Wisdom tooth pain: causes, removal and recovery

Wisdom teeth are the last teeth to come through, usually in the late teens. In many people the jaw has no room left for them, so they get stuck against the tooth in front or against the bone behind. A tooth that is stuck like this is called impacted.

Why a wisdom tooth hurts

A wisdom tooth that has only partly come through the gum is hard to keep clean. Food and bacteria get trapped around its edge, and this can lead to:

  • decay in the wisdom tooth or the tooth next to it
  • infection of the gum around the tooth (pericoronitis)
  • an abscess, which is a collection of pus around the tooth
  • infection that spreads into the cheek, tongue or throat (cellulitis)

An infected wisdom tooth can cause severe pain, swelling, a stiff jaw and a general feeling of being unwell. Very rarely, a wisdom tooth that has not come through forms a cyst.

Does it need to come out?

Not always. A wisdom tooth that is impacted but causing no problems can be left where it is. When it gets infected, antibiotics and an antiseptic mouthwash can settle the flare-up. Removal is usually advised when that treatment has not worked or the infections keep coming back.

What removal involves

The area is numbed with a local anaesthetic, which can last up to four hours. You feel pressure as the tooth is loosened, but no sharp pain. Some teeth need a small cut in the gum, and some are cut into pieces so they come out more easily. The removal itself usually takes between 5 and 30 minutes, and the gum may be closed with stitches that dissolve on their own.

At Beaut32, wisdom tooth removal is part of our minor oral surgery. If you are nervous about it, ask about sedation.

The first two weeks

Some pain and swelling are normal. Swelling is usually at its worst 48 to 72 hours after the extraction and can take up to two weeks to go down completely. For the first few days you may not be able to open your mouth wide. Most people need painkillers for three to seven days.

For the first 24 hours:

  • do not rinse your mouth, spit or drink anything hot, so the blood clot in the socket stays in place
  • do not smoke or drink alcohol
  • avoid heavy exercise
  • sleep with an extra pillow

From the next day, rinse gently with warm salt water (one teaspoon of salt in a glass of warm water) after meals. Eat soft food and chew on the other side. A cold cloth held against the cheek helps the swelling.

If the socket starts bleeding, roll up a clean piece of gauze or a handkerchief, put it over the socket and bite on it firmly for 15 to 20 minutes.

Dry socket and infection

Dry socket happens when the blood clot comes out of the socket. It usually starts three to five days after the extraction, with pain that gets worse instead of better, a bad taste and bad breath. It is more common in people who smoke. It is treated by cleaning the socket and putting a soothing dressing in it, so see us or your dentist if you think you have it.

Infection is less common and affects about 1 in 100 people. The signs are pain and swelling that get worse after the first few days, discharge from the socket, a high temperature and feeling unwell.

If your lip, chin or tongue stays numb after the anaesthetic has worn off, the nerve near the tooth may have been bruised. This usually settles within a few weeks. Permanent numbness affects fewer than 1 in 100 people.

When to get help straight away

Go to the nearest hospital emergency department if you have difficulty breathing or swallowing, or if bleeding does not stop when you press on it. Call us on +91 70171 40563 if your pain or swelling is still increasing after three days, or if numbness has not started to improve after two weeks.

This article is general information. It does not replace an examination.

Sources