Tooth Extraction Pain – During & After The Procedure

How much does removing a tooth hurt

Removing a tooth is a highly skilled procedure carried out by a dentist. The experience for the patient usually involves nervousness, which is natural as some pain is to be expected. However, the pain of having a tooth extracted is now largely in the post-operative period, after the procedure has been carried out, as the patient is generally under local anesthesia during the procedure. As long as the local anesthesia is effective, the person having their tooth removed will only feel pressure, not pain, meaning that they will be able to tell that something is going on in their mouth, but it will not be painful. Even the pain of the needle used to inject the local anesthetic is numbed by applying topical anesthetic beforehand to the site of injection. Overall, tooth extraction is a virtually painless procedure, and with good post-operative management, will remain a painless experience throughout the recovery period, though some soreness may be felt at the extraction site.

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The procedure of tooth extraction

The procedure of tooth extraction involves several steps done in an organized manner. The dentist will numb the tooth to be removed by injecting local anesthetic. Once the local anesthetic is in effect, the dentist will proceed to loosen the attachments of the tooth by applying dental instruments around the tooth. The application of the dental instruments will break the attachments and expand the socket in order to make space for the tooth to come out. Finally, once the tooth has been sufficiently loosened, the dentist will remove the tooth using dental forceps. There is the misconception that tooth extraction is carried out by literally pulling the teeth. This is not true. The tooth is removed through the application of controlled force through the forceps, and the tooth is moved back and forth in the socket until it comes out.

There are different types of extraction, depending on the case. If the case is relatively straightforward, the extraction is known as a simple extraction. If the case is complicated and requires surgical intervention, it is known as a surgical extraction. The case requiring tooth extraction can be a case of dental decay, a tooth broken beyond saving, or a combination of both, to name a few.

  • Simple extraction involves a tooth in which the crown and roots are relatively intact and the tooth can be removed in one piece. This is performed under local anesthesia and no surgical incisions are made during the procedure.
  • Surgical extraction involves a complicated case in which a surgical incision needs to be made in order to give proper access to the dentist to the tooth, which may then be removed in fragments. The bone in which the tooth lies may have to be partially removed in order to free up the tooth for removal. A surgical extraction results in greater post-operative discomfort for the patient, as there is a greater recovery period and more swelling is present.

Sedation used during tooth extraction

A dental extraction can involve different types of sedation.

  • Local anesthesia: This is the most commonly used type of anesthesia used for removing a tooth, in which only the tooth to be removed and the surrounding tissues are numbed.
  • Partial sedation: This is used in patients who are too anxious to undergo a dental extraction normally. In partial sedation, nitrous oxide is used to relax the patient. While the patient is aware of what is going on, they are still calm enough to go through with the procedure.

Post-operative pain management

It is normal to experience pain and swelling in the extraction site after the procedure is completed and the anesthesia has worn off. There are some basic ways to manage this pain.

  • Over the counter painkillers: The pain after a simple extraction can be managed by taking over the counter painkillers such as acetaminophen or ibuprofen, but not aspirin, as aspirin can increase the chances of bleeding.
  • Prescription painkillers: After a surgical extraction, a dentist will usually prescribe pain medication to be used for the particular case. The dentist’s instructions should be followed regarding the use of these prescription pain medications.

Post-operative complications

There are some complications that may occur after the dental extraction.

  • Dry socket: In the case of the blood clot that forms in the empty socket after dental extraction being dislodged, the nerves in the socket can be exposed, which causes severe pain. This is handled by the dentist, who places a medicated dressing on the dry socket which alleviates the pain and allows the socket to heal.
  • Damage to nearby teeth or the jaw: This may occur during the extraction procedure due to the dentist applying too much pressure. The adjacent tooth may be injured, or the jawbone may be fractured. Seeing the dentist is the proper solution to these problems.
  • Damage to the nerve: Usually, the extraction procedure is carried out without coming into contact with any nerves. In the case of an unusual anatomy or procedural error, a dental nerve may be injured, which causes pain after the procedure. The nerve pain will reduce and cease after a while, or it may continue as chronic pain.
  • Infection: Infection may occur at the extraction site due to improperly sterilized dental equipment or improper upkeep of oral hygiene after the procedure. This is a serious complication which requires immediate emergency medical attention.

Duration of pain after tooth extraction

It is normal to experience pain for three to seven days after the procedure, until the end of the recovery time. The pain of a surgical extraction may last for several weeks, depending on the complication of the case.

Pain in the jaw after tooth extraction

There may be pain in the jaw after a tooth extraction, usually due to having to hold the mouth open for an extended period of time. This can be managed by massaging the sides of the face, applying a hot pack to the face, and using over the counter painkillers. Eating hard food must be avoided, as well as opening the mouth too wide, in order to allow the jaw joint to recover.

Phantom pain

In rare cases, the patient may feel pain at the extraction site for a long time after the procedure. This pain goes away on its own after some time and does not respond to treatment, so the only solution is to be patient and give it time to resolve on its own.

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