After 5 Days of Tooth Extraction, I Am Still in Pain: Why?

Tooth extraction is a very normal dental procedure that should be healed within less than a week. Sometimes I come across some people who have passed 5 days after tooth extraction still in pain.

If the pain does not show any sign of reducing, you may have to go for further treatment. I will try to shed light on the possible causes of pain 5 days after tooth extraction in this article.

Why are You Still Feeling Pain 5 Days After Tooth Extraction?

If you have passed 5 days after tooth extraction still in pain, the following complications can be the reason for that:

Infection in the Socket

A dry socket can lead to infection, but it is not the sole factor behind it. If the pain where the tooth was pulled months ago follows with fever, swelling, redness, bleeding, discomfort 3 weeks after extraction, or discharge from the extraction site, you may have developed an infection from a dry socket.

5-days-after-tooth-extraction-still-in-pain

In that case, you may need to take an antibiotic otherwise it can spread to the other areas in your mouth.

Sinus Perforation During Tooth Extraction

There are sinuses above our upper molar teeth. The thin membrane between the teeth and sinuses can be affected during tooth extraction surgery. If the sinus floor is very close to your tooth roots, sinuses can be damaged during the tooth extraction and can cause pain in your teeth.

Formation of Dry Socket

Dry socket normally happens 2-5 days after the extraction and lasts for up to a week. The pain can be severe and continue for a few days. If the pain does not show any sign of decreasing, you should visit your dentist for a check-up.

Since the dry socket is the most possible cause of prolonged pain after tooth extraction, I will discuss it in detail.

What Is a Dry Socket?

After tooth removal a blood clot forms in the space to protect the nerve endings and bones underneath it. If the clot dislodges from the site before healing it or does never form, the bones, tissues, and nerve endings get exposed and cause gum pain after tooth extraction.

dry-socket

This situation is called a dry socket. When food particles or debris get stuck in the extraction site, it can aggravate the pain and take time to heal properly.

According to the research of Columbia University College of Dental Medicine dry socket happens in 2-5% of tooth extraction surgeries.

Dentists are yet unsure of the exact cause of dry sockets. Therefore, it is hard to say who is at greater risk of dry socket. However, certain oral conditions are more prone to dry sockets.

Most Common Causes of a Dry Socket

You will be at an increased risk of developing a dry socket after tooth extraction for the following reasons.

Avoiding the Post-surgery Care

If you did not follow the post-surgery instructions, there are chances that you might develop a dry socket.

Sucking Liquids, Spitting, or Rinsing the Mouth Vigorously

Sucking liquid through a straw, vigorous spitting, rinsing can impede the buildup of blood clots or dislodge it.

Removing the Medicated Gauze Too Early

A dry socket can develop if you remove the medicated gauze from your mouth too early after the surgery.

Having an Existing Tooth Infection or Periodontal Gum Disease

If you have already developed some infection like periodontal gum disease, you are at an increased risk of getting a dry socket. This preexisting infection can prevent the blood clot from building on the socket.

The oral bacteria from such infection are responsible for the lost blood clot 5 days after tooth extraction.

Smoking

Smoking is one of the most possible causes of developing a dry socket after surgery. While smoking the blood supply in the mouth reduces and the blood clot cannot develop due to that reason.

However, if the blood clot develops, it can be dislodged for the strong sucking force while smoking.

Doing Extraction of Impacted Wisdom Teeth

More critical surgery like the extraction of impacted wisdom teeth can lead to dry sockets. In this surgery, sometimes some jawbones and gum tissues from the surrounding area are removed or severely affected.

The risk of a dry socket rises to 20% when the impacted wisdom teeth extraction is done.

Having Denser Jawbones Due to Aging

Having denser jawbones can be a cause of developing a dry socket after the tooth extraction. The density of the jawbone increases with age and less blood is supplied to the teeth.

Therefore the extraction of teeth becomes critical and after the surgery blood clots do not form easily. Patients older than 30 years have an increased risk of dry sockets in their third molar teeth.

Taking Oral Contraceptive or Hormonal Changes in Women

In females taking birth control contraceptives or certain hormonal changes during the women’s normal cycle can increase the risk of developing a dry socket.

A few studies have estimated that women who go through tooth extraction surgery in their menstrual period are less likely to develop dry sockets.

Symptoms of Dry Socket

You can experience the following symptoms if a dry socket has been developed in the extraction site. If you do not notice these symptoms within a week of tooth extraction, you won’t develop a dry socket.

Increased Pain

Increased pain in the mouth after a few days of tooth extraction is the major symptom of a dry socket. In normal cases, pain and swelling start to decrease after a few days of surgery. If you develop a dry socket in the extraction site, pain begins after 2-5 days after surgery and gradually increases.

Pain in the Whole Side of the Extraction Site

The pain may affect the whole side of your face where the surgery has been done including eyes and ears. The pain is different from the pain of usual soreness during the recovery.

symptoms-of-dry-socket

The Jawbones Become Visible and the Surrounding Looks Greyish

The jawbone can be noticeable in the extraction site and the surrounding tissues may look grey.

Preventive Measures You Should Take for Dry Socket

You can reduce the risk of developing a dry socket by taking some preventive measures and avoiding some bad habits.

Clean the Socket

With a saline solution or another cleansing fluid, your dentist will flush out the extraction site. This will clean up any food particles, debris, or germs that are stuck in the socket and causing pain. 

According to some studies, rinsing with a chlorhexidine gluconate gel before and after the surgery can decrease the risk of developing a dry socket and throbbing pain after tooth extraction.

Medicated Gauze Application

Dressing the dry socket in a medicated gauze will alleviate the pain instantly and protect the vulnerable nerve ending and bones. The dressing is coated with a paste with pain-relieving properties.

How many times you will change the dressing will depend on the intensity of pain and other symptoms. Your dentist will instruct you how often and how to replace the gauge at home.

Medication for Reducing the Pain

Until the dry socket gets healed, you can alleviate the pain with over-the-counter painkillers like ibuprofen or other prescription drugs, depending on the intensity of your pain.

If there is no infection or other severe symptom, you can keep the pain in control with these painkillers.

Consult With Your Dentist for Other Medication

For reducing blood clot-dissolving after tooth extraction you can take some prescription medications after consulting with your dentist. If you notice any pus or discharge from an infected tooth before the surgery, your dentist can suggest antibiotics.

Consult about the other ongoing medications that you have to continue further.  Medications like oral contraceptives can affect the healing process, develop a risk of dry socket, and tooth extraction pain after 7 days.

Quit Smoking or Tobacco

Avoiding smoking is recommended both before and after the tooth extraction surgery. According to several types of research, 12% of smokers develop a dry socket after their tooth extraction whereas in the case of non-smokers the percentage is only 4%.

Avoid Hot or Acidic Drinks

Even after the surgery, you should continue drinking ample water. But alcohol, soda, carbonated beverages, caffeine, or other hot drinks can dissolve the blood clot.

While drinking any liquid for the first week avoid using a straw since straws can remove the blood clot in the socket.

Avoid Foods that Tend to Get Stuck in the Teeth

Do not eat food that is prone to get stuck in the teeth. Nuts, seeds, or gum will easily get stuck in the socket and aggravate pain. Eating soft foods like soup, yogurt, applesauce for the first 24 hours will help to not irritate the extraction site.

Follow the Post-surgery Instructions Properly

Poor oral hygiene after the extraction can cause gum infections and increase the risk of dry sockets. 

According to some studies, rinsing the mouth with a chlorhexidine gluconate gel before and after the surgery can decrease the risk of developing a dry socket.

Take Proper Rest After Surgery

Do not resume your normal activities or exercises just after the day of surgery. Take rest as the dentist suggests. After the surgery, avoid injury to the mouth. Any type of injury during this period can delay recovery.

Avoid Birth Control Pills If Possible

It will be better if you can avoid birth control oral contraceptives during the recovery period.

Home Remedies You Can Try to Cure Dry Socket

Besides taking dental treatment, you can opt for the following home remedies for further relief. 

  1. Flushing the socket at home

You can flush the socket also at home with a saltwater solution to get more relief. Your dentist can provide you with the necessary instructions about the process.

2. Brushing gently

After the tooth extraction, you have to continue regular brushing. You can brush your teeth around the dry socket gently.

3. Avoiding smoking or tobacco

Smoking is prohibited after a tooth extraction or any other dental surgery. Smoking is said to slow down the healing process of any dental surgery.

4. Avoiding foods that will irritate the dry socket

Spicy or acidic foods will irritate the dry socket. You should also avoid any carbonated drinks.

5. Applying a hot or cold compress

If there is swelling or intense pain, you can put a hot or cold pack against the dry socket area to get some relief. For the first 24 hours after surgery, you should only use a cold compress. After 24 hours, you will get a better result using a heat compress.

6. Using clove oil 

Applying one to two drops of clove oil to the affected area with a cotton swab can give some relief to the pain of tooth extraction.

However, these home remedies can give temporary relief from ear and jaw pain after tooth extraction so do not hold up the follow-up visit to your dentist’s chamber.

When Can You Stop Worrying About a Dry Socket?

A dry socket is not a quite common case, but you should be careful after tooth extraction since the first week after a tooth extraction is a risky period for developing a dry socket.

Usually, the pain from the dry socket starts or gets intense from the 3rd day after tooth extraction. If you have already passed a week after tooth extraction without increased pain, you should stop worrying about a dry socket.

Conclusion

If you have passed 5 days after tooth extraction still in pain, do not take it lightly. This post-surgery complication can lead to more severe problems soon. So, go back to your dentist’s chamber and also follow the oral care instructions at home.

Nishat Saif

As a dental health professional, I found it an obligation to discuss various dental issues to make you smile. As a passionate writer, I am here to answer all your queries. If you are not a good reader, don't worry, you can find me on YouTube, too. I always try to share my knowledge in every possible way. Hope that my efforts will add value to your dental well-being.

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