Pain after tooth extraction: how long does it last, and is it normal? These and other questions concern patients after dental procedures. Pain syndrome is normal in several cases: early postoperative period, complex removal, simultaneous implantation.
Normally, pain can persist from several days to a week, and its intensity should decrease. The appearance of symptoms such as increased pain, swelling, inflammation, bleeding or the appearance of purulent exudate is a reason to immediately consult a doctor.
How does a postoperative wound heal?
How long the area hurts after tooth extraction depends on many factors. The healing process after tooth extraction is a complex and lengthy process. Removal occurs with a rupture of the dentofacial connection, namely the connection with the alveolar process and the jaw bone.
The recovery process lasts about two to three weeks. Much depends on the surgical protocol, the clinical situation and the characteristics of the body.
Main stages:
- Formation of a blood clot. Forms 1.5-3 hours after extraction. The function of the clot is to protect the wound area from pathogens and secondary infection.
- Active tissue regeneration. The affected mucous membranes are restored, after 3-4 days swelling and inflammation decrease.
- Formation of granulation tissue. After 4-6 days, granulation tissue forms on top of the clot - the basis of a new epithelial layer.
- Granulation proliferation. After a week, the granulation tissue grows, completely covering the socket.
Already on the eighth to tenth day, the wound is completely healed and by the end of the second week a new epithelial layer is formed.
After two weeks, bone tissue begins to renew. After six months, the bone tissue in the area of removal becomes completely healthy.
Causes of pain
The occurrence of pain after tooth extraction is associated with damage to nerve endings, vascular structures and soft tissues. The peak intensity of pain occurs in the first hours after the cessation of anesthesia. The symptom persists for about 12 hours.
In case of incisions in the gums or damage to the bone tissue, as well as after implantation after removal, toothache may persist for 2-3 days. Pain syndrome also occurs in the case of displacement of the dentition towards the formed void. Therefore, doctors recommend prosthetics as soon as possible after extraction.
When to see a doctor
About 25% of patients experience a return visit to the surgeon after extraction of a posterior molar. This occurs due to the development of complications after surgery. When is it time to go for a follow-up appointment to prevent serious problems?
- The pain lasts longer than a week, does not decrease, on the contrary, it increases.
- New symptoms appear, the temperature rises, pain spreads to the entire jaw, to the ear area, to the temporal part.
The pain began to spread to the ear
- The swelling of the cheek intensifies and does not subside, occupying a larger area.
- Putrid odor from the mouth.
A putrid odor appeared and pus began to leak
- Any discharge from the socket, especially purulent discharge.
All this may mean the presence of a disease that began as a result of infection of the socket, the presence of foreign bodies in it (fragments of dental bone or other objects). The doctor will again order an x-ray, clean the hole, treat it with an antiseptic, and, if necessary, apply drainage. He will prescribe medication and give recommendations for gum care that will help normal healing.
Pain during difficult removal
The duration of pain after complex extraction (wisdom teeth, impacted or dystopic incisors) is associated with damage to a larger tissue area. Often such an operation involves making an incision in the gum, sawing out the roots, extracting tooth fragments, and draining an abscess, which increases the scope of the surgical intervention. If your ear hurts after wisdom tooth removal, this may indicate nerve damage.
In some cases, patients complain of persistent discomfort and pain for up to a week. Clinical manifestations such as swelling, swelling of the gums, enlarged submandibular lymph nodes, fever, and malaise are also common.
Methods for removing wisdom teeth
Wisdom teeth, which dentists call figure eights, complete the dentition. It is difficult to reach them with a toothbrush, which is why their enamel is especially susceptible to caries. In addition, they begin to erupt when the rest of the teeth have already grown. Eights sometimes rest against neighboring teeth, contributing to their destruction.
The difficulty of removing wisdom teeth largely depends on the location of the roots and the presence of concomitant diseases (pulpitis, periodontitis):
- if the roots are not intertwined, the tooth grows smoothly and there are no associated diseases, it is removed relatively simply, using forceps or an elevator;
- if the roots are tangled, the tooth is curved or its crown part is destroyed, the tissues around it are inflamed, dentists have to use more traumatic methods: cutting the gum and then applying sutures. In particularly difficult cases, the wisdom tooth is removed under general anesthesia.
Types of pain
The nature and type of pain depends on the type and surgical intervention, the duration of the operation, and the complexity of the clinical process. Clinicians distinguish the following types:
- Aching. It is felt immediately after the anesthesia wears off. Keeps for about 2-4 days. The jaw may ache when opening the mouth or chewing.
- Intense, enduring. Occurs during extraction of a complex tooth with drainage or opening of a purulent cavity.
- Phantom. Occurs after traumatic surgery and may be felt from time to time. Phantom pain occurs with weak immunity and a low pain threshold.
It is difficult to say how intense the pain will be in each specific case, which is why it is so important to follow medical recommendations to prevent complications.
Tissue damage
During extraction, soft tissue is inevitably damaged. Sometimes the doctor even has to cut the gum to gain access to the unerupted crown. Until complete healing, the wound may be slightly painful, and the tissue around it will remain red and swollen for some time. The pain can radiate to neighboring crowns or even ears. If the discomfort becomes less pronounced every day, swelling and redness subside, there is no need to worry.
You should urgently seek medical help if:
- inflammation and pain intensify,
- not only the soft tissues in the oral cavity swelled, but also the cheek,
- there was an unpleasant taste in the mouth,
- pus is released from the wound.
All this indicates inflammation of the tissue in the hole.
What else can pain indicate?
Severe pain after removal may indicate the development of complications. Pulsating pain that radiates to the ears and submandibular lymph nodes is not normal. The most common causes of complicated postoperative pain are the following factors:
- Violation of treatment protocol. Unfortunately, mistakes do occur, especially in the removal of complex teeth. The techniques and approaches used in different clinics may differ from the standards. Errors include leaving fragments of materials or a splintered tooth root behind.
- Alveolitis. Occurs in the absence of a blood clot. The disease complicates natural healing and interferes with normal tissue regeneration. That is why doctors do not recommend touching the wound with your tongue or rinsing your mouth intensively.
- Dry hole. One of the common complications and the cause of long-term pain after tooth extraction. Despite the moisture of the mucous membranes, bone tissue is visible at the bottom of the wound opening. This problem is typical for smokers during periods of hormonal surges. The doctor seals the wound with a swab containing medication.
- Trigeminal neuritis. Long-term pain persists when a tooth in the mandibular row is removed if the trigeminal nerve is damaged during the manipulation. Damage may be accidental due to structural anomalies or multiple branching of nerve structures.
The likelihood of complications developing is low if the removal protocol, medical recommendations after extraction, and timely response to alarming manifestations are followed.
Pain after dental implantation, tooth implant hurts
During dental implantation, the trigeminal nerve and its branches, the alveolar nerve plexus, may be damaged as a result of:
- Screwing the implant into the canal where the trigeminal nerve or its branches lies;
- Inflammation in the implant area (infection and/or implant rejection).
Some pain during the implant healing process is normal. If the pain after dental implantation lasts too long, is very severe, or is accompanied by numbness of the lip or cheek, we can check the condition of the trigeminal nerve using electromyography and a neurological examination based on the characteristic loss of facial sensitivity and the spread of pain along the trigeminal nerve system.
The rejection reaction and inflammatory processes in the implant area are usually clearly visible with CORRECT X-ray examination and computed tomography.
Implants in the lower and upper jaw. Pain after dental implantation
There may be direct pressure from the implant on the nerve or inflammation in the implant area with tissue swelling, edema and subsequent pressure on the nerve.
How can you reduce pain?
In the early postoperative period, it is important to follow basic recommendations that reduce the risk of negative manifestations:
- maintain the integrity of the blood clot - do not touch the wound with your tongue, rinse vigorously with solutions or water, just take an antiseptic or herbal decoction into your mouth, hold for a few minutes and spit;
- after a complex removal, take broad-spectrum antibiotics - this is important to prevent the infectious process;
- taking symptomatic medications for up to 2-3 days - in the first days, medications help reduce pain and inflammation;
- use a gel with a cooling effect for intense pain;
- do not eat for two hours after surgery, and eat solid food in the area of manipulation for 5-7 days.
You can reduce the pain if you chew a piece of ginger or propolis on the healthy side of the jaw, apply ice through a handkerchief to your cheek or chin, and rinse with the following ingredients:
- tea tree (10 drops per 500 ml of boiled water);
- steep chamomile decoction;
- decoction of eucalyptus and string;
- soda-salt solution (1 tsp soda, 1 tsp salt, 500 ml water).
The temperature of rinsing solutions should be comfortable - neither cold nor hot. Herbal solutions are best used as an alternative 3-5 days after surgery. In the early period, it is better to rinse the wound and oral cavity generously with water-based antiseptics.
The appearance of pain after tooth extraction is associated with trauma to the deep layers of the jaw structures. The tooth can hurt from several hours to 3-7 days, depending on the severity of the clinical situation and the scope of medical intervention. If questionable symptoms or other signs indicating complications appear, it is recommended to consult a doctor.
The jaw hurts and clicks after prosthetics or dental treatment
Dysfunction of the temporomandibular joint. The lower jaw is connected to the skull by two temporomandibular joints. Impairment of the function of these joints is possible after the installation of a denture, crown, bridge, any treatment or tooth extraction if this leads to malocclusion and/or damage to the temporomandibular joint. This is a typical complication after dental prosthetics. Read more about treating TMJ dysfunction here
Temporomandibular joint dysfunction
The green arrow indicates a healthy joint. The red arrow points to the joint that remains in the “open” position when the mouth is closed. This leads to wear and tear of the articular cartilage, pain and clicking when opening and closing the mouth. One of the reasons is the incorrect position of the upper right “eight” (tooth 1_8 lies horizontally).
How can we help you:
- Anti-inflammatory treatment will help relieve pain. If necessary, we inject anti-inflammatory medication directly into the lower jaw joint . This brings relief within a few minutes .
- Injection of botulinum toxin preparations (for example, Botox or Dysport) into spasmodic muscles. This is relevant in the case of an excessive increase in the tone of the masticatory muscles, if it is the muscles that are the “culprit” of dysfunction of the temporomandibular joint.
- Treatment by an osteopath. An osteopath works with the joints and muscles of the jaw using gentle manual techniques. This way you can solve a lot of problems that cannot be solved in classical dentistry. More about osteopathy
- Introduction of chondroprotectors (medicines for nutrition and restoration of cartilage) into the temporomandibular joint. Read more about cartilage restoration
