The phrase suggests an experience that is as unpleasant or difficult as physically pulling out teeth. Sitting through that meeting was like pulling teeth.
Pro Tip 2/3
Emphasize Frustration
Use it to stress the level of difficulty or resistance encountered in doing something. Convincing her to admit the mistake was like pulling teeth.
Pro Tip 3/3
Informal Expression
The phrase is informal, so it's best used in casual conversations or informal writing. Getting a refund from that shop is like pulling teeth.