Pain is normal after any dental extraction and will normally resolve in several days with the use of a regular painkiller and warm salty mouth wash.
Some patients will require an antibiotic if infection is suspected or if there is a strong chance of infection developing. Infection will prolong pain but once the antibiotic kicks in the pain should start to ease.
Occasionally an extraction socket will remain painful for several weeks or even months, for no apparent reason.
In these cases the options for management are limited.
1: Time and regular mouth washes and analgesics and hope the body will heal itself.
2: Antibiotics combined with time and mouth washes. Sometimes there will be a stubborn infection and a long course of antibiotics or several different antibiotics will eventually get on top of the infection and allow easing of the pain.
3: Clean out the socket. If the above all fail and x rays show nothing obviously wrong or anything left in the extraction socket then opening up the socket and cleaning the socket will usually allow the socket to heal. It is unclear why this works, but it is presumed that there is some small amount of debris in the socket preventing healing and removing this allows healing.
4: If all of the above fail then referral to a pain management specialist is often the only course of action available.