Dental extractions are common procedures performed by clinicians with varying levels of oral surgery expertise across diverse clinical settings. While modern dentistry prioritises tooth preservation, extractions remain frequently undertaken, making it essential for practitioners to fully understand the core principles of the procedure to ensure safe and effective outcomes [1]. Irreversible dental caries may leave a tooth beyond restoration, making extraction the only viable treatment [2]. Frequently, caries-related pulpal and periapical pathologies necessitate removal when endodontic therapy is not possible or when the tooth is deemed non-restorable after such treatment [3]. Severe periodontal disease can cause significant bone loss in the maxilla or mandible, often requiring tooth removal. Teeth with fractures that cannot be rehabilitated, as well as retained roots, may also warrant extraction either for prosthetic purposes or to prevent damage to surrounding structures [4]. Impacted teeth fail to erupt due to physical barriers, while supernumerary teeth can cause functional or aesthetic issues [5]. Orthodontic extractions are often indicated to create space in the arch, facilitating alignment [6]. In pre-prosthetic cases, extractions may be advised when a tooth compromises prosthesis fit or carries a poor prognosis [7]. Like all surgical interventions, extractions involve inherent risks that must be communicated to patients beforehand. Common postoperative complications include pain, bleeding, swelling, bruising, and infection. There is also potential for damage to adjacent teeth, particularly those with restorations, and site-specific complications such as oroantral communication or injury to the inferior alveolar nerve [8]. Post-extraction pain is a frequent concern, usually manageable with over-the-counter analgesics such as paracetamol and ibuprofen, which may be taken together for enhanced effect. However, in some cases, these medications are insufficient, prompting patients to seek further care [9]. When no alternative diagnosis explains the pain, reassurance and conservative management are appropriate, as discomfort typically subsides within 3–7 days [10]. In more severe cases, additional analgesics such as opioids or corticosteroids may be required [11]. A common cause of significant post-extraction discomfort is alveolar osteitis (dry socket), which occurs when the socket blood clot disintegrates before healing begins [12]. This condition is characterised by pain that initially decreases but intensifies 1–3 days after extraction, sometimes accompanied by reports of clot loss, foul taste, or halitosis [13]. Post-extraction temporomandibular joint discomfort may also occur, often of myofascial origin, and typically resolves with conservative care. Ultimately, effective management of post-extraction pain is crucial for patient comfort, adherence to postoperative instructions, and prevention of complications such as alveolar osteitis. Poor pain control may deter patients from seeking further care. Optimal strategies involve timely administration of analgesics, and when indicated, antibiotics particularly in the early recovery period. Patient-centred care in dentistry emphasises recognising and addressing patients’ postoperative experiences to refine clinical practice. Limited research exists on the exact nature of early post-extraction pain, particularly in relation to local anaesthetic use. A thorough understanding of these experiences enables clinicians to better explain pain trajectories, the role of analgesia, and the potential for protocol modifications [14]. Rationale of the Study This study is motivated by the necessity to enhance the understanding and management of post-extraction pain and discomfort in adult dental patients undergoing routine tooth extractions with local anaesthesia. This study aimed to examine this necessity. Dental extractions, while classified as minimally invasive, often result in considerable discomfort for patients, potentially affecting their recovery and daily activities. Inadequate pain management prolongs the recovery process, increases patient anxiety regarding future dental treatments, and elevates the risk of complications, including dry socket and infection. Current pain management practices exhibit considerable variation. Some practitioners routinely prescribe antibiotics and analgesics, while others adjust treatment according to patient feedback. Furthermore, the absence of standardized protocols, coupled with this variation, underscores a deficiency in comprehending patient pain experiences and the efficacy of the current post-operative care provided. This study aims to offer insights that can inform consistent and evidence-based pain management strategies. Insights were derived by systematically recording the pain levels, the duration of discomfort, and the efficacy of the prescribed medications thet are being experienced by patients. These findings enable dental professionals to enhance their methods, to accelerate the healing process, and to elevate patient satisfaction, ultimately improving the quality of post-extraction care provided.

The study centres on a sample of 150 adult patients who are presenting for scheduled tooth extractions. The study was open to patients who came to the department for this procedure. before starting the data collection, the participants who were intrested were informed about the study's aims and objectives and the written consent was obtained from them. According to the study's inclusion criteria, all the participants to be included should be at least eighteen years old, willing to participate, and should be able to attend follow-up appointments after surgery. Furthermore, the statistical analysis only included patients who answered every question on the study questionnaire. On the other hand, patients who were under the age of eighteen, refused to take part, or were not having a tooth extracted at the time of the study were not included. Data collection was accomplished through the use of a structured questionnaire that was self-administered and consisted of two primary sections. Some of the demographic information that was gathered in the first section included the patient's age, gender, educational status, and residential address, among other demographic details. In the second section, the information was gathered regarding the post-extraction experience, which included the amount of pain, discomfort, bleeding, swelling, and the overall satisfaction that was experienced throughout the process. With the intention of allowing patients to fill out the questionnaire on their own without the assistance of hospital staff, the questionnaire was designed to be straightforward and objective. After the data collection process was complete, each response was entered into an Excel spreadsheet in order to guarantee the accuracy and organisation of the data. Subsequently, the data were loaded into the SPSS software for the purpose of statistical analysis. The responses were evaluated by employing both descriptive and inferential statistical methods. The significance level of the study, estimated to be 95% (p < 0.05), was determined.

Out of 150 the gender distribution of the participants, with a nearly even split between males (48.7%) and females (51.3%) in a total sample of 150 participants. The study sample included 150 participants from a diverse age groups. The majority of the participants were in the 41-50 years age group i.e 24% of the sample, followed by the 51-60 years group at 18%, and the 20-30 years group at 16%. Participants aged 61-70 years constituted 17.3%, whereas those aged 31-40 years represented 14%. The youngest participants, aged 15 to 20 years, constituted 7.3% of the sample, while the smallest age group, 71 to 80 years, accounted for 3.3%. The varied age distribution offers a thorough representation of study subjects, ensuring inclusivity across a broad age spectrum. Table 1 describes the study found that 80% of them had pain as their main complaint. With 12% of patients reporting swelling, it was the second most common complaint, followed by tooth decay with 4%. While 0.7% of patients reported problems with a sharp tooth and 2.7% reported a mobile tooth, both conditions were associated with the need for tooth replacement. According to this distribution, the study's patient population's top concerns are pain and swelling. The distribution of patients' experiences during tooth extraction was assessed based on their subjective feeling and the forces delivered during the procedure was described in table 2. 94% of patients said they were comfortable with the extraction process. Another 6% said it was bearable, and none said it was terrible. In terms of the forces used, 85.3% of patients said they were comfortable, 14.7% said they were bearable, and no one said the forces were too strong. In general, the results show that most patients felt little to no pain during extraction. Table 1: Distribution of the patients based on the Chief Complaint Chief Complaint Frequency Percent Pain 120 80% Tooth replacement 1 0.7% Decay 6 4% Swelling 18 12% Mobile tooth 4 2.7% Sharp tooth 1 0.7% Total 150 100% Table 2: Distribution of patients based on the extraction period Extraction period Frequency Percent Quick 99 66% Adequate 43 28.7% Longer 8 5.3% Total 150 100% Table 3: Distribution of the patients based on the post extraction biting injury Post extraction biting injury Frequency Percent Present 20 13.3% Absent 130 86.7% Total 150 100% Table 4: Distribution of patients based on post extraction bleeding Post extraction bleeding Frequency Percent Mild 117 78% Moderate 29 19.3 Severe 4 2.7 Total 150 100.0 Table 2 shows that about 66% experienced a quick extraction period while about 28.7% had an adequate duration of extraction period, and only 5.3% reported that they underwent longer extraction. Table 3 reveals that 13.3% of patients sustained a post-extraction biting injury, whereas 86.7% did not. Table 4 indicates that 78% of participants experienced mild bleeding, 19.3% experienced moderate bleeding, and only 2.7% experienced severe bleeding following post-extraction haemorrhage. These tables collectively illustrate the spectrum of bleeding severities observed post-procedure, the incidence of biting injuries, and the allocation of extraction durations. Table 5: Distribution of patient’s pain experience based on the numerical scale Pain experience based on the numerical scale Frequency Percent 0.0 16 10.7 1.0 46 30.7 2.0 34 22.7 3.0 22 14.7 4.0 18 12.0 5.0 3 2.0 6.0 3 2.0 7.0 2 1.3 8.0 3 2.0 9.0 1 0.7 10.0 2 1.3 Total 150 100.0 In Table 5, the distribution of the patients' post-extraction pain that they experienced, as scored on a scale of 0 to 10, is shown. The most frequently reported pain score was 1.0 by 30.7% of the 150 patients, while 10.7% reported no pain (0.0). 22.7% of the patients had pain scores of 2.0, while 14.7% had pain scores of 3.0. Furthermore, 12.0% reported experiencing pain at a level of 4.0. Scores of 5.0, 6.0, and 8.0 were reported by 2.0% of patients, 7.0 and 10.0 by 1.3%, and 9.0 by 0.7% of patients.

This study evaluates the post-extraction experiences of adult patients undergoing routine tooth removal under local anaesthesia, with particular attention to pain, bleeding, and overall comfort. The results reveal that most patients experienced only mild discomfort and low pain levels; however, a substantial proportion reported varying degrees of pain, bleeding, and accidental biting injuries. These findings highlight the importance of tailored pain management strategies, as inadequate control can delay healing, increase anxiety about future dental procedures, and raise the likelihood of complications. By systematically assessing pain intensity, discomfort duration, bleeding severity, and patient satisfaction, the study offers valuable evidence that can inform more consistent, evidence-based clinical protocols. The results suggest that dental practitioners could benefit from adopting structured approaches to post-operative symptom management, which may include the creation of standardised guidelines and enhanced patient education regarding aftercare. These insights also lay the groundwork for further research into patient-centred pain control strategies, aiming to improve the quality and efficacy of post-extraction care. In terms of demographics, the present study and the research by Tandon et al. (2024) share similarities but differ notably in age distribution. Both demonstrated a near-equal male-to-female ratio, reflecting balanced gender representation. However, Tandon et al. reported a younger age profile, with 38.7% of participants aged 18–25 and 31.1% aged 26–30, focusing on issues relevant to young adults. In contrast, the current study included a higher proportion of older adults, with the largest share (24%) in the 41–50 age range, followed by 18% aged 51–60 and 17.3% aged 61–70. Only 16% were aged 20–30, and the youngest group (15–20 years) represented just 7.3% of the sample. These differences allow each study to address distinct patient needs and recovery determinants across various life stages [14]. Comparison with Assiry et al. (2023) reveals differing trends in procedural aspects and complication rates. Assiry et al. documented 92 complications (53.4% of cases), with soft tissue injuries comprising the majority of immediate complications (81.7%), followed by tooth fractures (15.8%) and uncontrolled bleeding (6.1%). Delayed complications were most frequently due to pain (35.3%) and dry socket (64.7%). Their work primarily examined procedural factors, notably extraction duration, in relation to complications. In their cohort, only 5.3% of patients experienced lengthy extractions, while 66% reported short procedures and 28.7% adequate duration. Bleeding was mild in 78% of cases, moderate in 19.3%, and severe in only 2.7%. Additionally, 13.3% sustained biting injuries immediately post-extraction. Both their study and the current research indicate that soft tissue injury is a frequent immediate complication, while dry socket is the most common delayed complication. However, the present study extends these findings by providing more detailed data on extraction duration and bleeding severity, offering a broader understanding of post-extraction outcomes [15]. This investigation into post-extraction pain management is strengthened by its diverse demographic sample, standardised data collection, and use of statistical analysis software. Its findings are particularly relevant for older adults, who may face greater post-extraction risks. Nonetheless, limitations include its single-centre design, reliance on self-reported symptoms, focus on immediate post-extraction experiences, absence of follow-up data, and lack of a control group factors that constrain the ability to assess the comparative effectiveness of current pain management approaches. Future research could build upon these findings through multicentre designs, longitudinal follow-up, and randomised controlled trials, enabling more robust comparisons between different pain management protocols. Additionally, exploring psychosocial determinants such as patient anxiety and individual pain thresholds could yield further insights. The use of validated pain measurement tools, such as the Visual Analogue Scale (VAS) and Numerical Rating Scale (NRS), would enhance the accuracy of symptom reporting and facilitate cross-study comparisons. Such approaches could contribute to the development of standardised, evidence-based post-extraction care protocols, ultimately improving recovery experiences and patient satisfaction in dental practice.

This study highlights the critical importance of effective pain and discomfort management in adult patients undergoing routine dental extractions. Findings indicate that most patients experienced tolerable levels of pain and discomfort, with only a small proportion encountering severe complications. The results emphasise the need for standardised pain management protocols to optimise patient outcomes and satisfaction. The diverse demographic profile provides valuable insight into recovery experiences across age groups, particularly among older adults who may face heightened complication risks. However, limitations such as the single-centre design and dependence on self-reported data underscore the need for multicentre, longitudinal research to improve generalisability and capture long-term recovery patterns. Overall, the study advocates for evidence-based, standardised approaches to enhance patient comfort, refine pain management strategies, and advance the quality of care in routine dental extractions.

1. R., Jadun, S., & Shah, A. (2022). An evaluation of patient informed consent for dental extractions. Primary Dental Journal, 11(3), 98–103. https://doi.org/10.1177/20501684221112527 2. Broers, D. L., Dubois, L., De Lange, J., Su, N., & De Jongh, A. (2021). Reasons for tooth removal in Adults: A Systematic review. International Dental Journal, 72(1), 52–57. https://doi.org/10.1016/j.identj.2021.01.011 3. Suzuki, S., Sugihara, N., Kamijo, H., Morita, M., Kawato, T., Tsuneishi, M., Kobayashi, K., Hasuike, Y., & Sato, T. (2021). Reasons for tooth extractions in Japan: the second nationwide survey. International Dental Journal, 72(3), 366–372. https://doi.org/10.1016/j.identj.2021.05.008 4. Wali, G. G., Sridhar, V., & Shyla, H. N. (2011). A Study on Dentigerous Cystic Changes with Radiographically Normal Impacted Mandibular Third Molars. Journal of Maxillofacial and Oral Surgery, 11(4), 458–465. https://doi.org/10.1007/s12663-011-0252-7 5. Sarica, I., Derindag, G., Kurtuldu, E., Naralan, M. E., & Caglayan, F. (2019). A retrospective study: Do all impacted teeth cause pathology? Nigerian Journal of Clinical Practice, 22(4), 527. https://doi.org/10.4103/njcp.njcp_563_18 6. De Araújo, T. M., & Caldas, L. D. (2019). Tooth extractions in Orthodontics: first or second premolars? Dental Press Journal of Orthodontics, 24(3), 88–98. https://doi.org/10.1590/2177-6709.24.3.088-098.bbo 7. Fernández-Barrera, M. Á., Medina-Solís, C. E., Casanova-Rosado, J. F., Mendoza-Rodríguez, M., Escoffié-Ramírez, M., Casanova-Rosado, A. J., De Jesús Navarrete-Hernández, J., & Maupomé, G. (2016). Contribution of prosthetic treatment considerations for dental extractions of permanent teeth. PeerJ, 4, e2015. https://doi.org/10.7717/peerj.2015 8. Weil, K., Hooper, L., Afzal, Z., Esposito, M., Worthington, H., Van Wijk, A., & Coulthard, P. (2008). Paracetamol for pain relief after surgical removal of lower wisdom teeth. Australian Dental Journal, 53(2), 184–185. https://doi.org/10.1111/j.1834-7819.2008.00031.x 9. Gazal, G., & Al-Samadani, K. H. (2017). Comparison of paracetamol, ibuprofen, and diclofenac potassium for pain relief following dental extractions and deep cavity preparations. Saudi Medical Journal, 38(3), 284–291. https://doi.org/10.15537/smj.2017.3.16023 10. Seymour, R., Blair, G., & Wyatt, F. (1983). Post-operative dental pain and analgesic efficacy. Part I. British Journal of Oral Surgery, 21(4), 290–297. https://doi.org/10.1016/0007-117x(83)90017-3 11. Cho, H., Lynham, A., & Hsu, E. (2017). Postoperative interventions to reduce inflammatory complications after third molar surgery: review of the current evidence. Australian Dental Journal, 62(4), 412–419. https://doi.org/10.1111/adj.12526 12. Houston, J. P., McCollum, J., Pietz, D., & Schneck, D. (2002). Alveolar osteitis: a review of its etiology, prevention, and treatment modalities. General Dentistry, 50(5), 457-63. https://pubmed.ncbi.nlm.nih.gov/12448899/ 13. Garola, F., Gilligan, G., Panico, R., Leonardi, N., & Piemonte, E. (2021). Clinical management of alveolar osteitis. A systematic review. Medicina Oral, Patologia Oral y Cirugia Bucal, 26(6), e691. https://pubmed.ncbi.nlm.nih.gov/34704976/ 14. Tandon, P., Sahoo, S. K., Mohanty, L., Jain, N., Hittalamani, V., Kamble, S. S., & Singh, R. (2024). Dry Socket Prevalence and Risk Factors in Third Molar Extractions: A Prospective Observational Study. Cureus, 16(3). https://pmc.ncbi.nlm.nih.gov/articles/PMC11032735/ 15. Assiry, M., Aloqbi, M., Albrahim, H., Alnabulsi, A., Alim, H., Ghamdi, M., & Bassyoni, L. (2023). Prevalence and Management of Post-Extraction Complications. Journal of Complementary Medicine Research, 14(2), 90. https://doi.org/10.5455/jcmr.2023.14.02.14