Tooth extraction closeup: dentist in blue latex gloves is removing a woman's tooth with a help of a cheek retractor and forceps.

How Painful is Tooth Extraction?

Are you feeling anxious about an upcoming tooth extraction? Don’t worry! 

While tooth extraction may seem daunting, it’s relatively straightforward and less complex than other restorative treatments, like root canal therapy.

If you’re wondering how painful tooth extraction is, you’re not alone. This guide will provide you with everything you need to know about managing pain during and after the procedure.

What is a Tooth Extraction?

A tooth extraction is the removal of a tooth from its socket in the jawbone. Extraction is usually a last resort when other dental procedures can’t save the affected tooth. 

Reasons for Tooth Extraction

In most cases, your dentist will prefer exploring restorative dental treatments to save the natural tooth. However, extraction is necessary in certain situations, such as in the general cases outlined below. 

  • Advanced gum disease
  • Impacted wisdom teeth
  • Severe tooth decay
  • Traumatic dental injuries

Types of Tooth Extraction

Depending on your situation, your dentist may recommend various types of tooth extractions. They include:

  • Simple extraction: This is a tooth extraction procedure for visible teeth. It involves numbing the surrounding gums with local anesthesia before carefully loosening the tooth and removing it from its socket with dental forceps
  • Wisdom teeth extraction:  Wisdom teeth are usually  impacted and hard-to-reach. This complex procedure may require general anesthesia or sedatives to minimize discomfort. In some cases, your dentist may need to make an incision in the gum tissue and remove sections of the jawbone to access the affected tooth fully
  • Surgical extraction: Some teeth may require extensive treatment to remove. In some cases, the dentist may have to divide the tooth into smaller pieces before removing each piece separately. In some cases, it may be necessary to lay a flap and remove some supporting jaw bone during a surgical extraction. 
  • Multiple extractions: This type of extraction is typically employed in cases of crowded teeth where the removal of multiple teeth is necessary to create space for orthodontic treatments such as braces or to prevent infection. Multiple extractions may also be necessary if you have extensive bone loss due to periodontal disease or extensive damage to multiple teeth from tooth decay or trauma. 

Pain During Tooth Extraction

While it’s true that tooth extraction can be a painful process, advancements in dental technology and anesthesia have significantly reduced the discomfort and pain associated with the procedure. Furthermore, being informed about the painful events that may occur during the extraction can help prepare you and make the experience less stressful.

Potential Sources of Pain During a Tooth Extraction


Injection of Local Anesthesia

Local anesthesia is usually necessary for most tooth extraction procedures. While you may feel a brief, sharp pain as the anesthesia is injected into your gum tissue, your dentist may apply a numbing gel on your gums, prior to the injection, to relieve discomfort.

Extraction Pressure

Extracting a tooth requires specialized dental instruments such as forceps, which may cause a feeling of significant pressure as the dentist loosens the tooth from its socket. However, in rare cases, you may experience pain or discomfort if the local anesthesia is ineffective at blocking nerve impulses from the surrounding gum tissue.  

To minimize any potential discomfort, the dentist will work slowly and gently to loosen the tooth, communicating with you throughout the procedure to ensure that the anesthesia has thoroughly numbed the gums and that you’re not experiencing any pain.

Bone Removal

Complex tooth extraction procedures may involve making an incision in the gum tissue and removing surrounding bone structures to access the tooth. While local anesthesia can help to reduce pain from the incision and bone removal, the procedure may still be uncomfortable, mainly if the bone tissue is dense.

To minimize discomfort, your dentist may use specialized tools, such as a piezo surgery device and surgical bur, to remove bone tissue more efficiently and precisely.


Complex surgical tooth extractions may require stitches to close up incisions and promote healing. While mild discomfort during the stitching process is expected, in rare cases, pain may be experienced, especially if the effects of the local anesthesia have worn off.

Pain Management Options for Tooth Removal

An important aspect of pain management during tooth extraction is using anesthesia. Depending on the specific extraction procedure, your medical history, and your level of anxiety, your dentist will recommend the most suitable option from the list below.

Local Anesthesia

Local anesthesia is administered by injecting a numbing agent (such as lidocaine or bupivacaine) into the gum tissue where the tooth is extracted. While under local anesthesia, you remain awake during the extraction procedure. 

The anesthetic works by temporarily desensitizing the nerves in the extraction site and blocking pain impulses from reaching the brain. The duration of the anesthetic’s effects depends on the type of local anesthetic and the amount administered. For instance, lidocaine is a fast-acting anesthetic that takes effect within 4 minutes and lasts 30 to 60 minutes.

Nitrous Oxide

Nitrous oxide, commonly known as laughing gas, is a mild sedative that can alleviate anxiety during tooth extractions. Administered through a nose hood, your dentist can quickly turn the colorless and odorless gas on and off throughout the procedure to ensure you remain calm. 

Nitrous Oxide stimulates the release of endorphins in the brain, which are pain-relieving and mood-enhancing hormones that help alter your perception of pain during the extraction.

While Nitrous Oxide is fast-acting, its effects wear off once you stop inhaling the gas. As such, it’s often used in combination with local anesthesia. 

General Anesthesia

General anesthesia is used in complex surgical extraction procedures to induce a state of unconsciousness, particularly if you have severe dental anxiety. The anesthesia is typically administered directly to your bloodstream via an intravenous (IV) drip. 

Your dentist will assess your medical history and consult an experienced anesthesiologist to ensure no complications arise once you’re under general anesthesia. 

Furthermore, an anesthesia team will monitor your vitals as the dentist performs the tooth extraction. Once the procedure is complete, you’ll be gradually awakened until you’re fully conscious and can breathe independently. 

Pain After Tooth Extraction

Experiencing some degree of pain or discomfort after a tooth extraction is common. Various factors, including the complexity of the extraction, your pain tolerance, and your medical history, can influence the severity of the pain. 

To help you understand what to expect, here are some common pain symptoms you may experience after tooth extraction. 

  • Mild discomfort: After tooth extraction, it is common to experience mild to moderate pain, such as a dull ache and swelling around the extraction site. This discomfort typically lasts only a few days and is a normal part of the healing process.
  • Throbbing pain: You may experience a throbbing pain that comes and goes in waves as the tooth socket heals. This typically lasts for the first few days and may cause inflammation around the extraction site. However, this pain can be managed with over-the-counter pain medication such as ibuprofen.
  • Sharp, flaring pain: It is normal to experience a sharp, flaring pain around the extraction site while eating or drinking due to changes in temperature or pressure. However, you should contact your dentist immediately if the pain worsens after a few days 
  • Pain radiating to the head and neck: After tooth extraction, you may feel a dull pain that spreads to parts of your head and neck. This sensation is typically caused by your brain misinterpreting pain signals from the inflamed nerves surrounding the extraction site as originating from other areas of your head and neck

Pain Management Tips After Tooth Extraction

While you will experience some pain and discomfort after your tooth extraction, you can take steps to manage it effectively. The following pain management tips can significantly alleviate pain or discomfort as you heal. 

  • Follow post-operative instructions: It’s vital that you follow the post-operative instructions provided by your dentist on how to care for the extraction site. This may include tips from inflammation management to dietary instructions.
  • Apply Ice packs: Applying an icepack on your cheek for short intervals can drastically reduce pain and discomfort on the extraction site
  • Use pain medication: Your dentist may recommend over-the-counter pain relievers such as acetaminophen and ibuprofen to help alleviate pain after the extraction. It would be best if you followed the recommended dosage to avoid complications
  • Watch your diet: Avoid hard and crunchy foods for at least a week after tooth extraction to avoid irritating the site. Go for soft foods like applesauce and yogurt as the tooth socket heals 
  • Avoid strenuous activities: To ensure a smooth recovery after the extraction, it is highly recommended that you rest for a few days. Strenuous activities could elevate blood pressure in the extraction site, leading to increased pain and potential complications

When To Seek Professional Help After a Tooth Extraction

Despite following post-operative instructions, complications may still occur after your tooth extraction. If you experience any of the symptoms listed below, it is important to contact your dentist immediately.

  • Severe and persistent pain that doesn’t subside after taking pain-relieving medication
  • A foul taste in your mouth accompanied by bad breath. This could indicate an infection 
  • Swelling and inflammation around the extraction site that worsens after the extraction
  • A dry socket that develops when the protective blood clot is dislodged from the tooth socket
  • Numbness and a tingling feeling in your lips, chin, or tongue, which could be a result of nerve damage
  • Excessive bleeding that continues for days after the tooth extraction

Your dentist will provide instructions on managing your symptoms until they can assess the extraction site and take necessary corrective steps for potential complications.

Myth Busting: Dispelling Common Misconceptions About Tooth Extraction

Tooth extraction has had a bad reputation over the years – just think about the phrase “pulling teeth”! But it’s important to know that some beliefs surrounding this procedure are often misleading. In fact, there are several common misconceptions about tooth extraction that we’d like to clarify for you.

Myth: Tooth Extraction is Severely Painful

Fact: Your dentist will administer anesthesia to alleviate pain and discomfort during the extraction procedure. They will also prescribe pain-relieving medication and give you post-care instructions to manage pain after the extraction and promote healing. 

Myth: Tooth Extraction Negatively Impacts Your Quality of Life

Fact: While missing teeth can cause a range of problems, such as difficulty chewing and bone loss in the jaw, There are various replacement options for the missing teeth, including dental bridges, dentures, and dental implants. 

Myth: Tooth Extraction is a Risky and Complicated Procedure

Fact: Most tooth extraction procedures are quick and straightforward. While the complexity of the procedure depends on factors like tooth location and medical history, advancements in dental technology have significantly reduced the risks associated with complex tooth extraction procedures. 

While tooth extraction may seem daunting, knowing what to expect beforehand can help reduce anxiety about the possibility of feeling pain during the procedure. With advancements in dental technology, modern anesthesia, and pain management techniques, pain during tooth extraction has been significantly reduced.

If you have any concerns about pain management techniques or tooth extraction, please give us a call to schedule a consultation to get further guidance and advice.