Few problems can bring a person to their knees like a toothache—and few teeth can hurt as bad as a wisdom tooth. Wisdom tooth pain is like no other: constant throbbing, jaw and earaches, swelling inside the mouth as well as in the cheeks and throat.
When wisdom teeth grow in between the ages of 17 and 21, many people do not have room for the wisdom teeth—the third molars— to fit into their mouth. When that is the case, the wisdom teeth have nowhere to go and begin to push against the roots of the other teeth or against the sides of the jaw and facial bones. The results of this constant pressure are the pain and swelling that accompany wisdom tooth growth.
What is a wisdom tooth?
In a normal full set of teeth, there are four wisdom teeth, also known as third molars. These are located at the back of the mouth in each of the four corners.
One result of many eons of evolution is that our jaw size has become smaller. Modern humans have a smaller jaw and less room for a full dentition. So many people suffer when the wisdom teeth try to grow into an area that has evolved to accommodate only 28 teeth. Those final four molars simply do not have room to grow normally and thrive like the others.
Wisdom teeth are a normal part of a person’s dental development. Located behind the 12-year-molar, or the second molar, wisdom teeth provide additional surfaces for chewing food. Like other teeth, they can serve as attachments for bridges to hold false teeth, as anchors for partial dentures, and can develop dental diseases such as cavities and gum disease if not kept clean and free of food debris and plaque, a bacterial film that forms on all teeth daily.
What causes wisdom tooth pain?
For people lucky enough to have plenty of room to accommodate wisdom teeth, these teeth grow in normally and in line with the other molars. They cause little or no discomfort when erupting through the gum tissue.
But for many unlucky people, the growth of wisdom teeth is anything but fun. Far from it. As the wisdom teeth grow and the roots develop down in the jaws, pressure from the lack of space as well as slow damage to the other teeth causes acute pain and suffering.
Many wisdom teeth do not grow in a straight path through the gums. Some grow sideways and push against the roots of the second molars as they develop in the jaw. Some are angled toward the face or the tongue and never grow into the mouth at all. These trapped wisdom teeth are called “impacted” because they cannot grow through the bone and gums naturally.
These abnormal growth patterns contribute to wisdom tooth pain in the jaw. Your dentist will monitor the growth pattern of your wisdom teeth with X-rays and watch for the following conditions that might trigger pain and signal the need to have the wisdom teeth removed:
- Wisdom teeth start through the gums but cannot come all the way in - These can trap food and bacteria that cause swelling and infection.
- Wisdom teeth begin to damage the second molars - When they are only partially erupted and push against the back of the second molar, wisdom teeth can be impossible to keep clean and cause further damage.
- Infections in your gums caused by the wisdom teeth - Swelling, pain, redness, foul odors, and bad tastes are all signs of infections.
- Cyst formation around an impacted wisdom tooth - Cysts are fluid-filled sacs that can cause damage to the bone and roots of the nearby teeth.
Wisdom teeth pain symptoms
Wisdom teeth do not always cause pain or other symptoms. They can sit under the bone and gums for years without ever causing trouble.
However, if any of these symptoms occur, you need to go to your dentist to see if the wisdom teeth are the cause:
- Damage to neighboring teeth
- Gum disease
- Tooth decay (if it is not possible or desirable to restore the tooth)
- Redness and swelling in the back of the mouth, either on the upper or lower jaws
- Tenderness or bleeding from the back of the mouth
- Jaw or TMJ pain (jaw joint close to the ear)
- Sour taste or bad breath
- Problems fully opening your mouth
Home remedies for wisdom tooth pain relief
There are times when going to the dentist because of wisdom tooth pain is simply not possible. There are seven home remedies for wisdom tooth pain that you can try.
Swish a solution of one cup of warm water with one teaspoon of salt for 30 to 60 seconds throughout the day. Saltwater has natural disinfecting properties and can reduce the bacteria in the mouth.
Most grocery stores and drug stores sell this numbing gel over the counter in their dental care supply displays. If you do not see this product on display, ask the pharmacist if they have some behind their counter. Spread the gel over the gums where the tooth is trying to erupt. Apply throughout the day.
Cloves and clove oil
Place a whole clove (not crushed) on the spot where the pain is the worst. It will start to cause a numb feeling after a few minutes. If you have clove oil, dab some on a cotton swab and brush it over the sore spot.
Over-the-counter pain medication
Use as directed. Do not place an aspirin directly on the gums as this can burn the tissue and cause more damage and increase the pain. Swallow the medication for relief from the pain.
Placing an ice pack against the jaw where the wisdom tooth is growing can reduce inflammation and also have a numbing effect. Hold the ice pack with a cloth around it against the jaw for up to 15 minutes at a time. Then leave it off for 15 minutes. Do this throughout the day.
These are especially effective for areas that are bleeding. Make a cup of tea with a tea bag. Allow it to cool, then place the tea bag in the mouth on the side where the pain is located. Do not add any sugar or cream to the cup of tea.
A study published by the Nutrition & Food Science journal in 2007 found that onions and garlic have anti-inflammatory and antimicrobial actions. As a home remedy, they recommend chewing on a small piece of onion on the side of the mouth where the pain is located. Spit out the remaining onion. This allows the juice to bathe the gum to help reduce inflammation and kill bacteria.
These home remedies will help with temporary relief from wisdom tooth pain in the jaw. But none of these provide a permanent solution. The wisdom tooth that is causing the pain is likely to continue or even get worse.
How can I get permanent wisdom tooth pain relief?
If your wisdom tooth is growing naturally into your mouth and you have plenty of room behind the other molars for it to grow all the way in, the pain you feel as it pushes through the gums is only temporary. The home remedies discussed here are likely to help with the temporary pain. When the tooth completes its journey through the gums, the pain will subside.
However, if the wisdom tooth is impacted or erupting at an angle, which is common, the pain will not stop until a dentist removes the offending tooth.
Many times, your general dentist can pull your wisdom tooth in her office. If the tooth is in a position that the dentist can access with his instruments, you can probably have the extraction completed in his office with a simple injection of local anesthesia. Recovery is typically easy with little or no complications expected.
On the other hand, wisdom teeth that become impacted underneath the bone or growing at an angle may need to be extracted by an oral surgeon—a specialist in surgeries of the jaws and face. Your general dentist will refer you to a surgeon she trusts. The surgeon may need to use some type of sedation—a way to put you to sleep—to keep you comfortable throughout the procedure. You will need someone to drive you home. Recovery may take longer than with a routine extraction.
Why should I have my wisdom teeth pulled?
Here are a few good reasons to make the choice to have your wisdom teeth removed:
- Shifting of other teeth: Wisdom teeth, especially impacted ones, can cause the other teeth to shift and cause problems with your bite
- Bone loss: Impacted wisdom teeth can destroy the bone where they are trapped
- Sinus problems: Upper wisdom teeth can interfere with the sinuses and cause infections, congestion, and headaches
- Cysts: These fluid-filled sacs form around impacted wisdom teeth and can destroy the bone.
- Gum inflammation: The gum tissue around the wisdom teeth can become infected and irritated
- Periodontal disease and cavities: Because they are hard to keep clean, wisdom teeth are often the site of gum disease and cavities
- Dentures and partials: For the elderly or those who must be fitted with false teeth, the wisdom teeth may interfere with the ability of the denture or partial to function properly
Getting permanent relief from wisdom tooth pain and avoiding the adverse conditions mentioned above means having the tooth or teeth removed. Hopefully, your general dentist can remove the tooth, but certain difficult cases require the skills of an oral surgeon to safely remove the wisdom tooth.
Whoever removes your wisdom tooth will provide postoperative instructions about what to do and what not to do after you get home to ensure fast and safe healing.
How long does pain after wisdom tooth extraction last?
For routine wisdom teeth extractions, expect five to seven days for a full recovery and around four weeks for the gums around the extraction site to grow back together. If the tooth was impacted and had to be drilled out of the jawbone, expect up to six months for total healing.1 Most patients return to work a day or two after the surgery.
Expect some mild pain and bleeding during the first 24 hours after the procedure. Your dentist or surgeon will provide you with clean gauze to bite on to stop the bleeding. You can also use a wet tea bag to stop the bleeding if the gauze does not help.
Some facial swelling is also common. Relieve this condition with an ice pack wrapped in a towel. Apply the ice pack to the swollen area for 15 minutes then leave it off for 15 minutes. Repeat this cycle for the first 24 hours after the surgery.
The American Dental Association (ADA) recommends over-the-counter medications such as NSAIDs (nonsteroidal anti-inflammatory drugs) such as aspirin, naproxen, or ibuprofen.
To minimize pain after wisdom tooth removal, follow these widely accepted instructions:
- Wait 24 hours before rinsing your mouth with any liquids.
- Eat a soft diet (ice cream, mashed potatoes, pudding, etc.) for a couple of days.
- Brush and floss the other teeth normally but stay away from the area where the tooth was pulled.
- After the first 24 hours have passed, gently rinse with warm salt water three or four times each day for at least five days.
One common cause of pain after a wisdom tooth extraction is a dry socket. These painful conditions are caused by the failure of the blood to clot properly or the loss of a clot. To prevent a dry socket from forming, avoid smoking and drinking from a straw for several days after having the tooth or teeth removed. Avoid foods such as popcorn and nuts for a few days as those tend to pack into the socket and disrupt the clotting process. Hot liquids and foods should also be avoided for the first few days to prevent a dry socket.
Although most people would rather keep their wisdom teeth and avoid having them pulled, unfortunately this rarely happens. Because of pain, swelling, cyst formation, damage to neighboring teeth, decay, and gum disease caused by the wisdom teeth, most people must have them removed.
You can control the pain from wisdom teeth temporarily by using several of the home remedies listed above. But, for a permanent solution, having the offending wisdom tooth pulled is usually the only answer.
Most dental insurance policies cover wisdom teeth extractions, whether by your general dentist or by an oral surgeon.
Wisdom tooth pain is a widespread problem that most people face at some point in their lives. The younger you are when you have them removed, the quicker you will heal. If your dentist recommends taking your wisdom teeth out, follow her advice: you will avoid a lot of pain and agony in your later years.
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This is not dental care advice and should not be substituted for regular consultation with your dentist. If you have any concerns about your dental health, please contact your dentist's office.