10-15 minutes to avoid tissue hypothermia);
• for 3-5 days, make oral baths
  with antiseptic solutions (take the solution, hold it in your mouth for a minute, spit);
• When carrying out daily hygiene, avoid the injured area
  , you can start using the toothbrush on the 2-3rd day, it should be new, with soft bristles;
• chew on the opposite side
  ;
• Eating is allowed after the anesthesia wears off (not earlier than 3-4 hours later
  ).

Treatment

Sick teeth need to be treated, the sooner the better. The dentist’s task is to save the tooth, but if measures are not taken in time, it will have to be removed to avoid serious consequences.

Methods:

• Remineralization Applications of calcium and fluoride preparations and electrophoresis help restore enamel at the initial stage.

• Filling the cavity The affected tissues are removed, their place is filled with filling material.

• Partial prosthetics A crown is placed on the tooth, which protects it from mechanical and biological influences. The crown is placed on a previously depulped, dead tooth.

• Removal If the pulp is affected and the inflammatory process threatens to develop into an abscess, the tooth is pulled out. You should not resist the removal of rotten teeth - they do nothing but harm.

It is easier to prevent any process than to take a long time to eliminate the consequences. By following simple preventive measures and regularly visiting the doctor, you can avoid tooth decay and maintain your smile and self-confidence for many years.

What is prohibited?

• To prevent accidental washing of a blood clot from the socket, it is forbidden to rinse your mouth. To treat the cavity, oral baths are quite sufficient;
• Hot compresses are prohibited, this stimulates severe swelling, the development of inflammation, and bleeding;
• You cannot puff out your cheeks, blow your nose too much, or sneeze;
• It is forbidden to touch the wound with your fingers, tongue, or objects;
• You can’t eat hot, cold, irritating foods; preference is for soft, warm, neutral foods;
• you cannot smoke or drink alcohol for at least a week - tobacco and alcohol slow down tissue regeneration;
• Hypothermia and overheating must be avoided - going to the sauna, swimming pool, solarium is prohibited for 5-7 days;
• Do not take aspirin or other blood thinners;
• do not engage in active sports, do not subject the body to excessive physical or sports stress.

How to reduce pain?

Analgesics will help relieve pain after removal of a molar (or any other tooth) - it is better if it is one of the non-steroidal anti-inflammatory drugs (NSAIDs). Antihistamines will help remove swelling, and antibiotics will help prevent inflammation. The doctor will prescribe effective medications according to the clinical picture. Medicines should be taken strictly as prescribed. Treatment for pain after tooth extraction depends on the cause of its occurrence. The most important thing after the intervention is to scrupulously follow the dentist’s instructions and recommendations. This will help reduce recovery time and avoid complications.

Author of the article Voznyuk Vladimir Aleksandrovich Maxillofacial surgeon-implantologist of the highest category

Work experience: 28 years.