How painful is having a tooth pulled? -

Details about what a patient may feel (pain, pressure) during their tooth extraction procedure, and why.  |  How likely is it that your extraction will hurt and how much?  |  What dentists can do to minimize and manage procedure discomfort.

Will you feel pain when your tooth is extracted?

No, you don't have to expect that having your tooth pulled will hurt. But we'd be lying if we said that getting one out never did. And that's basically what this page is all about. It explains:

  • What usually takes place when teeth are taken out.
  • The disappointing, hopefully minor, sensations that may occur during a patient's procedure (and why they're felt).
  • What you and your dentist can do along the way to create a comfortable, trusting environment for your extraction process. One that helps to insure that your experience is as pleasant and pain-free as possible.

What will you feel when your tooth is pulled? (Will it hurt?)

Here are the standard things you can expect to experience during your extraction process:

A list of painful events that may occur during your extraction procedure.

1) Numbing up your tooth.

Every extraction begins with numbing up your tooth. And the way that's done is the same as when any other type of dental work is performed. Your dentist will give you one, or more likely two or more, dental injections ("shots").

Your tooth and surrounding bone and gum tissue must all be numbed up.

What may be different when having a tooth pulled that you haven't experienced before is that all of the tissues that surround your tooth (bone and gum) must be anesthetized too.

And while there's nothing really different about the process used to do that for an extraction as opposed to other types of dental work, it may mean that you'll end up getting more total shots, and therefore have more potential for feeling needle pricks.

(For example, it's often different nerves that service the gum tissue on the cheek/lip side of a tooth vs. its tongue/palate side. And due to this configuration, separate injections are needed for each.)

Use this link to access our page that provides details about getting dental injections (types of injections, which hurt the most, etc...).

2) Testing to see if you feel pain.

Once your initial round of injections has been completed there's no reason why you should expect to feel any pain for the remainder of your procedure.

Having said that, there can be times when a patient's tooth or surrounding tissues still haven't been numbed up profoundly enough. It's never the dentist's intention, it's just something that statistically can happen.

a) How does a dentist test for numbness?

Since a dentist knows that some percentage of people will need further numbing, they'll follow a protocol that's designed to test and evaluate their patient's status before the work of actually removing their tooth is begun. That way whatever level of pain is felt is kept to a brief, bare minimum.

Here are some of the ways they'll evaluate and test:

i) Does your lip feel tingly?

Your dentist knows the specific areas each type of injection they give should numb up. And they'll quiz you about and test these regions just to make sure they have.

For example, before extracting lower back teeth a dentist will usually ask their patient if their lower lip feels tingly. That's typically a sign that the anesthetic that's been given has been effective.

But this type of questioning about how things feel is only valid in some situations. For example, the injections used to anesthetize upper back teeth may have been fully effective without causing much change in the way the adjacent lip or cheek tissues feel at all.

ii) Pressing and wiggling on your tooth.

Another way of evaluating a tooth's numbness is for your dentist to press on it firmly, or rock it side-to-side with their fingers.

iii) Testing your gum tissue.

A dentist knows which areas of your mouth should have been numbed up with the anesthetic they've administered. So as a test, it's common for them to use a pointed dental tool and deliberately poke your gum tissue in those areas, just to make sure you don't feel anything.

Just so you're not surprised or confused, we'll state that where they test may be some distance from the tooth that's going to be taken out. (For example, they may test your lower lip even though it's a back lower molar that will be pulled.)

iv) Testing as your extraction gets started.
  • A first step in the process of removing a tooth involves the use of a tool to strip away its surrounding gum tissue.

    Your dentist will be gentle as they first start to do this, so they can test out how you're doing. Then once they've confirmed that you're feeling no pain, they'll continue on with this task in earnest.

  • Likewise, when a dentist begins the process of loosing up a tooth they'll ease into applying full pressure, looking for confirmation from their patient's reaction that all is going well.

b) Setting up an "it hurts" signal.

Even with all of the checks mentioned above, it's still possible that your tooth isn't as numb as it needs to be to remove it totally painlessly.

Creating a trusting relationship.

Due to this inherent uncertainty, it's basic protocol for a dentist to set up a signal with their patient. A sign that can be used to unambiguously communicate to them that something is amiss, even when you are unable to speak.

  • One common signal is simply having the patient raise their hand immediately upon noticing that something isn't right.
  • Even when this motion isn't in the dentist's direct line of vision, their peripheral vision will easily notice this type of signal.

The agreement between the dentist and patient should be one where work is stopped upon the signal without hesitation. That way the patient is guaranteed that if something does hurt its kept to a minimum and just minor levels.

3) Managing pain discovered during testing or your procedure.

Once your dentist knows that you've not yet been numbed up enough, they'll then determine how to best resolve the issue.

Picture of a dentist giving a dental injection.

Numbing up a tooth for extraction.

  • In some cases they may repeat your initial injections.

    The goal here is not simply placing more anesthetic solution but instead an additional quantity in a slightly different (more on-target) location in hopes of it creating a more profound effect. (Nusstein 2010) [page references]

  • In other instances, some type of adjunct technique might be used. This could include giving you a shot in an entirely different location, or using a different injection method.
You may not feel these additional injections.

While you might find the idea of requiring additional shots taxing, relax. Receiving them may be quite uneventful due to the fact that the gum tissue in the area receiving them has already been numbed by your previous injections.

How likely is it that your first shots won't be totally effective in numbing your tooth?

A couple of papers have investigated this topic. And while the numbers they've reported may not be entirely reassuring, with just a little explaining you'll find they aren't really as bad as they initially seem.

Wong (2001)

This paper reviewed published literature that had evaluated the subject of:

  • Numbing up lower molars (probably the most challenging teeth to numb [Nusstein 2010]) ...
  • ... by way of using conventional dental shots (an inferior alveolar nerve block [IANB], a type of dental injection).

This review concluded that the use of conventional methods (IANB injections) to numb up asymptomatic molars (teeth that weren't hurting at the time of their extraction) was only successful 69% of the time.

Kanaa (2012)

While this paper focused on a different topic, it contained a section that provided background information about this subject. It cited two studies that placed the effectiveness of initial rounds of anesthesia for lower teeth at 63% and 76%.

Your dentist is quite aware of the possibility of numbing failure.

A person could look at the figures stated above and have some concerns about how painless their procedure will be. After all, they suggest that about one fourth to one third of patients being prepared for a tooth extraction won't be adequately numbed up after getting their initial injections.

But don't think for a second that your dentist doesn't anticipate this problem. That's why they use a protocol laden with evaluation and testing aimed at identifying ahead of time those patients whose situation requires further anesthesia.

Actually, this is the way you want it to be.

As much as you don't want to feel pain during your extraction procedure, what you also don't want is for your dentist to initially administer more anesthetic than is reasonably expected to be required. That's because doing so can lead to complications:

  • Administering more than that quantity that has already been effective serves no purpose.
  • Administering more will require additional shots, some of which might be felt.
  • There are limits on the total amount of anesthetic solution that can be safely used with a patient. (Maximum dosages are typically based on the patient's weight.)

    Having expended most of this quantity needlessly can jeopardize the procedure if later on pain control becomes a problem, or the procedure runs long.

Numbing up "hot" teeth for extraction can be even more difficult.

The numbers reported above are for numbing up asymptomatic teeth (teeth that weren't hurting at the time of their extraction).

The more difficult challenge is when dentists numb up "hot" teeth (teeth that are painful because they are experiencing irreversible pulpitis).

  • The review of published literature mentioned above (Wong 2001) determined that only 30% of initial attempts at numbing up extremely sensitive ("hot") lower molars using conventional methods (IANB injections) were successful.
  • Not all studies put this number for "hot" teeth (numbed via initial IANB injections) so low. Zain (2016) reported a 63% success rate for lower molars. Kanaa (2012) found a success rate of 67% for lower teeth in general, not just molars.
Why these numbers really aren't so negative.

The variation reported above withstanding, it's doubtful that any dentist would dispute that numbing up "hot" teeth can be a challenge. And that point alone is where good news lies.

  • Every dentist knows that the use of adjunct (supplemental) injections can improve anesthesia numbers substantially (see statistics below).
  • So, any dentist treating a "hot" tooth would know that these techniques are probably needed and therefore would go ahead and take those additional steps right off the bat.
  • After all, your dentist doesn't want your extraction to hurt any more than you do.
How much can adjunct numbing techniques help?

The Wong (2001) paper mentioned above also reviewed studies that evaluated the use of supplemental techniques with lower molars after an initial round of conventional (IANB) injections had failed.

  • For asymptomatic teeth, success rates could be raised from 69% to 97% with the addition of adjunct methods.
  • For "hot" teeth, the 30% number reported above could be raised to 83% effective.

That means with just routine discovery (all of the steps we mention above that a dentist takes to make sure that their patient really is numb), the vast majority of people can expect to enter the actual work of their extraction process having profound tooth anesthesia.

For those who aren't adequately numbed up, as soon as their discomfort is evident their dentist will simply continue down their list of solutions to find a way to control it.

How much pain can you expect to feel during your tooth extraction?

Statistics from studies.

We found a couple of studies that evaluated intraoperative pain (discomfort experienced during the extraction process alone).

  • Intraoperative pain was generally defined as those events that took place after giving the needed shots to numb up the patient's tooth (discomfort following "injection pain").
  • We're of the opinion that this definition would include the following scenario: 1) after the tooth had been numbed, 2) the extraction process was begun, 3) pain was felt, 4) additional injections were given, 5) the extraction process was then resumed and completed.

Research findings.

[Similar to those above, the studies mentioned here evaluated the extraction of mandibular (lower) teeth using conventional methods (IANB injection), which is probably the most challenging numbing situation.]

Kammerer (2012)

This study asked its 88 subjects who had lower molars removed to rate the level of pain they experienced during their procedure from 0 to 10, with 10 being the worst. The average of the scores reported was between 0 and 1.

Bataineh (2016)

This study evaluated intraoperative pain levels (rated 0 to 100) experienced by 52 patients having lower molars removed.

  • On average, the level of injection pain (IANB injection) was rated as 41 (the high end of the mild pain range).
  • As for the level of pain experienced during their extraction, 81% of patients reported mild pain, 17% moderate pain and 2% severe pain.
  • 89% of subjects reported that the level of discomfort they felt during their procedure was less severe than expected, 11% the same as expected and 0% felt it was greater.

In regard to the 2% (one person) who felt severe pain, the authors stated that their experience might be attributed to:

  • "... the intense pressure felt by some patients during the extraction, which may be difficult to differentiate from pain ..."

Pain vs. pressure is a critically important distinction that the patient must be able to make. We discuss why in our next section below.

Rousseau (2002)

This study evaluated 50 patients who rated their intraoperative pain from 0 to 100. Some of the extractions involved "hot" teeth. (These are teeth that were painful because they were experiencing irreversible pulpitis. As mentioned above, "hot" teeth are generally more difficult to anesthetize.)

  • Preoperatively, the patients rated their level of pain as being 61 (defined as moderate pain).
  • Postoperatively the patients were asked to rate their procedure pain. They rated it as 24 (defined as mild pain). (With this study, intraoperative pain was defined as including injection discomfort.)

So even though this study is somewhat off-target because it includes injection discomfort with intraoperative pain, on average even though some minor level of pain was noticed, what was experienced during the procedure was substantially lower than what the patient had been experiencing before their procedure.


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Why it's normal to feel pressure during your extraction.

What occurs.

The local anesthetics used in dentistry to numb up teeth and gum tissue are quite effective in inhibiting (conking out) the type of nerve fibers that transmit pain. But they're not as effective on those that transmit the sensation of pressure.

And because of this, it's normal and expected that you will feel the pressure, quite possibly a substantial amount of it, that your dentist applies to your tooth with their instruments as they loosen it up during your extraction process.

An explanation why.

The way our bodies are wired is that different types of nerve fibers, each of which transmit a specific type of sensation (pain, pressure, touch, hot and cold, etc...), have different physical characteristics.

And due to these differences (for example, the thickness of the protective insulating sheath that surrounds the nerve), local anesthetics are able to have a more profound effect on some types of fibers as opposed to others.

For the most part, fibers that transmit the sensation of sharp pain (the nerve responds intensely and quickly to painful stimuli) are the type most easily decommissioned by local anesthetic, hence this is the first sensation to be lost.

Following sharp pain is the loss of the ability to feel cold sensations, warmth, touch and finally pressure, thus explaining why it's usual and normal for it to be felt during an extraction procedure.

Picture of tooth sockets, immediately after extraction.

A dentist uses their tools to apply pressure to teeth so they loosen up and can be removed.

How much pressure will you feel?

We actually found a study (Ahel 2015) that evaluated how much force it takes for a dentist to extract teeth (upper front ones). The number came out to around 18 psi (pounds per square inch).

As it turns out, that's a difficult number to find a direct comparison for. We did however discover that regulation basketballs and soccer balls are typically inflated to around 8 psi.

So if you think in terms of putting one of those balls on the floor and pressing hard enough on it to just slightly indent it, when having an upper front tooth extracted you could expect to feel about twice that much pressure. That's really a fairly substantial amount of force.

How to distinguish between pain and pressure during your extraction.

One common problem that occurs during tooth extractions is that patients sometimes confuse the sensation of pressure with pain.

  • Some patients may not realize that it's normal and expected for them to feel pressure, or they may not have anticipated the amount of it involved, and therefore mistake feeling it for experiencing pain.
  • Patients may fail to realize that pain characteristically has a sharpness to it whereas pressure does not.
  • The patient may incorrectly assume that because they feel increasing levels of pressure that they will soon feel pain too.

    Remember, these sensations are carried by different types of nerve fibers. Feeling pressure in no way indicates that your fibers that relay pain haven't been successfully anesthetized (conked out).

Why making a distinction between the two is so important.

Being accurate in your interpretation of what's going on (feeling sharp or shooting pain vs. pressure) is vital.

That's because leading your dentist to believe that you are feeling pain instead of just pressure may lead them to needlessly administer more anesthetic.

  • As explained above, administering more anesthetic will do absolutely nothing to alleviate the sense of pressure you are feeling.
  • Using additional quantities of anesthetic place you at greater risk for complications during your procedure.
  • Since only so much anesthetic solution can be given safely (based on the patient's weight), administering some of this quantity needlessly could mean that little or none is available for use later on during the procedure (if needed).
  • Responding to unwarranted patient complaints that have no solution simply draws your dentist's attention away from the important task at hand (extracting your tooth).

Extraction pain correlates with anxiety levels.

It's important for us to mention that research has shown that the level of a patient's anxiety about their procedure is a predictor of how much pain they will experience during it. This is true for any type of dental work but especially tooth extractions.

Here's what studies have found:

Fagade (2005)

This paper evaluated 122 patients who had had extractions and found a positive correlation between patient anxiety scores and the level of procedure pain they experience.

Tickel (2012)

This study evaluated a group of 451 patients who had varying types of dental work performed (including extractions). Patients rated as "very anxious" were 5 times more likely to report experiencing pain during their procedure.

If you have anxiety about your extraction, make sure to let your dentist know.

A patient's level of anxiety can be controlled via the use of various sedation techniques administered either before or at the time of their procedure. The decision to employ such methods is both the responsibility of the dentist and the patient.

  • The issue should be brought up by the dentist during their pre-extraction examination and the patient's options explained to them. (We discuss conscious sedation techniques here.)
  • The patient must then be willing to admit that they do have apprehensions and be receptive to the dentist's suggestions and recommendations.

Our next page discusses how long extractions take. ▶

 

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Comments

Dentist should have put me out.

I had infection. Dentist scraped and drilled bone. Felt every bit of it. He didnt care. He kept saying one more second. At end I had fluid coming through skin. Assistant said i was pale. Couldn't get up for some time. In checking after I read lower bone not as porous as top and may not take shot as well. Dentist should have put me out.

F

Sorry to hear about your unpleasant experience.

You're right, the density of the bone surrounding a tooth does dictate what type of injections can be expected to be effective. We have content that discusses this issue in regard to infiltration and block injections.

You also mention the presence of infection around your tooth. The acid nature of infected tissue typically hinders an anesthetic's effectiveness.

Unfortunately based strictly on percentages, it's not all that common that the first round of a patient's injections aren't 100% effective (especially with "hot" teeth) but with the use of supplemental techniques the effectiveness level can be raised substantially. But even then failures do occur.

There's no simple solution. The use of general anesthetic would be unacceptable for all extractions from the standpoint of patient safety. Sedating patients could be considered but with it conventional tooth numbing is still required.

Probably the best rule of thumb is to select a practitioner (dentist, oral surgeon) who has as much experience as possible, so both performing the procedure and anticipation of real and potential problems are handled as expertly as possible.

Would pulling out a permanent tooth hurt as well?

I'm having a surgery in which the dentist will open up my gum to extract a permanent tooth. Obviously, anesthesia will be used. Will I feel much pain?

Rick

Your procedure would probably be best described as either a surgical extraction or else the removal of an impacted tooth (akin to removing an impacted wisdom tooth).

Either way, short of any complicating factors [like an active infection (swelling/pain would be an indication) or acutely inflammed pulp (spontaneous pain could be an indication) (see "hot" teeth section above)] there's no reason to expect that the local anesthetic your dentist uses to numb up your tooth won't be effective, as it would be for any other tooth (the tooth's position doesn't affect which/what surrounding nerves connect with it).

Your procedure might be expected to be more involved than a routine extraction (longer duration, greater surgical difficulty). If so, you and your dentist might consider the use of some method of conscious sedation to help you tolerate your surgery better. But its use has to do with patient management only and not pain control.

Good luck, expect the best.

Does it hurt getting teeth extracted?

For me it didn’t hurt as much as I thought it would! All they do is they first take a blue type of gel so your mouth will feel numb and tingly after a while. After, they asked me to close my eyes so they can give you the shot and the assistant held out her hand so I could squeeze it if I felt any pain. After that you will feel pressure when they take out the tooth(or teeth) but it doesn’t hurt at all! Finally, they give you a cotton that you bite down on and then your done!!

When i first went to the

When i first went to the dentist, i was scared. They put a numbing gel on my gums and told me to close my eyes for the shots. I had 4 shots and they did hurt, it felt really sharp, I have anxiety so as son as i felt the injection pain i was uncontrollably shaking and tears coming out my eyes. After they told me im doing well etc and they pulled out my teeth. I had 2 taken out and the whole procedure took around 10 minutes which was really good.

Alicia

You mentioned you were scared about your procedure right right from the start. In hindsight, it seems your experience could have been made more pleasant via the use of some type of sedation technique.

The use of some medications requires some pre-planning, so they aren't always an option. But a decision to use nitrous oxide (laughing gas) is often made right at the time of the appointment.

Tooth extraction pain

got my tooth extracted a few hours ago. They told me I also had gingivitis.
They numbed my mouth which was good. The extraction was still painful though, I could hear and feel the tooth breaking as they were getting it out of my gum. I shut my eyes tight at those bits, and she kept asking if I were okay,, but I never told her to stop because I wanted to get through with the extraction asap. It hurt more than I thought it would. I have no idea why it hurt though even though they numbed my mouth.

Englan

We're glad for you that your extraction is over and you're fine.

For people reading this comment we must point out the sentence "she kept asking if I were okay,, but I never told her to stop because I wanted to get through with the extraction asap."

As we describe at length on this page above, insuring that a person's extraction process is as pain-free as possible involves communication between the dentist and the patient.

In this situation the dentist was never offered the opportunity to provide additional anesthesia because the need for it was never communicated to them.

Tooth Extraction

I just got a tooth pulled a few hours ago. They rubbed a gel around the tooth and gums . The Dentist walked in to give me injections to numb the area. He gave me two injections never felt them go in. They left the room for a few minutes while the meds took affect. When they came back he tested the area to make sure it was indeed numb. I felt when he poked the gum so they injected me one more time. After a few minutes he came back extracted the tooth .
Through out the procedure, I was asked several times if I was ok and to raise my left hand if I felt any pain. I asked what was injected forgot the name but it was the best stuff acts quickly and lasts for hours. I have severe anxiety and not once did I feel any pain from start to finish. I was however told to breathe after it was over. Best experience I ever had with a dentist

alpj

Thank you for posting. We really apologize for not getting your comment posted quicker.

Not every extraction process will be totally painless. But as alpj explains, if you give your dentist prompt and accurate feedback you tip the scales far in your favor of having a pain-free experience.

tooth extraction

i am 12 and about to have 3 teeth removed tomorrow. I am very nervous about the pain it will inflict, any tips?

Jason

We're sure you'll do fine and after it's all over hopefully pleasantly surprised about how easy it was.
As this page discusses at length, your dentist will do those normal and usual things that should make your extraction painless. They'll then test and quiz you (before your extraction is started) to confirm that what they've done has been successful.
Only you can provide the needed feedback. If all is well, then let them know. If anything is amiss, let them know so they can remedy it.
The same goes for during your procedure. Have a way you can signal if anything isn't right so it can be remedied immediately.
Your dentist has a number of different things they can do to manage a patient's concerns and discomfort. But each step builds on what's been learned about the effects of the previous ones. In part, they need to know what hasn't worked so they can make the needed adjustments or change tactics so they can be successful in their next step.
Once again, good luck.

Although it’s a year later

Although it’s a year later lmfao I’m 12 and getting two teeth extracted in a couple of weeks lol

I'm Getting My teeth pulled!

I'm 10 and my teeth are pushed out front. My dentist said that I have to remove 2 top teeth and 2 bottom teeth, so they can put braces on. Can you guys tell me what happens and if it'll hurt?? On a scale of 1-10 (1:hurts so bad-10: No pain at all) Thanks

AS

We like to think that people find that the whole experience is more pleasant than they might have expected.

While our pages aren't exactly geared toward your age group (and instead more toward adults), you might choose to read through the following pages:

What's the extraction process like.
Do dental injections hurt?

And if you haven't already, you should read this entire page. It answers questions like the ones you've asked.

Tooth pulled tomorrow

I am 13 and I'm getting my very last baby molar tooth pulled out and I am nervous and scared. And it's weird because that tooth is half out and half still in my gum according to the X Ray I got yesterday, I know it's a little bit of pain, but I am SCARED and I need advice please.

Sonia

You're overlooking all of the things your comment states that are favorable for your procedure.

You state you are 13 yr. That is the normal age for this tooth to fall out on its own. Despite the fact that it hasn't, there certainly is a chance that the root of the tooth has already resorbed significantly, thus making the extraction less difficult than it would have been at any time previously.

What you say about the appearance of the tooth on the x-ray suggests the same thing (the tooth is 1/2 out and 1/2 in).
Just concentrate on being a cooperative patient and no doubt your tooth will be out in a flash.

Tooth root pull out

I am 52 haven't been to dentist for a long time I went the other day as I have a tooth at the front broken of need to get the root out I so scared pls tell me what the worst that can happen

Wendy

We're eternally disheartened by requests to discuss dentistry from the standpoint of "the worst that can happen." Instead, we'd be eager to point out some reasons why your procedure might be easier than expected.

You state it is a front tooth that needs to be removed.

1) Front teeth have single, often conical shaped, roots. That shape offers less of a challenge to remove than most back teeth.

2) Being a front tooth, your dentist will have great access and good visibility of the surgical site. This should make the outcome of the procedure more predictable and the procedure quicker than a comparible procedure for a back tooth.

3) While this would only be an issue for a front upper tooth, front teeth usually have less physical association with the sinuses than back teeth. This drastically reduces any chances of complications associated with them.

4) Front tooth extractions have a lower incidence of dry socket formation.

Patient cooperation means everything when a tooth extraction is performed. After discussing your apprehensions with your dentist, the two of you might consider using some form of conscious sedation technique to put you more at ease.

I attempted to have my tooth

I attempted to have my tooth extracted yesterday but I could feel like a cold sensation which too me felt like pain I was given 4 injections and was told told that I couldn’t receive anymore so I rescheduled the extraction for today and was told to eat before I go in. Was the cold sensation pain or heavy pressure. I had an extraction before and didn’t feel this pain should I request to be sedated if the same pain is felt today

Danielle

As mentioned above, nerve fibers that carry different types of sensations have different physical characteristics, and for that reason are affected by dental anesthetics differently.

For the most part, pain fibers that feel sharp pain (respond intensely and quickly to a painful stimulus) are the type most easily affected (conked out).

Generally speaking, this is the order of affect that local anesthetics have on nerve fibers: Pain is usually the first to disappear, then followed by the loss of cold sensation, warmth, touch and finally pressure.

Only you and your dentist can sort this out. But as you suggest, if you think that anxiety may be influencing your interpretation of events, some type of conscious sedation technique may provide a solution.

We will point out that your post itself describes the sensation as thermal, not pain. Also, your dentist's pre-extraction testing should have included some type of poking or prodding that should have served as a test for the evaluation of loss of pain sensation.

Best of luck.

Wisdom tooth

Hi there, I have a fully erupted lower left wisdom tooth that had decay in it. The dentist suggested XLA as she said wisdom teeth are tricky to fill. I started to have the procedure done and luxation was done - it kept feeling very sensitive and as soon as the forceps touched my tooth the only way I can describe it is as if I had bitten down on tin foil? I’ve had the other 3 wisdom teeth out and did not feel a single thing (one was even surgically removed) what would cause this sensation? It’s made me super apprehensive and I couldn’t complete the XLA. I’ve been given Metroidazol for 5 day but there was no infection present on the X-ray. Will it be ok to just fill when I go back or will I have to have it extracted? Thank you for any advice

Al

We're not really going to be able to shed much light on your situation.

In passing, we will point out that you don't actually use the word pain in describing what you felt. You also mention that anxiety control was the issue that kept your procedure from being completed.

Possibly mitigating your anxiety issue is something you should discuss with your dentist if trying again.

In regard to the need for an antibiotic ... the signs of infection that show up on x-rays take time to develop, so that may not be a conclusive test. At the same time, a lack of obvious signs doesn't necessarily mean that an infection doesn't exist either.

It must be that your dentist presumes an infection is present. And by placing you on antibiotics for several days and bringing the infection somewhat under control that the effect of the anesthetic during your next try will be more profound (due to a less acidic environment in the tissues due to infection).

We wish you the best with your procedure.

Please keep asking for more

Please keep asking for more anesthesia. They are able with a gel to numb you enough so you don’t feel the needles. Raise your hand the second you feel pain and they will numb you more. If you have trouble breathing while you lying flat (I am a mouth breather and I felt like I was going to suffocate) please get some Breath Right strips for your nose. I was able to go three hours with it on during the procedure without any problem. My dentist now stocks them.
He was very surprised by how well they worked. Please do not be a martyr. You would be surprised at how much numbing medicine they can give so you feel no pain. Been there and Done that a lot! Would rather go to the dentist than my OBGYN,

Tooth extraction

How long after a tooth extraction is it possible to have "dry socket" pain?

JVL

We have a whole series of pages that covers the topic of dry sockets, including how long they may last. We hope your recovery is as speedy as possible.

Tooth extraction

I’m 13 and I’m getting 2 of my wisdom teeth pulled tomorrow I’m really nervous what is going to happen?

Chloe

Good luck today. Just ask your dentist any questions you have, and follow their instructions during your procedure. We're sure you'll do great.

We have over 30 pages that explain various issues associated with wisdom teeth and tooth extractions, so just surf around or use our "site search" button at the bottom of each page to find information about what's especially on your mind.

As starting points, here are the "home" pages for our wisdom teeth and tooth extraction sections. Also, at the end of each page's text is an index of that topic's other pages.

pain

i have just had 2 teeth out they were loose and painful I had 2 injections in my gum , when the dentist started pulling the pain was so bad I grabbed her arm ,she then went straight on and pulled the next tooth out ,it wasn't pressure, it was as if pulling the tooth out with no pain relief , never again I have had loads of teeth out but never had pain like that its put me of for life :( why would this happen ?

Susan

Sorry to hear about your bad experience.

You mention that you had "2 injections in my gum," which implies that it was expected that depositing the anesthetic directly adjacent to the teeth would numb them (that's common for certain teeth).

You also mention your teeth were "loose and painful." That could be a description of teeth that have an associated infection, and generally speaking the presence of infection tends to inhibit the effectiveness of local anesthetics (the solution given via dental shots).

So possibly the underlying problem lay in the fact that while normal protocol was followed, the conditions in the tissue (infection) inhibited the effectiveness of the numbing solution. That's not an uncommon scenario. And when it occurs, there are additional ways to anesthetize teeth.

The larger issue here is that it would be expected that the dentist's initial pain-response testing would have identified the failure. And also there seems to have been no prior agreement of patient signals, or acknowledging the signals, that pain was felt.

As this page discusses, anesthetic failure is not terribly uncommon. But a dentist can use a protocol where the failure is discovered early, and hopefully after only minimal pain has been experienced, and then corrected.

Extraction for 2 baby teeth

Hello, i am 17 and tomorrow i need to get 2 baby teeth that haven't came out yet. I never have gotten teeth pulled before so I am a bit nervous about it. I have braces on and need the teeth removed so my other teeth that are moving can keep straightening . One tooth is grinded low on top near the back and the other is very small and on the bottom front area. Will it be quick and painless ? What's the worst that could go wrong. Thank you

Keith

Good luck with your procedure.

Focusing on the "worst that can happen" really isn't the way to approach a tooth extraction. In fact, that train of though can easily enough result in a self-fulfilling prophecy.

We'd like to think that this page explains how patient and dentist activities and cooperation help to keep the potential for any unpleasantness to a bare minimum. It also provides study statistics about the frequency with which patients report feeling pain.

In your case, as positives, baby teeth are typically smaller than their adult counter parts. So removing them is often easier. Also, numbing baby teeth generally offers less of a challenge for the dentist than many adult teeth. So you have that going for you too.

As far as the "quick" question, we have a page that discusses how long it takes to get a tooth pulled. Good luck.

Extraction hurt

I’ve had teeth pulled before and felt the usual pressure as they call it but no pain, other than injections to numb, until today. I had a broken tooth that had to come out. Was given the injections to numb which numbed one side. I begin to get concerned because the area around the gum was not numb but he gave more injections right before pulling and those injections hurt worse, however the numbing began instantly. I felt the normal pressure and things related to taken out a broken tooth and was doing fine until time to get the “root” of the tooth out. I begin to feel pain as he was pulling. I could feel the root of the tooth coming down the socket and the pain coming with it was nothing I’ve ever felt before, EVER. I was clinching my fist, making noises so he knew it hurt and tears came to my eyes. I could tell it was sliding down the socket and that it was almost out so I closed my eyes and tensed my body and let him finish. He didn’t offer to stop and do anything so I want to know if that tooth may have been around a nerve or something for me to feel only the root part coming out. I’m at a loss and just wanted to leave when he was finished. I planned to ask him on next visit but have had more pain than usual after having a tooth pulled this time. It’s just odd to me.
Thank you

Vic

You state:
... Was given the injections to numb which numbed one side. I begin to get concerned because the area around the gum was not numb ...

We're guessing this was a lower back tooth. If so, the purpose of the first injection the dentist gave (a manidibular block) was to numb the broken tooth and jawbone. The soft tissue to the side of the tooth is serviced by a different nerve.

Numbing both nerves at the same time would mask from the dentist if mandibular block injection had been effective or not, hence the needed wait time between the two shots. And if that second injection involved an area of "tight" tissue, yes it could pinch.

----
While clearly we have no firsthand knowledge about your case ...

Evidently the mandibular block injection didn't provide as profound a level of anesthesia as was needed. In general terms, there should be additional injections a dentist can use to remedy this if they realize they are needed.

We understand that you made gestures to your dentist that should have indicated to them that you were in pain. And yes, per whatever agreement you had in place they should have honored that.

To the dentist's defense, in cases where the level of anesthesia is not perfect it's not terribly uncommon that with the final "pull" of the tooth out of its socket some pain might be felt. (We're assuming that this is due to the final separation of nerve fibers associated with the tooth. Although that is just our conjecture, we don't know.)

In these cases, the bad news is that the patient felt it. The good new is the procedure is over. Typically that sensation is so fleeting that predicting it and resolving it isn't really possible.

With your case, you state that your pain was associated with removing the "root" of the tooth, which would be the final aspect of the extraction (when the above might take place).

We can see how your dentist might have anticipated that getting this last part of the tooth out would be quick and easy, thus over before you knew it. Instead, it wasn't. In hindsight they probably they would have done things differently. In the heat of the extraction process however, making that decision isn't always so clear cut.

Fast Tooth Extraction - Hammered it loose

Had a tooth extracted yesterday. Upper right #12 or #5. It was 1/2 decayed, couldn't be repaired, saved. Without warning, my dentist used some kind of hammer, mallet, to loosen tooth from bone without breaking it into pieces. I was shocked & traumatized with the amount of pressure I felt....OMG...luckily, I was numbed up enough so I felt no pain. I still can not believe that this dentist was hammering, 2-3-4, hard blows to my tooth. I don't know how he did it. I had never even heard of such a procedure. I'm wondering, why isn't this procedure described anywhere, & if it's not common procedure, are there any side affects to my jaw, mouth, etc., that I should be watching for? I also hope that the teeth on each side did not get whacked with all that hammering force, pressure. Geeeeezzzz....???

L.R.

Historically it was common for dentists to use a mallet and chisel to section teeth (cut them into multiple pieces for easier removal).

When air turbine dental drills became widely used in dentistry (1960's), they became the preferred choice for this task. [That's not to say that using a (air driven) drill necessarily makes a better choice. But it does create a more pleasant patient experience.]

While we can imagine that oral surgeons still use a mallet and chisel for some purposes and situations, it's not so common for a general dentist to do so.

We will mention that teeth #5 and #12 are sometimes two-rooted teeth. So possibly the dentist did have sectioning in mind. However, doing so for these teeth isn't necessarily common practice.

You mention that the tooth was extensively decayed, implying that there was little tooth structure for extraction forceps to grasp. From that, we're assuming your dentist drove their tool into the ligament space between the tooth and bone (like how a dental elevator is used, although usually just with hand pressure), thus the tooth came out.

Since we know so little about your procedure, we won't second guess your dentist's choices.

Generally a dentist will be concerned about the level of forces applied, for fear of breaking bone, pushing the tooth beyond it's socket (like into the sinuses) or traumatizing adjacent teeth. No doubt your dentist had factored these issues in.

As far as what to watch for, we have a page that describes the expected healing process after extractions. If you notice anything that diverges from that, you should be in touch with your dentist for evaluation.

If there was any major bone breakage, we're assuming your dentist would have identified that at the time of your procedure. Any small fractures might not be identified, but would also likely just heal uneventfully on their own (with no one ever knowing they really existed).

In general, the sharp edges of tooth fracture should be apparent now. Sensitivity issues associated with cracked teeth or traumatized tooth nerves would also be expected to be apparent this time frame.

Longer term, bone fracture issues will have shown themselves and/or healed. It's possible that trauma to teeth during the extraction might lead to future problems (need for root canal, tooth breakage, the expansion of small cracks created during the extraction process) but all of those things would be essentially impossible to directly correlate to events during your procedure.

Tooth Extraction

So I'm 11 and I'm getting my 19th molar taken because it has a infection and I was wondering how long would it take for the anesthesia to settle in and what are the tools used for the extraction

A.M

Good luck with your procedure. We anticipate that you'll find the process easier than you expect (we noticed that you placed your comment on our "extraction pain" page.)

This link: Time needed to numb a tooth for an extraction. will answer your first question. (The usual initial injection in preparation for extracting tooth #19 is an IANB.)

This link: The steps of the extraction process. explains the use of dental instruments during an extraction.

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