Tooth hurts after extraction: how to relieve pain

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 disease development. Where does the disease begin?

The most unexpected microorganisms can cause severe and fatal illnesses. Now let's look at the chain of development, that is, the cycle of transformations from health to illness and the death of an individual. At school we studied the cycle of life in nature, the water cycle, watched interesting films about animals, about the food chain.

But at the same time, we have always considered ourselves “Kings of Nature,” not assuming that inside us, in our body, the same cycle of different lives is possible, coming and going, but living by eating our cells, each other, or feeding on other people’s scraps. Everyone has the same motto: “Survive at any cost, winners are not judged!” This means infiltrating into the best place, individual for each specific type of parasite, finding food for growth, reproduction, protecting its offspring and helping it spread.

So let's look at this process. Sparing the feelings of convinced atheists, I will start not with the true causes of the development of diseases - spiritual, energy-informational, but with “materialized” ones, that is, those that can be seen, touched, identified, calculated and measured. These reasons are the microorganisms living in us. I will paraphrase the Bible saying “what is outside of us is also in us” to “what is on the earth and in the air is also in us.”

Let's consider the process of disease development and the role of various microorganisms involved in it. The trigger mechanism for the development of the disease is viruses. They are able to penetrate cells, weakening them or completely destroying them. These do not necessarily have to be formidable viruses specific to immune cells. Any other viruses that penetrate us from childhood gradually lead to a weakening of the immune system, a weakening of the protective properties of cells, organs, and systems.

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.

Reason four: financial

In the initial stages, caries treatment is relatively inexpensive and absolutely affordable for everyone. However, with the development of complications up to the loss of a tooth, treatment becomes increasingly more expensive: treating pulpitis is already noticeably more expensive than caries, since the volume of manipulations and materials consumed are greater. As for the loss of a tooth that has not been treated in time, prosthetics will cost quite a hefty sum. Therefore, those people who do not care too much about their health may benefit from the financial argument.

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.

What to do if your child is afraid of the dentist

When children say they're afraid of the dentist, this is a common reaction. The reason for fear usually lies in the fact that the child has not previously visited the dentist, but may have heard negative reviews from surrounding children or adults. Also, children are scared by the unknown.

Playing doctor will help you cope with fear, where parents will cheerfully talk about the bacteria living in the mouth, how they destroy teeth, methods of protection and dental examination. You can watch a children's program together about the work of a dentist, go on a tour of a children's dentistry, or allow your child to communicate with the doctor on their own.

Stages of socket healing

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.
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.
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.
After 7-10 days
, the hole has shrunk significantly,
new bone begins to form
, which will completely fill the defect after 4-6 months.
After 2 weeks
,
the gums have completely healed
.

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.

Why do we most often recommend removing teeth with periodontitis?

Our natural teeth are a hotbed of inflammatory processes. They have a porous structure, so it is on them that all microbes, which have a destructive effect on periodontal tissue, first settle. If implants with an active surface are placed next to such teeth, even the most resistant ones, which contain chemical elements that promote the healing of bone cells (such as SLActive® from Straumann and TiUnit® or TiUltra® from Nobel Biocare), they will still are unable to cope with a massive attack from all sides and bone tissue atrophy. That is, by preserving our natural teeth, we risk losing all the results of implantation.

So if there are only a few teeth left, they are destroyed and affected by diseases, then there is no point in preserving them - it is much easier to carry out removal with simultaneous replacement with implants, after which it will be enough to carry out regular oral hygiene (on your own and with a dental hygienist) and actually forget about dental problems forever. After all, if there are no teeth, there is no inflammation.

We categorically do not recommend implantation on one jaw if there are foci of generalized periodontitis of a severe and acute stage on the second - even though there is no direct contact, it is still dangerous. Our body is a single whole, let alone the oral cavity. Pathogenic microorganisms will circulate along with saliva, so inflammation of the tissues around installed implants is only a matter of time. It is impossible to talk about any lifelong service in such a situation.

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.

How to relieve tooth inflammation

If inflammation of the root does not give you peace, then it is best not to delay a visit to the doctor. Traditional medicine at home is not intended to treat such a complex disease - we can say with confidence that self-medication will not bring the expected results. Relieving painful spasms and swelling with herbal infusions will only bring calm to the patient for a while, but the inflammatory process will develop and return after a while with more severe consequences.

The following will help to tame the pain for a while:

Painkillers. They will help you endure acute pain, which is not advisable to endure, but it is best to drink them 12 hours before going to the doctor so that he can make a correct diagnosis;
To relieve pain, you can rinse your mouth several times with a special solution, mixing a teaspoon of salt and soda in a glass of water, adding four drops of iodine;
Using calendula tincture, you can relieve inflammation, mix a tablespoon of tincture with a glass of water, rinse your mouth up to 5 times;
One of the modern recipes for relieving toothache: place two drops of propolis tincture on cotton wool and apply to the painful tooth, the pain should subside within an hour;
Boil one teaspoon of chamomile and oak bark in a liter of water, leave for 20 minutes, cool slightly, rinse for inflammation;

It is important to remember that applying warm compresses to a sore spot is strictly prohibited! Rinsing and taking painkillers cannot be considered treatment, because even if you managed to relieve the pain, the inflammatory process has not been stopped, it will proceed unnoticed and will resume with renewed vigor, the consequences of which can be unpredictable.

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
).

Is it possible to carry out implantation against the background of advanced periodontitis?

Implantation with preservation of living teeth in this form of the disease is extremely rare, but is not excluded. In general, this is assessed at the stage of primary diagnosis - the doctor will understand what results can be achieved with complex treatment, whether it makes sense to spend time and money on therapy, or whether it is better to immediately remove mobile teeth, replacing them with implants, thus stopping the inflammation process once and for all.

It is also important to understand the attitude of the patient himself - it is worth preserving your teeth if you are ready to fight for your natural teeth to the end, if you are ready for the fact that over the next year you will need to visit a periodontist at least once a month and undergo regular treatment, and after installing implants you will have to strengthen hygiene and similar courses will become commonplace for you.

Periodontitis is an infection. Do not follow the lead of those doctors who offer implantation without complex treatment. One-time cleaning, curettage or splinting is not enough; inflammation will progress, which means there is a high risk of it spreading to the tissue around the implant. Rejection in such a situation is guaranteed - you will lose money, time, nerves and will be forced to undergo implantation again, but 100% with the removal of living teeth and most likely with bone grafting, because its own is destroyed.

Thus, implantation for this form of periodontitis while preserving your teeth can be carried out subject to the following parameters:

if there is something to save - if you only have 3-4 teeth left, there is no point in investing time and money,
if, based on the diagnostic results, we understand that it will be possible to eliminate the disease during a period of stable remission and the risks of implantation will be minimized due to this,
if you are ready for long-term treatment and follow all your doctor’s recommendations in the field of lifestyle changes, nutrition, and oral hygiene.

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.

Endocrine disorders

With chronic periodontal inflammation, blood sugar levels increase. This provokes prediabetes and, if the patient is not treated, diabetes. The treatment program for diabetes mellitus necessarily includes sanitation of the oral cavity - if the inflammation is not removed, the glucose level will remain high.

Without treatment, caries also provokes other problems: constant pain, insomnia, disruption of the nervous system, loss of appetite, weakened immunity, etc. Dentists at the Dentospas clinic recommend regular examinations by a dentist and performing dental treatment in a timely manner, without waiting for complications and serious consequences.