Experiencing some pain after a tooth extraction is a common part of the healing process. Managing this discomfort effectively is important for a comfortable recovery and to prevent complications. Various options are available to help alleviate pain, ranging from over-the-counter medications to prescribed pain relief and practical home care measures.
Over-the-Counter Pain Relief
Non-prescription medications are often the initial approach for managing pain. Nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen (Advil, Motrin) and naproxen (Aleve) are effective because they reduce inflammation, a major contributor to post-surgical pain. A common dosage for ibuprofen is 200-400 mg every 4-6 hours, while naproxen can be taken as 220 mg every 8-12 hours.
Another common over-the-counter option is acetaminophen (Tylenol), which primarily blocks pain signals. It can be taken with NSAIDs for enhanced relief. A typical dosage for acetaminophen is 325-1000 mg every 4-6 hours, but do not exceed 4,000 mg within a 24-hour period to avoid liver toxicity. Combining an optimal dose of an NSAID with acetaminophen has been shown to be more effective than either medication alone for dental pain.
Prescription Pain Management
When over-the-counter medications do not provide sufficient relief, a dentist may prescribe stronger pain management options. These can include higher-dose NSAIDs, such as prescription-strength ibuprofen, naproxen, or diclofenac.
For more severe pain, opioid pain relievers like hydrocodone with acetaminophen or oxycodone may be prescribed. Opioids work by altering the brain’s perception of pain. These medications are reserved for short-term use due to potential side effects, including dizziness, nausea, constipation, and the risk of dependence or addiction. Follow the dentist’s instructions precisely regarding dosage and duration, as non-opioid pain management can be equally or more effective for most dental pain with fewer risks.
Home Care and Comfort Measures
Beyond medication, several home care strategies aid in pain management and promote healing. Applying an ice pack to the cheek for the first 24 hours reduces swelling and discomfort. Apply ice for 15-20 minutes at a time, with 20-minute breaks. After 24 hours, moist heat can be applied to reduce swelling and improve comfort.
Rest is important, and limiting physical activity for the first 24-48 hours helps prevent excessive blood flow that could disrupt the healing blood clot. Maintain a soft diet, avoid chewing on the extraction side, and refrain from using straws or spitting forcefully to protect the blood clot that forms in the socket. Rinsing gently with warm salt water (half a teaspoon of salt in 8 ounces of warm water) after 24 hours helps keep the area clean and reduces the risk of infection.
When to Seek Dental Advice
While some pain and swelling are normal, certain symptoms indicate a need for professional dental attention. Worsening pain after the first few days, especially if severe, throbbing, and radiating to the ear, eye, or neck, could be a sign of a dry socket. A dry socket occurs when the protective blood clot dislodges or fails to form, exposing the underlying bone and nerves.
Signs of infection include increasing swelling after 48-72 hours, persistent bad taste or odor from the extraction site, visible yellow or white discharge, or a fever above 100.4°F (38°C). Persistent or excessive bleeding beyond 24 hours also warrants contacting the dentist. Any prolonged numbness beyond a few hours post-procedure could indicate nerve involvement requiring evaluation. Consult with a dentist if there are concerns about the healing process or if pain becomes unmanageable.