After a tooth extraction, some amount of pain and discomfort is to be expected over the next couple of days. The severity and duration of the pain is highly individualized due to differences in recovery and pain tolerance.
On average, you should expect some level of discomfort for about a week after the extraction. Although if you’re lucky, it may be much shorter than that. On the flip side, it could also be much longer than that if you have poor healing and pain tolerance.
Note: We and the vast majority of our colleagues abbreviate extractions as “EXT” or “EXO”.
The progression of pain
Pain begins immediately after a tooth extraction once the anesthesia wears off. It will last and persist over the next week or so but with varying levels of intensity.
You read that correctly. The post-operative pain from tooth removal is not constant. The amount and severity of it will differ depending on which day it is post-surgery.
If you plotted the progression of pain after a tooth extraction on a chart, you would see what we have in the diagram above. The pain distribution will look like a left skewed bell curve.
- X-axis = Days post-extraction
- Y-axis = Pain intensity or severity
Most painful days after an extraction
The first three days are the most painful after a tooth extraction. Immediately after the procedure, the intensity of pain rapidly increases and peaks between 48-72 hours.
During this time period, we highly recommend taking your pain medication even if you have high pain tolerance. This may be the worst time after the surgery but the good news is right around the corner if you can bear through these 2-3 days.
Pain wanes after peaking
After the pain peaks, it is a downhill rollercoaster ride from day 3 with rapidly decreasing discomfort. The amount of pain should lessen with each successive day, fourth day, fifth day, sixth day, etc.
Sometimes during this period, those with high pain tolerance can try stopping their pain relievers to see how they feel. If the discomfort is doable, you may try to not take any. We understand that taking too many pills can be hard on the stomach.
However if you don’t want to deal with the discomfort it is perfectly okay to continue taking the pain relievers. There is nothing wrong with that!
Discomfort ends after a week
Typically by the end of the week you should barely feel any pain if any at all. There may be a miniscule amount of soreness or tenderness but that is normal. It shouldn’t be anything that disrupts your life because it should be so mild that you don’t even pay attention to it.
As evidence for what we’re saying, your dentist probably only gave you enough pain medication for a week. What that implies is that you shouldn’t need to take anymore after this point. Therefore we will confidently say that all of the pain from removing a tooth will last about a week at most.
Pain management protocol
Managing the pain is an important part of the tooth extraction aftercare. This is achieved by using a combination of pain medication and a cold compress, both of which serve a couple of purposes.
- Minimizes the discomfort.
- Reduces the facial swelling.
When to begin taking pain medication
You should begin taking the pain medication as soon as you can but preferably before the anesthesia or numbness wears off. Doing so will help you stay ahead of the pain.
If you wait for the numbness to wear off first, you may experience more discomfort than you would have. Reason is because the pain relievers take about an hour before it starts working. That means you’ll have about an hour where you have no pain alleviating assistance. We call this following behind the pain.
What does the cold compress do?
The cold compress while not a medication, can help reduce swelling and pain. The cold helps to numb the side of your face which you press it upon. The pressure will also help to keep the swelling down.
How to use a cold compress:
- Place cold compress over the affected area.
- Alternate 15 minutes on with 15 minutes off.
- By alternating it’ll help prevent frostbite on your face.
When can I stop taking medication?
Depending on your pain tolerance level, there are various points in time where you may try stopping the medication.
- High pain tolerance. You may attempt to stop taking the pain medication after the third day. If it is too much to bear, you may resume taking it.
- Medium pain tolerance.You may try stopping the medication sometime between the 5th and 7th day.
- Low pain tolerance. If you don’t tolerate pain very well, there is absolutely nothing wrong with finishing the entire prescription that your dentist gave you! They should’ve given you enough pills for about a week or so.
However, regardless of how tough your nerves of steel are, we always recommend to take the pain killers for at least the first three days. Even if the pain doesn’t bother you, we do want you to take it to reduce inflammation and swelling.
Most commonly, your dentist will prescribe you a NSAID (non-steroidal anti-inflammatory drug) which is ibuprofen. It does more than just alleviate pain because it will bring the inflammation and swelling down! Taking it will reduce the chances of your face looking bloated.
When to seek help
The question we get asked a lot from our patients is, “when is the amount of pain abnormal?”
The answer to that question would be that it depends. It is rather difficult to quantify it since the discomfort that you’re feeling is subjective. Not that we don’t believe that you’re in pain because if you say you are then you certainly are.
Nonetheless, we’ll try our best to give you a guideline as to when to seek professional help.
- Worsening pain after the third day. If you follow our pain progression chart, the discomfort typically peaks 48-72 hours after the surgery. However, the pain should taper off after that point. Therefore the best time to tell is if pain gets worse on the fourth day or so. If it does, you may have a complication such as a dry socket or an infection. Both scenarios would require intervention by your dentist.
- Non-subsiding pain. If during the 4th-7th days you don’t notice any improvement in pain, something may be wrong. Under normal circumstances, it should gradually lessen with each passing day. You may call your dentist if it feels like it is throbbing.
So, how long does it last again?
After a tooth extraction, the pain should last for approximately a week or so. The intensity of the discomfort should peak around 48-72 hours after the procedure. After that it should rapidly decline from there on with day to day improvements.
That is the normal progression of pain after having your tooth removed. If you notice deviation from what we’ve described above, there is a fair chance you may have a complication. If that is the case you should seek a follow up appointment with your provider who did the treatment!