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.