Sometimes a tooth can be so badly damaged that nothing can be done to save it, and the tooth has to be extracted. A good dentist will do everything to try and prevent an extraction, and to save living, healthy teeth, and to avoid the use of prosthetics. But the time will come when the tooth dies, or becomes so decayed or so infected that keeping it is simply no longer an option. Usually teeth that are so far gone cause quite a bit of pain, and patients are just happy to get rid of the nuisance.
You can take a painkiller right after extraction, and usually over the counter ibuprofen or Tylenol will be enough, but you and your dentist may collectively decide that something a little stronger is in order. If this is the case, please do not exceed the recommended dose, and always read the instructions and information in the box. Depending on the state of your oral cavity, you may need to take a course of antibiotics while healing, so that the extraction site doesn’t become infected.
But the pain may not leave after extraction. Usually, if pain persists, it will come back after 2 or 3 symptom free days. This is a terrible thing, as just when you think everything is okay, and the swelling is starting to go down, you start to feel awful again, and these pains are usually very sharp, too. Post extraction pain is usually a sign that something is not going right with the healing process. The pain is usually caused by something going wrong in the alveolus, a part of the gums that not many of us know about. Our teeth are anchored in little beds of bone, sinew and flesh, and these little holes are the alveolus. The alveolus is a complex system of nerves, the alveolar crest, ligaments and some soft bone material, and when a tooth is extracted, sometimes that delicate system can be disturbed, and that can be a painful thing indeed.
There are two things that can cause post extraction pains. One is when the alveolus has come into contact with air, this is terribly painful, and can cause some very nasty halitosis as well. The other is that the alveolus itself has become damaged during the extraction. This is super bad news, because if the nerve was hit, there is nothing that can be done to rehabilitate it.
When the alveolus is exposed to the outside world, the condition is colloquially known as dry socket, but doctors call it alveolitis, or infection of the tooth beds. The alveolus is an internal organ, and like most internal organs, ti does not fare well in the open air. It likes to be covered in a layer of gums, and if ti doesn’t get what it wants, it sends intense pain signals to the brain. This pain is particularly intense because there are a lot of nerve endings in there, and when the outside oxygen dries out the alveolus, it dries out, shrivels and dies. This is why maintaining the blood clot is so important. A protective blood clot should form over the extraction site, allowing the site to heal. The blood clot will become gum tissue, and if the blood clot is removed, the socket will dry out. Sometimes the blood clot is not big enough, and parts of the jaw and alveolus may be exposed. If this is the case, call your dentist at once, before the socket dries out, and then you can forego some of the worst pain you have ever felt in your life.
You must pay attention to food as well, most importantly; you should not eat or drink anything while the anesthetic is working. For a whole day after the extraction, you should revert to a liquid diet, and avoid hard seeds and food that comes in little, hard pieces, like sesame seeds or poppy seed, because these can become lodged in the wound, and can scratch the sensitive surface. You should not eat milk or milk products for a day after extraction, as the bacteria from the milk can infect your extraction site. You should also be wary of tea, coffee, and spicy foods, as these may irritate your nerve. Smoking slows down the healing process, so smoking is prohibited for 3 to 4 days after extraction.
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