Prolonged throbbing pain after tooth extraction, but not dry socket

Throbbing pain typically ends within 7 days after a tooth extraction, but it may be prolonged to 2 weeks or even longer due to various factors, including inflammation, infection, or trauma to the extraction site. It is essential to determine the cause of the pain to manage it effectively

While dry socket is a well-known cause of post-extraction pain, there are other potential causes that require attention.

Dry socket occurs when the blood clot that forms in the empty socket after a tooth extraction becomes dislodged or dissolves, exposing the bone and nerves. Pain from dry socket typically begins a few days after the extraction and can be particularly intense at night when blood flow to the area increases.

Here are some possible causes of throbbing pain after tooth extraction:

throbbing pain extraction

Causes of prolonged pain after tooth extraction

1. Inflammation

Inflammation of the surrounding gum tissue and bone is a natural response of the body to any injury, infection, irritation, or surgical procedure, including tooth extraction.

In the case of a tooth extraction, inflammation can occur in response to the trauma of the procedure and the resulting tissue damage. The body sends white blood cells to the area to fight off any potential infection and start the healing process. This is characterized by swelling, redness, and warmth, as well as pain and discomfort, which may take several days to subside.

While inflammation is necessary for healing, there are certain situations where it may fail to subside, causing its symptoms to continue for longer than expected.

Prolonged inflammation may result from poor oral hygiene, smoking, underlying medical conditions, or inadequate aftercare following the extraction. The presence of bacteria in the extraction site can also prevent the inflammation from healing. If the extraction site becomes infected, the body’s inflammatory response can continue for an extended period, leading to pain for weeks following the procedure.

Additionally, some people may have a heightened immune response, which causes it to overreact to the tissue damage caused by the extraction, leading to excessive inflammation and prolonged pain.

It is essential to follow proper aftercare instructions after a tooth extraction, such as keeping the extraction site clean and avoiding smoking or drinking alcohol, to reduce the risk of infection and minimize inflammation.

Over-the-counter anti-inflammatory medications, such as ibuprofen, can also help to reduce inflammation and relieve pain.

2. Trauma

Tooth extraction is a traumatic procedure that can cause damage to surrounding tissues and nerves, but it should heal gradually over the next few days with proper aftercare.

However, new trauma to the extraction site, such as accidentally biting the area, can cause inflammation and throbbing pain to emerge weeks after the procedure was completed. It can also cause bleeding and delay the healing process, leading to prolonged pain and discomfort.

It is important to follow post-extraction instructions carefully and avoid activities that could cause trauma to the extraction site, such as smoking or using a straw, or even touching or irritating the area in any way to minimize the risk of trauma.

3. Infection

If bacteria enter the extraction site, an infection can develop. This can cause prolonged pain due to the body’s response to the presence of bacteria, especially if it is accompanied by fever, swelling, discharge of pus, and even foul odor or taste in the mouth.

In some cases, an infection can develop in the socket or in the surrounding tissue, leading to a condition known as alveolar osteitis, or dry socket. This can delay the healing process and cause persistent pain.

Infections are usually quite serious, and should be treated promptly by a dental professional, possibly using antibiotics.

4. Nerve damage

During the extraction, the nerves surrounding the tooth may be damaged or affected, resulting in pain that can last for several weeks. This is more common with surgical extractions, where the dentist needs to manipulate the surrounding tissues to remove the tooth.

Nerve damage can also occur if the tooth was impacted or if the roots were curved or long. In some cases, the damage may be temporary and resolve on its own over time, while in other cases, it could be permanent.

The pain associated with nerve damage is typically a sharp or throbbing pain that is felt in the jaw, teeth, or ear. It may also be accompanied by numbness or tingling in the affected area. If nerve damage is suspected, it is important to follow up with your dentist or oral surgeon for evaluation and treatment.

How to treat nerve pain after tooth extraction

Treatment options for nerve damage may include medications to manage pain and inflammation, as well as physical therapy or referral to a specialist for nerve repair or grafting procedures. In some cases, surgery may be necessary to relieve pressure on the affected nerve.

  • Pain Medication: Your dentist may prescribe pain medication to manage your pain. Over-the-counter pain relievers, such as ibuprofen or acetaminophen, may also help to relieve mild to moderate nerve pain.
  • Nerve Blocks: Your dentist may recommend a nerve block to help reduce nerve pain. A nerve block involves injecting an anesthetic near the nerve to block pain signals.
  • Ice Pack: Applying an ice pack to the affected area for 20 minutes at a time can help to reduce inflammation and numb the area, reducing nerve pain.
  • Warm Compress: A warm compress can also help to relieve nerve pain. Place a warm, damp washcloth on the affected area for 20 minutes at a time.
  • Relaxation Techniques: Stress and tension can exacerbate nerve pain. Practicing relaxation techniques such as deep breathing, meditation, or yoga may help to reduce nerve pain.

5. Sinus pressure

Upper back tooth extractions (molars and premolars) can sometimes cause sinus pressure and throbbing pain in the upper jaw. The maxillary sinuses, located above the upper teeth, can become inflamed or infected after a tooth extraction, leading to pressure and pain in the area. This condition is known as maxillary sinusitis, and it can cause prolonged pain, headaches, and even fever if left untreated.

The symptoms may be worsened by changes in air pressure, such as during a flight or a change in altitude.

If you experience prolonged sinus pain 2 weeks after tooth extraction, especially in the upper jaw, it is important to consult with your dentist or oral surgeon to determine the underlying cause and proper treatment. This type of pain is typically relieved with sinus medication.

6. Dry socket

Although dry socket pain usually occurs within the first few days of extraction, a dry socket can sometimes develop later, causing persistent pain.

The disruption of the blood clot can be caused by several factors, including smoking, sucking on a straw or spitting, and aggressive rinsing or brushing. Following the disruption, bone and nerves in the socket may become exposed, causing pain and discomfort. This pain can be exacerbated at night when you’re lying down, as the blood flow to the affected area increases, leading to increased pressure and discomfort.

To prevent dry socket and the associated pain, it is essential to follow the post-extraction instructions provided by the dentist. This includes avoiding smoking or using tobacco products, avoiding vigorous rinsing or brushing, and avoiding hard or crunchy foods for the first few days after the extraction.

If dry socket does occur, you should contact your dentist for prompt treatment, which may involve placing a medicated dressing in the socket to promote healing and reduce pain.

Final thoughts

In summary, the causes of prolonged pain after tooth extraction can be varied. It is important to follow the aftercare instructions provided by the dentist or oral surgeon, including taking any prescribed medication, to minimize pain and discomfort.

If the pain is severe or does not improve after a few days, you should consult your dentist to rule out any complications or infections.


  • Editorial team

    A team comprising oral health care professionals, researchers, and professional Writers, striving to impart you with the knowledge to improve your oral health, and that of your loved ones. 

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