The discomfort you feel after the anaesthesia wears off following a tooth extraction is temporary and less than the pain of an infected tooth. However, if you have severe pain after a tooth extraction that lasts more than three days, you should contact your dentist for an oral assessment of the wound site.
Severe Pain After a Tooth Extraction: Signs of Normal Healing Pain
In most cases, temporary tooth extraction pain and sensitivity are normal. Although your No Gaps Dental professional is careful to avoid causing unnecessary damage to your gums and the underlying bone, your body’s pain receptors detect the trauma and respond with inflammation. While this is normal, it may be uncomfortable or painful.
The pain worsens once the anaesthetic wears off. Throbbing pain during the first 24 hours post-extraction is a sign that your body is healing. Headaches, pain around the temples, neck or jaw and a sore throat may result from swelling and should subside within 1-3 days. 
Some temporary side effects of tooth extraction include:
- Bleeding
- Discomfort
- Soreness
- Swelling
- Tenderness
The amount of tooth extraction pain and the length of recovery time can differ depending on the tooth extracted. For example, a complex wisdom tooth extraction typically causes more intense and long-lasting pain.
For the first 24 hours after your tooth extraction, blood clots will begin to form, and you will experience some bleeding and minor tooth extraction pain. Swelling usually peaks at around 24-78 hours. If tooth extraction pain and bleeding persist beyond three days, contact your No Gaps Dentist to ensure there are no post-surgical complications.
Following your dentist’s post-extraction instructions can help alleviate discomfort and speed your recovery. These may include:
- Using an over-the-counter pain reliever to alleviate the discomfort and reduce swelling
- Taking any medications you are prescribed
- Applying ice to the affected cheek for 15-20 minutes at a time to soothe the inflammation
- Using a salt water rinse after the first 24 hours to prevent infection (rinse gently and let the water fall out of your mouth rather than spitting)
- Eating a soft food diet of foods like lukewarm broth, yoghurt, scrambled eggs and smoothies (but avoid using straws so you don’t dislodge the blood clot)
- Avoiding crunchy, spicy or salty foods that can irritate the wound or dislodge the blood clot
- Avoiding vigorous activity and resting with your head elevated to avoid blood pooling, which can prolong your healing
- Maintaining good oral hygiene after the first 24 hours by brushing gently and avoiding the extraction site
Severe Pain After a Tooth Extraction: Secondary Condition Called Dry Socket
After tooth extraction, you will have a hole in your gums that is filled with a blood clot that protects the nerves and bones. Immediately following your tooth extraction, your dentist places gauze in the gap and asks you to bite down. This helps the blood clot form. Unfortunately, sometimes a blood clot can fail to develop correctly or is dislodged before the tissue can fill the hole.
When this happens, you may experience a painful condition called dry socket. The pain can be excruciating when food and air make contact with the nerves in the gap.
Although dry socket can occur for no apparent reason, you can help prevent it by avoiding drinking from straws, spitting, and smoking. In a clinical study of dry socket, the condition occurred in approximately 34 (2.6%) of 1,274 extractions. It was more common in complex extractions than in simple procedures.
While dry socket needs to be addressed by your No Gaps Dental dentist, you can manage the pain at home with OTC medication such as ibuprofen which reduces the inflammation and swelling. You can also press a cold compress to the side of your face of the affected area.
If you think you have dry socket, contact your No Gaps Dental dentist immediately. They can clean the area and pack the site with medicated gauze to promote healing.
Severe Pain After a Tooth Extraction: Painful Infection
Bacteria can sometimes invade the tooth extraction site, although this is more common if you have gum disease. You can usually return to brushing and flossing your teeth after 24 hours, which can help control the bacteria in your mouth.
Using a salt water rinse can help prevent infection.
According to a Cochrane review of randomised controlled trials, the risk of infection post-extraction is 25% in patients with a low immune system and 10% in healthy patients.
Signs of an infection after a tooth extraction include swelling that doesn’t subside, pus at the wound site and fever.
If you have an infection, contact your dentist so they can prescribe antibiotics.
Severe Pain After a Tooth Extraction: When to See Your Dentist
Following a tooth extraction, it’s normal to feel some mild pain. However, contact your dentist if you experience any of the following symptoms:
- Continued tooth extraction pain after three days
- Pain that spreads to your temple, ear, eye, or neck
- Severe or worsening pain
- Bad breath
- Dry socket that you can see
- Fever
- Redness at the extraction site
What to Expect at Your No Gaps Dental Consultation
When you come to No Gaps Dental for tooth extraction pain, your dentist will examine the wound for signs of a blood clot, food debris or an oral infection.
If dry socket has occurred, your dentist will rinse the site and apply a medicated dressing that will need to be replaced every few days until your recovery is complete. Your dentist may prescribe stronger pain relief and antibiotics for an infection.
If you are experiencing tooth extraction pain, call one of our 15 No Gaps Dental locations or contact us on (02) 8007 6727 for immediate assistance.
Note: Any surgical or invasive procedure carries risks. Before proceeding, you should seek a second opinion from an appropriately qualified health practitioner.
References
A clinical study of “dry socket”
https://pubmed.ncbi.nlm.nih.gov/6815111/
Prevalence of Postoperative Infection after Tooth Extraction: A Retrospective Study
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8208874/#:~:text=According