Wisdom tooth pain: relief at home and when to see a dentist

Why wisdom teeth hurt

Wisdom tooth pain usually means the tooth does not have enough room, or the gum around it is infected. These are the third molars at the very back, and they tend to come in between the late teens and the early twenties. Many people never have trouble. Others have pain on and off for years.

The main causes are a tooth stuck under the gum or against the next tooth (an impacted tooth), a tooth that is only partly through the gum, a cavity that is hard to reach and brush, or crowding that pushes on other teeth. Pain can also spread to your jaw, ear or head, which is why it can feel confusing.

Age matters. Wisdom teeth usually try to come in between about 17 and 25, but pain can start earlier or later. If your jaw is small, there may not be room. If you had braces or teeth pulled in the past, the picture changes too.

A wisdom tooth can also push on the molar in front of it. This can cause decay between the two teeth that you cannot see or clean. If the second molar starts to hurt, mention it to your dentist, since the real source may be the tooth behind it.

The most common problem: pericoronitis

When a wisdom tooth is only partly through, the gum can form a flap over it. Food and bacteria get trapped under the flap. The gum becomes red, swollen and sore. That infection is called pericoronitis, and Cleveland Clinic describes it as common in young adults.

Symptoms include pain at the back of the mouth, swollen gums, a bad taste, trouble opening your mouth and sometimes swollen glands in the neck. In bad cases you can get a fever or pus. Because food keeps getting trapped, the problem often returns, even after it calms down.

Even a clean wisdom tooth can be hard to keep clean, since it is so far back. Plaque builds up and the gum becomes irritated. A dentist can clean under the flap and show you how to keep it clear at home.

Because the flap keeps trapping food, a one-time cleaning may bring only short relief. Your dentist can tell you if the tooth should be watched, cleaned regularly or removed.

What helps at home

Home care can ease mild pain. It will not fix a stuck tooth or a deep infection.

• Rinse with warm salt water, half a teaspoon of salt in a cup of warm water, several times a day.
• Brush gently around the tooth and clean under the gum flap with a soft brush. A water flosser on low can help.
• Hold a cold pack on your cheek for 15 minutes at a time.
• Eat soft foods and chew on the other side.
• Use an over-the-counter pain reliever that is safe for you.

Pain medicine: what the evidence says

A review covered by Case Western Reserve University found that 400 mg of ibuprofen taken with 1,000 mg of acetaminophen eased dental pain better than opioid drugs, with fewer side effects. Many dentists now advise this approach for pain after a wisdom tooth is removed too.

Check with your doctor or pharmacist before using them, especially if you have kidney, liver or stomach problems or take blood thinners. Do not put pain pills on your gums. And do not rely on medicine for more than a few days without seeing a dentist.

Avoid chewing gum or hard foods on that side. Do not poke the area with a toothpick or a sharp object, because that can push bacteria deeper. Warm salt water works best when the water is warm, not hot.

A cool compress outside the cheek helps with swelling. Keep your head up when resting. And drink water to flush food and bacteria around the tooth. If the area is very swollen, do not push on the flap or try to cut it. Let a dentist treat it.

If you have a lot of pain, do not suffer through it to avoid the dentist. A short visit can clean the area, check for infection and give you a plan. Many people feel relief the same day.

When to see a dentist

Medical News Today advises seeing a dentist if home care has not helped after about five days. WebMD says any pain, fever or bleeding in this area deserves a prompt visit. Do not wait if you notice:

• Swelling in your cheek or jaw
• Trouble swallowing or opening your mouth
• A fever
• Pus or a bad taste that does not go away
• Pain that keeps coming back every few weeks

When it is an emergency

Trouble breathing, trouble swallowing or swelling that spreads toward your neck or eye is an emergency. Go to an emergency room or call 911. The American Dental Association also lists severe pain from a wisdom tooth, called third molar pain, among conditions that need urgent dental care.

If you are unsure, call a dentist and describe your symptoms. We would rather hear from you early.

After removal, the sore feeling usually peaks in the first couple of days and then gets better. Your dentist will tell you how to care for the area, such as avoiding straws and smoking, which can disturb the blood clot and cause dry socket. If you notice severe pain several days after, call the office.

Ask your dentist about the whole plan: who will do the removal, what kind of numbing or sedation is offered, how long to expect to be out of work or school and what the cost will be with your insurance. Knowing the plan up front makes the day much calmer.

Do you need it taken out?

Not every wisdom tooth needs to come out. A healthy tooth that is fully through, clean and not hurting can stay. Your dentist will take an X-ray, look at the position and tell you what they see.

Removal is often advised when a tooth keeps getting infected, is badly decayed, damages the next tooth or is stuck and causing pain. Treatment for an infection comes first, such as cleaning the area and sometimes antibiotics. Then the tooth is removed once the infection is under control. The procedure is done with numbing medicine, and some offices also offer options to help you relax.

The right time to remove a wisdom tooth is usually before it causes a big problem. A planned removal is calmer than an emergency one, and you can pick a time that fits your schedule. If your dentist says to wait and watch, ask what signs would change the plan.

Teens and young adults often ask whether to take the wisdom teeth out before they hurt. Your dentist can follow the teeth with X-rays at your checkups and tell you when removal makes sense. If your teeth are healthy and have room, you may keep them for life.

Wisdom tooth care in Kendall

If your back tooth hurts, we can take digital X-rays and show you what is going on.

KDA lists emergency care 24/7. If you are in pain, call us at 305-271-1421 and tell us what is going on. Our regular office hours are Monday to Friday, 8:00 AM to 5:00 PM, and we are closed Saturday and Sunday.

You will find us at 8833 SW 107th Ave, Miami, FL 33176, in the Kendall Mall. We have served South Florida since 1973. We take digital X-rays and 3D scans in the office, so we can see what is wrong the same visit. We accept most dental insurances and most Medicare supplemental plans, and financing is available.

Common questions

This article is general information, not medical advice. Your dentist will confirm what is right for you at your exam. General information checked against: my.clevelandclinic.org, medicalnewstoday.com, webmd.com, case.edu, dentalcompare.com.