Pain after tooth extraction

Pain after tooth extraction is an inevitable, usually fast-paced investigation, provided that the extraction is successful and the patient's care for the cavity is respected.

Modern dentistry, its surgical component, seeks maximum preservation of the patient's teeth, thanks to unique technologies, materials and equipment, this has become quite commonplace. However, there are either emergency cases or conditions of so called "neglected" teeth, when doctors have to resort to extraction, that is, tooth extraction.

Despite all the efforts of the pharmaceutical market, which offers new and effective anesthetics, one must admit that removal is a small surgical operation that somehow injures bone tissue and gum tissue, often with oral mucosa.

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Cause of pain after tooth extraction

Dolor post extractionem - so called in Latin pain after tooth extraction. This unpleasant and inevitable phenomenon has its own causes, caused by various factors: 

• The condition of the tooth or teeth in general.
• The number of teeth to be removed at the same time.
• Presence of a purulent inflammatory process in the oral cavity.
• Associated stomatological diseases - parodontosis, stomatitis, abscess, caries and others.
• Localization of a diseased tooth.
• The degree of destruction of the tooth, teeth.
• Presence in the anamnesis of the patient of chronic diseases of internal organs and systems.
• Age of the patient.

As a rule, the main causes of pain after tooth extraction are associated with the trauma of the gum and bone tissue during the operation. This is an inevitable consequence, which ideally should disappear after a maximum of 24 hours. In order to correctly respond to pain symptoms, it is necessary to find out how the extraction injuries occur: 

1. When removed, the integrity of the ligaments holding the tooth is inevitably broken, because it must be ripped out. In this case, nerve fibers and blood vessels are torn, otherwise the diseased tooth will continue to "sit" in place and provoke inflammation and pain.
2. At the time of extraction, a mechanical pressure is applied to the walls of the tooth socket, with inevitable crushing of the nerve effector endings.
3. As a result of mechanical pressure during the operation, there is some expansion of the infection zone, until the moment of removal of the localized one. The inflammatory process is temporarily activated and spreads to nearby tissues.

These causes of pain after tooth extraction are considered normal phenomenon, belonging to the category of extraction injuries.

Specific factors provoking dolor post extractionem (pain) can be associated with such consequences of removal: 

• 85% of the causes of pain symptoms are lunar neuritis, damage or inflammation of the alveolaris inferior (nerve) of a toxic infectious or mechanical nature. This complication is also called posttraumatic alveolitis. Alveolitis can develop as a result of getting an infectious agent in the hole, especially often in a "dry" hole, when the necessary blood clot is not formed in it. The inflammatory process in the periosteum lining the well causes a strong, throbbing pain, spreading along the arrangement of the nerve trunks. In the edematous hole, purulent contents may appear. Alveolitis manifests its symptoms 3-4 days after the extraction of the tooth with non-compliance with the rules of oral hygiene. In addition, lunar neuritis can develop into phlegmon and cause a strong general intoxication of the body. Such complications are extremely rare and are associated with late treatment of the patient to the dentist or attempts to solve the problem of pain by means of heating, compresses and alternative means. Professional treatment of the alveolitis consists in aseptic washing, therapy with antibiotics. Also, it is not superfluous to recall that the blood clot after removal is very important, so rinsing in the first 2-3 days is not done in order to avoid opening the hole for infectious inflammation. 
• Causes of pain after tooth extraction can be associated with fracture of a single segment of the alveolar process. This damage is visible during the procedure and is immediately treatable. Fracture can occur due to the individual anatomical properties of the jaw of the patient, as a result of fusion of the tooth with the bone tissue of the jaw (ankylosis). Fractures are treated under steady-state conditions by the application of plates or splinting. Signs of fracture of the process - puffiness of the face, bleeding, severe pain. Such complication arises extremely rarely, and if it happens it is only when the lower teeth are extracted. In addition, the risk of fracture is minimized before surgery, when a panoramic image is taken (OPTG). 
• Acceptable extraction injuries are a wound at the site of removal, hyperemia of the mucous membrane of the mouth, swelling from the side of the removed tooth. Edema comes off in 2-3 days, helps to speed up this process of cold compress. 
• The cause of the pain can be associated with increased bleeding, which always worries the doctor. This may indicate a violation of blood coagulability, high blood pressure, diabetes, but most often due to an elementary failure to follow the oral care after extraction. Also, bleeding is associated with possible damage to the vascular bundle, which passes close to the lower eighth teeth. Bleeding is eliminated by tamponade, antihemorrhagic drugs. 
• Traumatic injury of the bottom of the maxillary sinus is possible with the extraction of upper teeth. Perforation causes a characteristic sound of a whistle on exhalation, aching pain, intensifying at night. This complication is almost never seen, since its occurrence is prevented in advance, before the operation with the help of a detailed panoramic image. 
• Psychosomatic cause or so-called phantom pains, manifested after a month or more after tooth extraction. This is due to individual increased sensitivity and the process of regeneration, restoration of bone tissue, nerve endings, vessels.

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Pain after removal of wisdom tooth

Pain after removal of the wisdom tooth is more intense than after extraction of other teeth. As a rule, the eighth tooth is removed, which may lack space in the arc and it begins to move adjacent teeth. The very development of the eight is often accompanied by painful symptoms, especially when it erupts for a long time and under the wrong inclination. If the wisdom tooth is removed at the eruption stage, the extraction is faster, and the complications are minimal.

During the operation, the inevitable, rather severe injury of the gums occurs, due to the anatomical location of the wisdom teeth. But even the most severe pain after the removal of the tooth wisdom passes for 2 days. If the pain intensifies on the second day and is accompanied by hyperthermia, you should not postpone the visit to the dentist, as these are typical signs of the beginning of the alveolitis. The infectious process is easier to neutralize at the outset with the help of antibacterial therapy, possibly - stitching on the gums, antiseptic irrigation and tamponade wells. If the process is neglected, it can give a serious complication in the form of osteomyelitis of the jaw bone. The pain after removal of these teeth is aching, spreading throughout the gums, the inflammation of the socket and the gums pain symptom can be very strong, and accompanied by fever.

Symptoms of pain after tooth extraction

Typical signs and symptoms of pain after tooth extraction are as follows: 

• Primary pain within 2-3 hours after the end of the action of the anesthetic. The pain is aching, transitory and subsides after 1-2 days. As a symptomatic treatment, a non-steroidal anti-inflammatory drug or an analgesic may be prescribed. 
• Swelling of the gums, cheek tissues in the tooth extraction zone. This is a temporary post-traumatic inflammatory process, especially when it is found in the removal of the wisdom tooth in the lower jaw. Edema can increase on the second day after extraction, this is considered a valid phenomenon. In no case swollen cheeks can not be warmed, on the contrary, cold compresses can significantly speed up the reduction in swelling. 
• Painful sensations when opening the mouth. This is also an acceptable temporary phenomenon caused by inflammation of the mucosa, gums and chewing muscles. As a rule, the pain subsides on the third day and disappears definitively after 5-7 days after removal. 
• The hematoma is on the cheek on the side of the tooth extraction. This is due to possible mechanical pressure when extracting wisdom teeth, and also possible in patients suffering from hypertension. The bruise comes off within 3-5 days. 
• Elevated body temperature, up to 38-39 degrees, especially in the evening or at night. This is caused by the resistance of the immune system, aimed at neutralizing post-traumatic inflammation. Thus, hyperthermia for 1-2 days is considered a protective reaction of the body, and not a pathology.

As a rule, the symptoms of pain after tooth extraction disappear after 5-6 days, rarely they persist for more than a week, which indicates the possible development of complications. Usually, the dentist conducting the removal appoints follow-up visits and oversees the healing process of the wound. If the symptoms develop atypically and cause acute, severe pain, persistent temperature, general worsening of the condition, you should not hesitate, but immediately visit a doctor. The following symptoms are dangerous signs: 

• Strong puffiness of the face, exciting both cheeks.
• Bleeding, which does not stop within a day.
• Febrile state, chills.
• Nausea and vomiting.
• Purulent discharge from the socket of the removed tooth.
• Cough, shortness of breath.
• Severe pain after tooth extraction.

Strong, sharp pain after tooth extraction can develop after 2-3 hours, when anesthesia ceases to be effective. The pain subsides with each hour and disappears on the second day, if this does not happen, you need to go to the dentist and find out the cause of the complication.

The nature and intensity of pain depends on the type of extraction. With the removal of the wisdom tooth, severe pain is almost inevitable, this is explained by the necessary traumatization during the operation. Most often, the pain symptom is removed by analgesics, in cases when they do not work, antibiotic therapy is used, since an inflammatory process in the alveolitis or infection of the gum tissue is possible.

In addition, severe pain after tooth extraction is provoked by the remains of bone fragments, roots. It should be noted that such cases have not been observed in recent years, since any experienced physician after the extraction performs an inspection of the cavity, aseptic irrigation, and if necessary appoints a second panoramic photograph.

One of the possible causes of severe pain can be a purulent process in an empty hole. This is due to the absence of a blood clot, which either does not form due to severe bleeding, or is washed out by an unacceptable rinse on the part of the patient. The clot performs the task of protecting the exposed wound in a unique way, if it does not form, a condition called a "dry hole" develops. In the empty hole can get infected saliva, food, provoking inflammation right up to the abscess.

Aching after tooth extraction

Aching after extraction (removal) of the tooth is a completely acceptable symptom, the nature and duration of which depend on the complexity of the removal process. With a favorable operation, the patient needs to be patient for 2-3 days, after which the aching pain subsides.

"Starts" aching pain immediately, as the action of the anesthetic drug ends. Pain can be transient, intermittent, and rarely develops into a strong one. If the pain is exhausting and does not allow to fall asleep, it causes discomfort, it can be removed with an analgesic and a cold compress on the side of the face where the tooth was removed. Pay attention, the compress should cool, and not warm, therefore it needs to be changed every 10-15 minutes, besides in cold procedures breaks are necessary. If aching sensations do not pass within two days and spread over the gum, you need to return to the dentist and get recommendations for more intensive treatment. It is likely that long-term pain is associated with complications - alveolitis, purulent process in a "dry" hole, where a blood clot did not form.

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Headache after tooth extraction

The head can hurt both in the presence of the tooth, and after its removal, which is quite natural and can be explained by the proper arrangement of the teeth.

Headache after tooth extraction is most often caused by swelling of the gums, less often - by the alveolitis or abscess. As a rule, painful sensations are localized in the zone of innervation of nerve endings damaged during extraction and are performed together with the main posttraumatic symptoms, that is, after 2-3 days.

The most dangerous complication of extraction is the inflammation of the trigeminal nerve, which provokes a strong, intolerable, headache. Neuropathy of the trigeminal nerve can be caused by traumatic damage to the nerve branches when removed, less often by an incomplete root canal obstruction with partial removal (preparation for prosthetics). Also, the cause of the headache can be a purulent inflammatory process in the hole, the remains of the tooth root in the gum.

A severe headache after tooth extraction, accompanied by fever, confused consciousness, enlarged lymph nodes, nausea and vomiting, requires emergency medical attention, as it is a sign of acute intokisation of the body.

If after tooth extraction a throbbing pain

Pulsating nature of pain is a typical symptom of inflammation of the pulp, more precisely, in its nerve. Underexcirpation, when the pulp is not completely removed, the inflamed nerve - these are the factors that cause a toothache after pulping.

Pulp is actually the flesh, tooth tissue, rich in blood vessels and nerve endings, receptors. Thus, it is a very sensitive tissue that is innervated by the branches of the trigeminal nerve. Any her inflammation is accompanied by strong, throbbing pains. It should be noted that extirpation (removal) of pulp is indicated in cases of acute or chronic infectious process - pulpitis. If the removal was not carried out to the end, the process not only continues, but is also activated by operational mechanical action. Consequently, after tooth extraction, throbbing pain in case of underextension is associated with exacerbation of inflammation and irritation of neural bundles.

In addition, pulsation can indicate a developing purulent process in the gums or the socket of the removed tooth. The gums become inflamed as a result of falling into it of the fragments of the root, and the hole in the absence of a dense clot of blood covering the wound hole.

Treatment of pain after tooth extraction

All measures involving pain reduction after extraction should be planned and recommended by the treating dentist, as they depend on many factors - the patient's age, indications for removal and other reasons. Nevertheless, there are standard tips that help reduce pain.

Treatment of pain after tooth extraction is as follows: 

• Immediately after extraction, it is necessary to ensure the cold in the area of the face, from the side of the removal site. It can be a cold compress, ice. The procedure should cool, and not warm the gum tissue, breaks are also necessary, so as not to provoke hypothermia, not to chill gums.
• Day and more you can not rinse, brush your teeth. A blood clot that closes the wound should form in the hole. 
• Rinse is allowed on the second or third day. Solution: teaspoon of soda or half a spoonful of salt on a glass of boiled water at room temperature. The procedure should be done 2-3 times a day.
• With severe pain, you can take analgin, ketanov, antipyretics.
• A dentist can prescribe a treatment after tooth extraction in the form of antibiotics if complications of an inflammatory nature develop. Drugs that effectively neutralize the infection are Sumamed, Biseptol, Amoxiclav and so on. Note that antibiotics should be drunk according to the doctor's recommendations, by the course, even if the pain is already passing.
• The doctor can stitch, especially if the wisdom tooth is removed. Modern dentistry has all the means to alleviate the pain and condition of the patient, so the seams are applied with threads that dissolve themselves.
• In cases of complications, the course of antiseptic irrigation, tamponade can be conducted out-patient.

How to relieve pain after tooth extraction?

In order to relieve pain after tooth extraction, at the initial stage cold procedures are applied. If the extraction was successful, a cold compress on the cheek is enough. If the pain increases and becomes intolerable, an analgesic or anti-inflammatory drug is indicated. As a rule, appoint Ketanov, Diclofenac, less often Analgin. Spasmolytic drugs are not effective, because they perform a completely different task. In addition, it is unacceptable to receive anesthetics independently, they should be recommended by a doctor, taking into account all the features of the operation and the patient's state of health.

Also, the following tips help to relieve pain after tooth extraction: 

• The tampon applied on the hole can not be removed immediately, it should provide protection of the wound for 20-30 minutes before the formation of a blood clot.
• You can not remove blood from the hole, rinse your mouth within 24 hours after tooth extraction.
• Do not eat for 2-3 hours after extraction to avoid infection of the wound.
• You can not warm your cheek, gum, take a bath in hot water.
• Do not touch the wound with any household items. Access to the hole is allowed only to the doctor under sterile conditions.
• Do not eat sharp, too hot dishes, chew the side where the tooth was removed.
• As well as warming, the hypothermia of the gums, cheeks is unacceptable.
• It is advisable to give up smoking, and alcohol intake is contraindicated categorically.
• All prescribed medications should be taken by the course.
• It is necessary to observe the regime of visiting the doctor and not to miss inspections.
• Do not use so-called alternative means of treating pain, they can provoke complications up to an abscess or phlegmon.

How to prevent pain after tooth extraction?

Prevention of pain after extraction is the strict observance of all medical prescriptions and the implementation of recommendations for oral care. The main goal pursued by the prevention of pain after tooth extraction is to minimize possible complications, such as alveolitis, a purulent infectious process. The rules for preventing a pain symptom are simple: 

• Do not disturb unnecessarily the wound for 2-3 days. Do not touch it with tongue, objects, do not rinse your mouth and do not chew on the injured side.
• Purification of the oral cavity can begin to be carried out 2 days after removal, it consists of irrigation with antiseptic solutions, which can be purchased at the pharmacy on the recommendation of a doctor.
• You can not tolerate the growing pain, if it becomes acute, you need to take an analgesic once, maximum - 2 times a day. If the pain does not subside, you should visit the dentist, but do not suppress the pain symptom, as the clinical picture will be blurred.
• Cold helps to prevent pain during the first day, on the second day it is not effective, and can provoke inflammation of the gum.

Prevention of pain after tooth extraction, is the systematic care of the oral cavity and regular visits to the dentist until the moment when you have to part with the tooth. Both the treatment of other diseases and the prevention of pain symptoms are a warning of the cause, that is, of the disease. Then the toothache will only be an unpleasant memory, not a reality, and getting rid of it will be considered a real gift of fate. As Bernard Shaw once wrote: "A person suffering from toothache, considers everyone happy who does not have a toothache."