Short answer: Because a tooth extraction is done under local anesthesia, most people do not feel pain during the procedure; what they feel is usually pressure and pushing. After the anesthesia wears off, mild to moderate tenderness is expected for the first 24–72 hours, and it can usually be controlled with the pain relievers your dentist recommends. Pain that gets worse 2–4 days after the extraction may be a sign of dry socket and requires a visit to your dentist.
One of the most common questions before sitting in the dental chair is "does it hurt to have a tooth pulled?" The short answer is this: thanks to modern local anesthesia, most people do not feel pain during an extraction; what they feel is usually pressure, pushing and pulling. After the anesthesia wears off, some tenderness is expected for a few days, and it can usually be kept under control. In this article we give a realistic picture of what to expect in terms of pain during and after a tooth extraction, and share practical tips for reducing pain and anxiety.
Does it hurt during the extraction?
When local anesthesia is given correctly and has taken full effect, there is usually no pain during a tooth extraction; the patient perceives the tooth being loosened as pressure and pushing. Anesthesia blocks the pain fibers, but it does not completely remove the sense of touch and pressure. That is why the feeling of "I can feel something" is usually not pain but pressure from the procedure itself.
Some factors can affect what you feel during an extraction:
- Infected teeth: In areas with severe inflammation, the acidity of the tissue changes, which can reduce the effect of the anesthetic. In this case your dentist may give additional anesthetic or recommend getting the infection under control first.
- Impacted teeth or teeth with complex roots: With teeth that remain inside the bone, such as wisdom teeth, the procedure can take longer and a minor surgical procedure may be needed.
- Anxiety level: High anxiety can increase pain perception and make pressure feel like pain.
If you feel a sharp sensation during the procedure, simply raise your hand to signal your dentist. The procedure can be paused and additional anesthetic given if needed. Agreeing on a signal in advance helps you feel more in control.
How is anesthesia given?
Anesthesia for a tooth extraction starts with a topical numbing gel applied to the gum, after which the anesthetic is slowly injected with a fine needle around the tooth or near the relevant nerve. The topical gel greatly reduces the feeling of the needle going in. Injecting the anesthetic slowly also keeps discomfort during the injection to a minimum.
- Infiltration anesthesia: Used especially in the upper jaw, it is applied to the gum right next to the tooth and numbs a local area.
- Nerve block anesthesia: Because the bone is denser in the back of the lower jaw, this method is used to numb the nerve further back. In this case the lip, half of the tongue and one side of the chin may stay numb for a few hours.
It usually takes a few minutes for the anesthesia to take full effect. Your dentist begins the procedure after testing that the area is numb. For patients with very high anxiety or those scheduled for extensive surgery, sedation may also be considered when conditions are suitable. During the examination, be sure to mention the medications you take, especially blood thinners, and any chronic conditions.
Pain after the extraction
Pain after a tooth extraction begins once the anesthesia wears off, is usually most noticeable in the first 24–72 hours and then gradually eases. After a simple extraction this tenderness is mild to moderate for most people; after surgical extractions, such as an impacted wisdom tooth, there may be more pain and swelling.
What is expected
- Aching and throbbing at the extraction site
- Slight oozing of blood in the first hours
- Swelling of the cheek after surgical extractions, usually peaking on the second or third day
- Slightly limited mouth opening after extractions at the back of the mouth
What is not normal
- Dry socket: Pain that gets worse instead of better 2–4 days after the extraction, radiates to the ear and comes with a bad smell from the socket may indicate early loss of the blood clot. It is more common in smokers and after extraction of lower back teeth, and it needs to be treated by your dentist.
- Bleeding that does not stop with pressure
- Fever, increasing swelling and discharge of pus
- Numbness of the lip or tongue that continues for hours
If you have any of these symptoms, you should see your dentist without delay.
Tips to reduce pain
The most effective ways to reduce pain after an extraction are to protect the clot, apply cold on the first day, take the pain reliever your dentist recommends on time and avoid putting strain on the area.
- Bite on the gauze: Bite firmly on the gauze your dentist placed for the recommended time, usually around half an hour.
- Protect the clot: For the first 24 hours, do not rinse your mouth forcefully, spit or use a straw. These actions can dislodge the clot.
- Apply cold: On the first day, apply ice wrapped in a cloth to the outside of the cheek for short intervals.
- Take pain relievers on time: Taking the pain reliever your dentist recommends before the anesthesia has fully worn off, and on the recommended schedule, makes pain easier to control. The choice of medication is up to your dentist.
- Eat soft, lukewarm foods: Do not eat until the anesthesia has worn off; after that, choose soft, lukewarm foods such as yogurt, soup and purées. Chew on the other side.
- Stay away from smoking and alcohol: Smoking clearly increases the risk of dry socket.
- Keep your head raised: Raising your pillow a little on the first night can reduce swelling and throbbing.
- Keep up your oral hygiene: Brush your other teeth as usual; from the next day, rinse gently with warm salt water if your dentist recommends it.
Managing fear
The first step in managing fear of tooth extraction is to share your anxiety openly with your dentist and ask for each step of the procedure to be explained to you in advance. Uncertainty increases anxiety; knowing what will happen reassures most people.
- Time your appointment well: You may prefer a morning appointment so that anxiety does not build up during the day.
- Agree on a signal: Agree on a hand signal you will use when you want a break during the procedure.
- Do breathing exercises: Breathing in slowly through your nose and out slowly through your mouth reduces muscle tension.
- Distract yourself: Some people find that listening to calm music on headphones helps.
- Bring a companion: Having someone you trust with you is reassuring, especially on the way home after the procedure.
- Do not come on an empty stomach: Unless your dentist says otherwise, eating a light meal before the procedure reduces the risk of weakness and dizziness.
For people with very intense dental fear, options such as sedation can be considered when conditions are suitable. For your other questions about tooth extraction, you can visit our frequently asked questions page.
What happens to the gap after an extraction?
Leaving the gap of an extracted tooth empty can, over time, cause neighboring teeth to tilt into the space, the opposing tooth in the other jaw to over-erupt, and the jawbone to shrink. For this reason, especially for extractions other than wisdom teeth, it is helpful to discuss before the extraction how the gap will be managed with an implant, bridge or denture. In some cases, a bone graft can be placed in the socket during the extraction to preserve space for a future implant.
Examination before a tooth extraction in Ankara
If you have a tooth that may need to be extracted, it is important first to discuss whether the tooth really cannot be saved and how the gap will be managed after the extraction. At our polyclinic in Park Oran Ofis in Oran, Çankaya, after an examination and X-ray assessment, the procedure and aftercare are explained to you step by step. To make an appointment, contact us.
Frequently asked questions
Does the injection hurt during a tooth extraction?
Before the injection, a topical numbing gel is applied to the gum and the anesthetic is given slowly. As a result, most people feel only a brief, mild prick.
How many days does pain last after a tooth extraction?
After simple extractions, tenderness is usually most noticeable in the first 24–72 hours and eases within a few days. After surgical extractions, it may take a little longer. Pain that increases rather than decreases should be reported to your dentist.
What is dry socket and how can you tell?
Dry socket is a condition caused by early loss of the blood clot in the extraction socket. It usually shows up 2–4 days after the extraction as worsening pain that radiates to the ear, along with a bad smell, and it needs to be treated by your dentist.
Does anesthesia work when an infected tooth is extracted?
In areas with severe inflammation, the effect of the anesthetic may be reduced. In this case your dentist may give additional anesthetic or recommend getting the infection under control before the extraction.
