“What is the best painkiller after tooth extraction?”

The best pain relief comes from any of the NSAIDS, non-steroidal anti-inflammatory medications.  These include Ibuprofen or Advil/Motrin and naproxen or Aleve.  I personally recommend Advil and the minimum dosage is 600mg every 6 hrs, or 800mg every 8hrs.   However, before starting these make sure with your primary care doctor that they will not be contraindicated with any meds you currently take.  Managing inflammation will reduce your pain very well as it is the primary reason for most pain.  As our head and neck areas swell, it causes more of the nerves in the region to be recruited in the sensation.  The more nerves involved, the greater the potential for discomfort.  So, using anti-inflammatories is the first line, and if these do not work then seeing the surgeon or dentist for prescription strength meds would be in order.Hope this helps, Dr.G. 

Heroin.

Actually, the best pain killer for post tooth removal/extraction is ibuprofen. If more relief is desired then acetaminophen is added. Studies show that a regimen with both ibuprofen and acetaminophen works much better than narcotic pain killers.