Why does the tooth next to my extraction ache?

You probably expected some soreness where your tooth was pulled, but now the tooth right next to it hurts too, and that can be genuinely unsettling. The good news: It doesn't always mean that tooth is damaged. Pressure and inflammation around the healing socket can irritate the tissues supporting the tooth next to it. Dry socket or a separate problem in that tooth can also cause pain in the area. If the ache is severe, getting worse or comes with swelling, fever, bad breath or a bad taste, call your dental provider. 

What you will learn in this article: 

• Pressure or inflammation after lower wisdom tooth surgery may make the next tooth ache. 

• A dull ache that worsens when you bite may come from the tissues supporting the tooth. 

• Severe pain that spreads and comes with bad breath may point to dry socket. 

• Worsening pain, fever or increasing swelling should be reported to a dental provider. 

If you are unsure why the tooth next to your extraction hurts, schedule an appointment with an Aspen Dental provider. Your care team can check both areas and help you understand what is going on. 

Can an extraction make the neighboring tooth hurt? 

Yes, it can. One study looked at pain in the tooth next to a pulled back tooth. It says swelling and pressure on the tooth can cause the pain.¹ 

The study points to the ligament that holds the tooth in its socket. Pressure can strain that ligament. The pain from that strain can be mistaken for pain inside the tooth. That is why a dental provider needs to look.¹ 

What does that kind of pain feel like? 

In the study, pain in the neighboring tooth was often a dull, steady ache that built over time. It could be more noticeable at night or when pressure was placed on the tooth, such as when biting.¹ 

Your symptoms may not follow this pattern. A dental provider should check pain that does not settle or continues to get worse.

Can biting or clenching cause it? 

They may add pressure to an already sore area. Researchers noted that biting on gauze harder than needed, clenching or grinding at night could put extra stress on the tissues supporting the neighboring tooth.¹ 

Follow your dental provider’s instructions for using gauze. If you think you clench or grind your teeth, let your dental provider know. 

Could it be dry socket instead? 

Pressure and clenching aren't the only possible explanations, though. The American Association of Oral and Maxillofacial Surgeons explains that dry socket can happen when the protective blood clot breaks down, comes out too soon or does not form well. This can expose the bone and nerves. Signs may include severe pain, bad breath, slower healing and pain that travels toward the ear, temple or chin.² 

Because the pain can spread, it may be hard to tell exactly where it starts. A dental provider or oral surgeon can examine the socket. 

Could the neighboring tooth have its own problem? 

Yes. The neighboring tooth may have a separate problem, such as tooth decay, a crack or a loose filling. The pain may not be related to the extraction at all. 

Your dental provider can examine the tooth and take an X-ray if needed. This can help show whether the ache comes from the extraction site or from the tooth itself. 

When should you call your dental provider? 

Call your dental provider if the ache keeps getting worse, does not begin to settle or becomes severe. After wisdom tooth removal, fever, increasing swelling, redness, pus or a lasting salty or bad taste may signal an infection. Pain that spreads toward your ear, temple or chin or comes with bad breath can also occur with dry socket.² 

Follow the instructions your dental provider gave you for tooth extraction healing. If you notice a bone spicule or another sharp feeling at the site, mention that too. 

You do not have to wait and wonder about worsening pain. Reach out to your dental provider to have the extraction site and neighboring tooth checked. 

Why does the tooth next to my extraction ache? FAQs 

Still have questions about an ache near your extraction? These answers cover a few common concerns. 

How can a dental provider tell where the pain is coming from? 

Your dental provider can examine the socket and the neighboring tooth. They may check how the tooth responds to gentle pressure, look at your bite or take an X-ray if needed. 

What details should I tell my dental provider? 

Explain when the ache began, whether it is getting better or worse and what triggers it. Mention pain that spreads, wakes you at night or gets worse when you bite. Also report bad breath, a bad taste, fever, swelling or any clenching and grinding. 

Does an aching neighboring tooth always need treatment? 

No. Soreness caused by nearby pressure or inflammation may improve as the area heals. If the dental provider finds a separate problem in the tooth, they can explain what treatment may be needed. 

Who should I contact about the pain? 

Start with the dental provider or oral surgeon who performed the extraction. You can also contact your regular dental provider. If the pain is severe or getting worse, do not wait for a routine visit.

Sources 

¹ National Institutes of Health, Journal of Dental Anesthesia and Pain Medicine: “Post-extraction pain in the adjacent tooth after surgical extraction of the mandibular third molar.” https://pmc.ncbi.nlm.nih.gov/articles/PMC6726888/ 

² American Association of Oral and Maxillofacial Surgeons: “Potential Complications of Wisdom Teeth Extractions.” https://myoms.org/what-we-do/wisdom-teeth-management/potential-complications-of-wisdom-teeth-extractions/