post-procedure dental pain
October 5, 2011 1:53 PM   Subscribe

Should it hurt this much two days after having two teeth pulled?

So I had two teeth pulled on Monday. I had been in pain for two weeks before that, and had some pain meds for four days prior to the procedure.

One tooth was a rear lower molar. The other was a front lower center tooth.

Right now, two days after the procedure, I am in discomfort. I have been taking aspirin and acetaminophen. It hurts still. The right side of my head throbs.

I know that during the procedure, a lot of stress was placed on my jaw, and I held my mouth open and firm throughout. So maybe there's some residual effect of that.

Also, at one point, the dentist said that he couldn't give me any more novocaine because I was already at the clinical limit for it. Then he gave me more anyway.

I should explain more about that. I am dentist-phobic. But prior to this experience, I never realized that I'd never been fully numbed before. I know that every dentist I've ever seen has maxed out their novocaine on me. When I was a kid, it took three people besides the dentist to hold me down in order to give me a filling, because I felt everything he did, and he didn't believe me. Every dentist has been like that, not believing me when I say I can feel what they're doing. Even the wonderful nitrous oxide gas, which lets me find a happy white room in my brain, doesn't help when someone is prodding right on a nerve.

The two root canals I had (approx 20 years ago) were absolute torture. I think the one dentist broke out the longest files he'd ever used (28mm?) all while practically laying on top of me boring those things into my lower jaw.

So it wasn't until this last procedure -- 2 days ago-- that I realized that I've essentially been tortured by dentistry. No wonder I haven't seen anyone for my teeth in 10 years. This dentist did right by me, recognized my pain (even when I told him to just go ahead) and did more targeted injections.

Prior to the more targeted injections during the procedure, he did a couple extra injections that had a couple of weird effects. The whole side of my face became numb, up to my scalp, and I couldn't focus my eyes, probably because the nerves around that eye were affected.

This whole procedure, I was quivering like a terrified chihuahua. It took me 3 hours to calm down afterwards. I smelled so bad --- fear sweat is funky stuff.

So, given my problematic history with dentistry, should I be concerned about the continuing pain?
posted by yesster to Health & Fitness (26 answers total) 2 users marked this as a favorite
Response by poster: Oh yeah -- couple more things:

- i'm generally very pain tolerant. Won't give all the specifics here, but I know I'm not a "wuss". Wean myself off pain meds whenever prescribed.

-currently sanitizing my mouth and additionally medicating with vodka
posted by yesster at 1:56 PM on October 5, 2011

Best answer: I have only had one tooth pulled before, but in my experience you should not be worried. I was in super awful pain for a few days and constant throbbing pain for easily a week. I figured there must have been something horribly wrong ("my jaw is falling off! I know it!") but when I went back to the dentist he said everything was healing over fine, and in another week he was right.

It totally sucks for now, though. You have my sympathy!
posted by jess at 1:57 PM on October 5, 2011 [1 favorite]

Best answer: FYI if you've had your teeth full on pulled, the pain *could* be from dry socket... Did the dentist mention this possibility/offer any guidelines for mitigating?
posted by stenseng at 2:00 PM on October 5, 2011

Best answer: Throbbing after extraction? All the other issues aside, is it possible you have dry socket?

Dry socket is distinguishable from general wound-related pain by the deep, throbbing pain that accompanies it—it feels like it's in your bones, because it is (your bone is actually exposed at the extraction site). It's fairly common. I have a fairly high pain threshold and had no trouble with the pain around the wound when I had my wisdom teeth pulled—didn't even need the pain meds—but dry socket had me sobbing at my desk, unable to concentrate on anything.

So, yes, call your dentist. Even if you're healing normally, unmanageable pain is never fun and should be solved if possible.
posted by peachfuzz at 2:01 PM on October 5, 2011 [1 favorite]

Best answer: Things are always the worst two to three days after you get a procedure done. It sounds sucky but reasonable.

However, if things haven't started to go down within the next few days, do check in with your dentist or your primary care doctor to see about getting some actual pain meds. (regardless of your situation with pain meds, which you don't need to get into here.)

Then, if things haven't cleared up in a few MORE days (like, if your skin is hot to the touch) make sure you haven't gotten infected.

I don't think you should get that far, but my husband had some issues with a single wisdom tooth removal a couple months ago. He's had multiple surgeries, so he's not particularly pain intolerant, but when your body tells you something's weird, it's probably weird.
posted by Madamina at 2:03 PM on October 5, 2011

Yeah, definitely watch for the dry socket.

I'm pretty pain tolerant, and mouth pain is some of the worst I've experienced, because there isn't a damn thing you can do about it to make it better. Also, the pain from wisdom teeth I had removed after I'd been in pain because of them was miles worse than the pain from teeth removed before they become problematic. But if it's been two days and you're not feeling some reduction in pain, I think it's worth seeing your dentist. At the very least, maybe you can get more effective pain meds.
posted by EvaDestruction at 2:06 PM on October 5, 2011

Response by poster: will probably do clove tomorrow
posted by yesster at 2:07 PM on October 5, 2011

I definitely agree with this:

However, if things haven't started to go down within the next few days, do check in with your dentist or your primary care doctor to see about getting some actual pain meds. (regardless of your situation with pain meds, which you don't need to get into here.)

When I had a wisdom tooth yanked, my dentist wrote me a painkiller prescription before I left the office. As luck would have it I got by on Advil, but based on that it's pretty common to have the kind of pain that needs serious meds.
posted by drjimmy11 at 2:08 PM on October 5, 2011

Aspirin and acetominophen are not very effective anti-inflammatories, and your pain could very well be from swelling. Can you not take NSAIDS (ibuprofen, naproxen)?

Last gnarly dental work I had done, they put me on massive amounts of ibuprofen starting 24 hours before the appointment and for three days after.
posted by Lyn Never at 2:08 PM on October 5, 2011

Response by poster: have appt. for monday
posted by yesster at 2:08 PM on October 5, 2011

Best answer: Like you, I am not sensitive to lidocaine. Dental work sucks.

I had four impacted wisdom teeth extracted during my senior year of high school. I thought it would be an easy procedure and made plans for eating lots of pudding and watching bad movies with my two best friends, who were going to stay home with me. It turned out to be an absolutely miserable experience. My mouth really, really hurt, my pudding was unappetizing, and I fell asleep during Ferris Bueller's Day Off. It took about two weeks before I felt better, I think.

At one point during my recovery, I went back to the surgeon because I thought the amount of pain I was having meant that something was Very Wrong, but he told me that some people just heal much more slowly than others.

All this to say that I think your experience is probably within the realm of normal. Also, because of my lidocaine insensitivity, I get IV anesthesia for dental extractions. Obviously, this isn't practical for a regular filling or whatever, but it is a LOT better than getting all those injections in the mouth. My dentist has been very sympathetic and tries to be super quick with the drill when I do need a filling.

(Get this: my grandma, who is a 4'10", 80-pound wisp of a woman, has never received novocaine for any dental procedure ever, including extractions, fillings, and root canals. She just goes in, the dentist does his thing, and she drives herself home afterward. Some people are just better able to tolerate this kind of thing.)
posted by easy, lucky, free at 2:19 PM on October 5, 2011 [1 favorite]

Best answer: I'm concerned that there may have been some untreated infection. Were you prescribed antibiotics before the extractions?

My next concern is dry socket. How was aftercare described to you? Were you instructed to not drink through a straw? Did you drink through a straw? Cigarettes? Have you been smoking them? Those are the two most common causes.

I am not a dentist. I will never be a dentist. I used to manage a dental office.
posted by bilabial at 2:33 PM on October 5, 2011

Best answer: First: IANAD, just another patient who is similarly dental-phobic. Obviously, my experience is not your experience and my doctor's advice to me is not your doctor's advice to you.

Don't let the mentions of dry socket above terrify you. Yes, it's most definitely a concern after extraction and you should follow your dentist's recommendations to avoid it, which include (but might not be limited to) not using a straw, not smoking, and generally not sucking anything.

But throbbing pain does not necessarily mean you have dry socket. My wisdom tooth extraction, which healed up fine without any dry socket, caused a very strong throbbing pain for days after the procedure. (I was terrified, absolutely certain I had dry socket despite all my precautions. At my check-up, I was astonished when the oral surgeon beamed and pronounced "Gold star!") In my case, that pain was why they prescribed Vicodin ahead of time. I used it for several days, and the one time I decided to skip it and see how bad the pain was, I wished I hadn't.

Which is just to say: pain after extraction is totally normal. In fact, my post-extraction instructions specifically mentioned that I shouldn't be surprised or worried to notice an increase in pain over the first 3-5 days.

Also: did the dentist speak to you about using ice packs to reduce swelling and pain? I found towel-wrapped ice packs (actually I used a packet of frozen peas, which conforms nicely to the face) invaluable in keeping the pain down.

If you were in a post-panic state, you might not have absorbed the aftercare advice very well. Did they give you aftercare instructions in writing?

IF not --- or if they did but you want reassurance --- give the dentist's office a call and tell them how you're feeling, ask what you can do about it. If you're interested in getting a prescription for pain medication, mention that, too. (Note: they may not be able to prescribe it over the phone, and even if they can, you will probably not be able to mix the meds and vodka.) They're used to fielding calls from patients, discussing symptoms, and assessing the need for medication.
posted by Elsa at 2:49 PM on October 5, 2011

Best answer: Also: it sounds like you're combining alcohol and acetaminophen, which can be very dangerous. Ask your doctor or dentist what is safest for you to take.

The whole side of my face became numb, up to my scalp

In case you're worried about this, I'll just say: this sounds pretty normal to me. Well, not "normal" but not worrisome. Apparently I'm novocaine-resistant, so my dentist and I have established a pretty good routine. He always gives me what he thinks should be enough novocaine, then taps around to see if I can feel anything (which I always can).

Then he shrugs and gives me enough to numb that side of my face up to my hairline. It has a very odd effect on my contact lenses, and your inability to focus your eyes quite right sounds about the same. Like I said, not quite "normal" (because most "normal" people never get that much novocaine) but not completely out-there, either.

Don't be terribly surprised if the injection sites themselves feel a little raw, too. It's unpleasant but it will heal up soon.

But this does sound like a good time to check in with the dental office to see what they recommend. They might even have a website for aftercare instructions.

And general coping advice from one dental-phobe to another: at every appointment, before they start doing anything, I remind my (amazingly wonderful) dentist and assistants of my anxiety, making it clear that it's not about them but about my phobia, and I ask them to make a few tiny accommodations to ease it.

For example, I ask them to please let me know what's going to happen and how long they expect it to take. (This means that I know how long I'll have to hold my mouth in a given position and can adjust accordingly.)

My dentist also knows that if I raise my hand, it means OH NO I CAN FEEL THAT PAIN and he stops ASAP and gives me more novocaine, or at least explains why he can't. It helps me feel in control, which is very helpful.
posted by Elsa at 3:06 PM on October 5, 2011

It sounds a little crazy - but moisten a teabag and put it on the places that hurt (inside your mouth). It gels with pain, swelling and bleeding - with the added benefit of tasting good if you have some yummy tea around (black tea is best).

I just had teeth out - and this is strange but effective.
posted by crankyrogalsky at 3:08 PM on October 5, 2011

I got a lot of relief from the pain and swelling by using ice on my face after I had a tooth pulled. I did 20 minutes ice/20 minutes no ice for a couple of days afterwards and I think it helped a lot. Otherwise I managed it with vicodin and advil. The vicodin made a huge difference, and I'm surprised you weren't given a prescription for it before you left the office.

Note: do not combine vicodin or other pain killers containing acetaminophen with more acetaminophen (Tylenol.) OR alcohol.

Feeling the novocaine up the side of your face sounds normal to me. I often have that feeling.
posted by gingerbeer at 3:25 PM on October 5, 2011

Response by poster: Thanks everyone.

I've been through several surgeries. Seven on my head. A few others.

This is wrong and bad.

I need help.
posted by yesster at 4:03 PM on October 5, 2011

Response by poster: I mean, I am going to get help.
posted by yesster at 4:04 PM on October 5, 2011

Best answer: Yesster I am sorry that you are in pain. but generally speaking, 2 days after having two tooth sized things pulled from your skull will almost always leave you in discomfort of varying degrees. it's a normal part of the healing process if nothing else. It's why you are given pain meds and post-op instructions.
Aspirin is not a good idea, and neither is alcohol. sanitizing your mouth, if it involves swishing of any kind, or moving air or fluids around inside your mouth in any way is also not recommended.
Nsaids, as others have mentioned, will reduced inflammation and take the pain down a few levels. narcotic pain meds should get you the rest of the way. rest, ice on and off in short (10-15 min) intervals, and nutrients, in the form of soft foods or calorie rich shakes help you to heal as well.
Are you running a fever? Do you have remarkable facial swelling or swelling in your mouth that might close your airway? These are two criteria that might raise your post-op course to the level of needing intervention after 2 days, but pain in itself would not.

In my practice my staff spends as much or more time explaining post-op expectations and instructions as i do extracting the teeth. teeth are not designed to come out, so the process, including the injection sites, the muscles, and the tissue which has to heal after the extraction, exacts a cost, which is very often pain.

Follow the instructions, take your meds, lay off the vodka, get rest and nourishment and let your dentist know what you are experiencing. good luck.
posted by OHenryPacey at 5:27 PM on October 5, 2011

Response by poster: again thank you all

I have no assistance until tomorrow.

I will be fine. Really haven't had that much vodka. Not my liquor of choice anyway.

A few years ago, my colon shut down. Took me about an hour to get dressed, another hour and a half to drive myself to the ER which was only 20 blocks away. Was in ICU for 24 hours.etc. then a couple weeks later had a section of my colon removed and walked out of there less than 24 hours later.

This is worse.
posted by yesster at 5:54 PM on October 5, 2011

Response by poster: No. Getting worse.

The dentist removed one wrong tooth I think.

Pain and pressure are insane.

Completely sober, lots of pain. Dental practice doesnt answer.

Will they freak out if they find me on their doorstep when they open?
posted by yesster at 7:45 PM on October 5, 2011

Best answer: You sound really freaked out, which is understandable. I myself freak out about anything and everything that is or might be or could possibly go wrong with me.

First, search your online yellow pages for a 24 hour emergency dentist. There may or may not be one in your area. If there is, give them a call and tell them what is going on. They may be able to help.

If that doesn't work, absolutely call your dental practice first thing in the morning (I wouldn't just show up there). Tell them how much pain you are in. Make them understand that you need to be seen ASAP.

But mostly, please try to calm down. I 100% understand that you are really truly in pain. But you're also focussing on it and obsessing about it right now which is only making it stand out more.

If you have ibuprofen, take that. It will be more helpful than aspirin.

I hope you are feeling better after you talk to your dentist tomorrow morning (first thing!).
posted by misanthropicsarah at 8:12 PM on October 5, 2011

were you able to go to the dentist and get things resolved?
posted by misanthropicsarah at 8:40 PM on October 6, 2011 [1 favorite]

Yes, please let us know what happened. Hope that you are doing okay.
posted by futz at 2:27 PM on October 7, 2011

How are you feeling? Were you able to get some help from your dentist?
posted by gingerbeer at 11:19 AM on October 10, 2011

Response by poster: OK - phoned dentist Thursday and he called in a prescription for pain meds, didn't seem too concerned.

Saw dentist this morning. They took a crapton of x-rays of all my teeth (were going to do this anyway). All remaining teeth are fine - no cavities! The sockets of the two extracted teeth are healing fine.

No explanation for my pain. It's basically hurting right at the hinge of the jaw on the right side, mostly the bottom of this hinge. No explanation and no real concern either.

I don't explain pain well, I think.

It does seem to be getting better day by day. Still quite uncomfortable. I sleep in 3-hour bursts. Thankfully I don't have a lot of work to do right now, so this isn't much of a problem.

I have been applying icepacks a few times a day, which helps. Dentist gave me a prescription for about two days worth of vicodin.

Was referred to a periodontist for treatment. Apparently I have quite advanced periodontal disease.

Thanks all for your concern and your input.

And yeah, part of my issue on the night I posted this was a bit of a freakout.
posted by yesster at 11:58 AM on October 10, 2011

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