Sore wisdom tooth socket

Impacted Tooth

What Is It?
An impacted tooth is a tooth that gets blocked as it is pushing through the gum into your mouth (erupting). Wisdom teeth often are impacted.

Wisdom teeth usually begin to come in between the ages of 17 and 21. Dentists call these teeth third molars. They may become impacted because there’s not enough room in your mouth for them. A wisdom tooth also might be trying to come in sideways. Or, it might be tilted in your jaw.

An impacted tooth can be painless. You may not even realize it’s there. However, when an impacted wisdom tooth tries to come in, the flap of gum on top of it can become infected and swollen. This can hurt. You might even feel pain in nearby teeth, or in the ear on that side of your face.

An impacted tooth can lead to an infection called pericoronitis. If untreated, this infection can spread to the throat or into the neck. Severe infections require a hospital stay and surgery.

Impacted teeth also can get cavities. An impacted tooth can push on the neighboring molar. This can lead to tooth movement, decay or gum disease. It also can change the way your teeth come together. Rarely, impacted teeth can cause cysts or other growths in the jaw.

Symptoms
Symptoms include:

  • Swelling of the gum in the back of your mouth
  • Difficulty opening your jaw
  • Bad breath
  • A bad taste in the mouth
  • Pain when you open your mouth
  • Pain when chewing or biting

Pain can occur for several days and then disappear. It can come back weeks or months later.

Diagnosis
Your dentist will examine the area. If necessary, he or she will take X-rays. X-rays can show where your wisdom teeth are and if they are impacted.

Expected Duration
When the tooth is taken out, the symptoms will go away.

Prevention
There is no way to prevent an impacted tooth. You can prevent cavities by brushing and flossing.

Treatment
You can sometimes relieve minor irritation by rinsing with warm salt water (1/2 teaspoon of salt in 8 ounces of water). Over-the-counter pain relievers also may help.

If the tooth continues to cause pain, is infected or interferes with nearby teeth, the usual treatment is to take it out. Extracting one tooth can take 5 to 30 minutes, depending on where it is. In some cases, an infection requires antibiotics.

Patients are often referred to an oral and maxillofacial surgeon to have an impacted tooth removed. Before removing the tooth, your dentist or surgeon will discuss the procedure and the type of anesthesia and sedatives he or she will use. You will not be able to eat for six hours before surgery. If you take any medicines, keep on schedule with them. Someone should drive you to the appointment and drive you home.

After the surgery you may have swelling of the cheeks and jaw. It may be hard to eat certain foods. Follow your dentist’s or surgeon’s instructions carefully for the best recovery. Complications of surgery are rare, but do occur.

An impacted tooth may not bother you or affect nearby teeth. In this case, you won’t need immediate treatment. However, your dentist probably will recommend that the tooth be taken out to avoid future problems.

Many people have all four of their wisdom teeth taken out at once. Sometimes this surgery is done before the teeth have started coming in. This prevents future problems. This usually is done in an oral and maxillofacial surgeon’s office with sedation and local anesthesia. Often, it is better to have your wisdom teeth taken out before you turn 21. The surgery usually is less complicated. The tissue and bone also heal better.

When To Call a Professional
Call your dentist if you feel pain in your back teeth. If you visit your dentist regularly, he or she will keep track of your wisdom teeth and let you know if you need to have them taken out. Your dentist may take extra X-rays to check your wisdom teeth. Routine X-rays often don’t show these teeth.

Prognosis
The outlook after surgery is excellent.

Overview


Wisdom tooth removal

Why are wisdom teeth removed?

Your wisdom teeth don’t usually need to be removed if they’re impacted but aren’t causing any problems. This is because there’s no proven benefit of doing this and it carries the risk of complications.

Sometimes, wisdom teeth that have become impacted or haven’t fully broken through the surface of the gum can cause dental problems. Food and bacteria can get trapped around the edge of the wisdom teeth, causing a build-up of plaque, which can lead to:

  • tooth decay (dental caries)
  • gum disease (also called gingivitis or periodontal disease)
  • pericoronitis – when plaque causes an infection of the soft tissue that surrounds the tooth
  • cellulitis – a bacterial infection in the cheek, tongue or throat
  • abscess – a collection of pus in your wisdom teeth or the surrounding tissue as a result of a bacterial infection
  • cysts and benign growths – very rarely, a wisdom tooth that hasn’t cut through the gum develops a cyst (a fluid-filled swelling)

Many of these problems can be treated with antibiotics and antiseptic mouthwash.

Wisdom teeth removal is usually recommended when other treatments haven’t worked.

Dentists and surgeons follow nationally approved guidelines for the removal of wisdom teeth.

0 Shares Modified: 21 January 2020 Painful wisdom teeth can be excruciating

Are you looking for wisdom tooth pain relief solutions or wondering how long the wisdom tooth pain will last? Wisdom teeth are notorious for the problems and pain they can cause, which is why they are often removed. Even then, it’s normal to experience some pain after extraction, too.

Fortunately, there are various ways to help get rid of wisdom tooth pain in your jaw or gum while a tooth is coming through, or following an extraction.

In this article, we explain some of the symptoms and causes, including why your wisdom tooth hurts and how to stop the pain if it’s affecting the oral health of you or someone you know.

Wisdom tooth pain symptoms

Wisdom teeth (or ‘third molars’) are located right at the back of your mouth. Most people have four, but you might have fewer than this or none at all. It’s also possible, although not as common, to have more than four wisdom teeth.

Wisdom teeth cause problems for many people and sometimes have to be removed. You might experience pain from:

  • Eruption – A wisdom tooth coming through the gum — this often causes wisdom tooth pain when chewing
  • Impaction – When a tooth aligns incorrectly during eruption and ends up pushing against the adjacent tooth
  • Decay – This is common in hard-to-reach third molars
  • Infection – Caused by partial impaction or decay
  • Extraction – Pain may continue for a while after a tooth is removed

Whatever symptoms you experience, you should certainly mention any oral pain to your dentist at your next checkup. They will examine your mouth to determine the cause of the pain, and they may take an x-ray to see the position of any unerupted or partially erupted teeth.

If you have any of the signs of impaction or infection mentioned below, the tooth pain is getting worse, or you’re having trouble opening your mouth, you should make a more urgent appointment.

If you are in severe pain, are having trouble breathing or eating, or have swelling around your eyes, throat or neck, you should go to urgent care rather than waiting to see a dentist.

What does pain from wisdom teeth feel like?

If none of your wisdom teeth have erupted yet, you might be wondering what does wisdom tooth pain feel like? Is that aching at the back of your mouth a cavity or is it from your wisdom teeth?

How to know if it’s your wisdom teeth hurting

It may well be wisdom tooth growing pain if you have any of the following symptoms:

  • Pain behind your second molars (right at the back of your mouth)
  • Pain in your gum or jaw at the back of your mouth
  • Red or swollen gums in the affected area
  • A hard bump in your gum or the tip of the tooth visibly emerging
  • Headaches, particularly when upper teeth erupt

If a wisdom tooth erupts normally, any pain should be quite mild; perhaps just a dull ache. It’s similar to the teething pain that babies experience. More severe pain might be a sign of a complication like impaction or infection.

When does wisdom teeth pain stop?

After experiencing a few weeks of pain from your wisdom teeth, you may be wondering what the normal time span is for wisdom tooth pain duration. Everyone has their own wisdom teeth pain timeline. Wisdom tooth eruption pain may begin before there are any external signs of the tooth appearing. Then, it can take several weeks or months for a wisdom tooth to fully break through the gum and grow into its correct position.

It’s common to experience some soreness and sensitivity while the crown of the tooth is erupting, especially if you bite down in that area. Once it has pushed through the gum, provided it is not impacted, it should stop hurting.

Some people only experience pain from their wisdom teeth growing for a relatively short time. For others, it may drag out for months or even years. If this is the case for you, you may want to find ways to treat your pain naturally, since it’s not ideal to keep taking painkillers for a sustained period of time.

It’s also possible for wisdom teeth to never erupt, but to remain quite happily under the gum and never cause any problems to the other teeth. So just because you have unerupted wisdom teeth, it doesn’t necessarily mean you’ll have to deal with painful wisdom teeth at some point.

Besides just growing, what causes wisdom tooth pain?

Impacted wisdom teeth can cause pain and become infected

When there isn’t enough room in your jaw for your wisdom teeth to erupt properly, they may grow at an angle and become impacted. Teeth can be fully impacted (meaning they are still completely covered by gum) or partially impacted (meaning part of the tooth has emerged).

If the tooth becomes impacted as it is erupting, it may cause pain in the adjacent tooth as it pushes against it. You might also notice that part of the tooth is poking through the gum but it seems to have stopped coming through and is continuing to hurt. Your dentist will need to take an x-ray to check what’s going on beneath the surface.

Even if a wisdom tooth does come through straight, it may put pressure on the other teeth, meaning they gradually become crowded at the front.

Wisdom tooth pain or infection

You may be wondering if you are experiencing normal growing wisdom tooth pain or an abscess. Third molars can easily become infected, either because they haven’t erupted properly or because they are difficult to clean. If you can’t reach right to the back of the tooth to brush and floss it, this can lead to tooth decay, gum disease and eventually an abscess.

Pain from a tooth infection is usually severe and you may also have a swollen, painful gum around your wisdom tooth. You might taste or see pus seeping from around the tooth. Additionally, if your wisdom tooth pain is accompanied by a sore throat, it’s most likely caused by an infection. You may also experience wisdom tooth pain in your cheeks due to infected glands.

If the pain is unmanageable, it could be a serious infection or abscess that may be considered a dental emergency, and your wisdom tooth pain may result in a trip to the emergency room. If you experience extreme wisdom tooth pain and have no insurance, don’t let that stop you from seeking help. Depending on your income you may be able to receive retroactive Medicaid to help you pay for your medical emergency bills. Read more about Medicaid insurance for low-income families.

How to ease wisdom tooth pain while pregnant

You might experience heightened problems with wisdom tooth pain during pregnancy because changes to the hormones in your mouth make it more susceptible to gum disease and infection.

If you’re planning to get pregnant, it’s best to have a dental checkup first so your dentist can check for potential problems that should be dealt with beforehand. Dentists generally avoid carrying out procedures like fillings and teeth extractions during pregnancy, if possible.

If you need extra wisdom tooth pain relief while pregnant, speak to your dentist or doctor to check what’s safest for you and your baby.

What helps wisdom tooth pain?

An impacted tooth may need to be removed

If you’re wondering how to get relieve wisdom teeth pain without visiting a dentist, you can try certain home remedies to reduce inflammation and pain. However, if your tooth keeps hurting, it’s best to visit a dentist. They will check what’s causing the pain and what, if anything, needs to be done about it.

In the case of infection, the dentist may first administer antibiotics and painkillers. Your dentist may choose to remove a tooth before you experience pain if x-rays show a high likelihood of impaction or complications. This is a sort of preemptive wisdom tooth pain treatment and gets a head start on stopping the pain and preventing further infection or other problems. Even if an impacted wisdom tooth doesn’t cause you pain, your dentist may decide that extraction is the best option due to potential decay and pain down the road.

In the following table is an overview of how to relieve the pain according to the source. Below this, you’ll find more information about various home remedies that can help reduce tooth pain.

Cause of pain Treatment Pain relief options
Wisdom tooth growing None if it’s growing correctly – just wait Painkillers and other home treatments
Impaction Extraction if it’s painful or affecting other teeth Painkillers and other home treatments as an interim measure
Infection Antibiotics to fight the infection; extraction as a last resort Painkillers prescribed by dentist or over-the-counter
Extraction Take special care while the wound heals Painkillers and other home treatments

Pain relief at home

Many people find that the best painkiller for wisdom tooth pain relief is ibuprofen, because of its anti-inflammatory properties. Acetaminophen, the active ingredient in Tylenol, can also be effective. It’s safe to take both ibuprofen and paracetamol as wisdom tooth pain killers, up to the maximum dose of each one, if your teeth still hurt after taking one or the other. However, if you’re in this much pain and haven’t seen a dentist yet, you shouldn’t put off making an appointment.

If you have wisdom tooth gum pain, you may get more relief from a topical anesthetic treatment such as Orajel or Anbesol.

In the helpful video below, Dr. Bonnie Padwa describes some wisdom tooth pain symptoms and causes. When experiencing these systems you should be sure to see your dentist. But until you are able to get your teeth extracted, or in the case that you are experiencing normal growing pain, you can use home remedies to manage the pain.

Natural treatment

If you prefer to use natural wisdom tooth pain relief, salt water and clove oil are both effective.

Cloves have antibacterial, anesthetic and anti-inflammatory properties. You can apply diluted clove oil directly to the painful area for quick relief. A saltwater mouth rinse is also an effective way to kill bacteria and reduce any swelling.

Read more about how to use these and other ways to help pain at home.

Wisdom tooth pain after surgery

The best thing for wisdom tooth pain caused by impaction or infection is often a tooth extraction. If your dentist can see that leaving the tooth in place is likely to cause further problems, they will recommend removing it.

Unfortunately, the pain doesn’t necessarily end there. Extracting third molars can be quite complicated because of the size and position of the teeth, and this often leads to swelling, discomfort and pain where the wisdom tooth used to be following the procedure. You can read more about wisdom teeth problems and the extraction process here. For now, we’ll focus on how to manage and relieve pain after a wisdom tooth extraction.

How long does wisdom tooth pain after extraction last?

After your anesthetic has worn off, the extraction site itself will feel sore for several days. The rate of healing will depend on how large the wound is and whether you have stitches. Your dentist might prescribe you a course of antibiotics to prevent infection and will either supply painkillers, or inform you of the best over-the-counter painkillers for wisdom tooth pain relief.

Smoking increases the chances of infection and pain after wisdom tooth extraction

Here are some tips for minimizing pain and reducing the chances of infection in the days after an extraction:

  • Rest as much as possible and avoid strenuous exercise
  • Don’t touch or poke the wound with your fingers or tongue
  • Avoid hot or cold foods and drinks
  • Don’t smoke, vape, or drink through a straw (the sucking action can dislodge the blood clot)
  • If using mouthwash or salt water to rinse, do so gently
  • Brush very carefully around the extraction site

Closely follow your dentist’s advice for protecting the wound and the blood clot that forms inside. If the blood clot becomes dislodged, you’ll experience intense pain from the exposed bone. This condition, known as ‘dry socket’, requires additional dental care.

Read our guide to wisdom tooth recovery for more information, or our guide to tooth extraction for information about tooth extraction in general.

Even after your gum is well on the way to healing, you might continue to experience nerve pain after your wisdom tooth extraction, especially if it was a complicated procedure. It takes time for your body to repair the trauma to your nerves, and it will be several months before your jaw bone has grown to fill in the hole where the tooth roots were.

If you feel like your pain is increasing in the days after an extraction, consult your dentist.

Why is pain worse at night?

There are a wide range of reasons why your wisdom tooth pain may be worse at night. The causes can include anything from wisdom tooth pain from an abscess to wisdom tooth pain in your jaw and ear from clenching or grinding. Try sleeping in an elevated position to relieve some of the pressure, and pursue professional help as you would with any toothache.

Conclusion

If you are in pain and haven’t visited your dentist yet, it’s best to do so. There are several causes of wisdom tooth pain, some of which require medical intervention.

While you are waiting to see your dentist – or if they have already confirmed the pain is just from a wisdom tooth coming through the gum – the best form of wisdom tooth pain relief is probably ibuprofen, acetaminophen, or a topical pain relief medicine. There are also various home remedies you can try; clove oil is one of the most effective.

To ease pain after a wisdom tooth extraction, follow your dentist’s instructions, which may include taking painkillers and using a salt water rinse.

How to Relieve Wisdom Tooth Pain from Teeth Growing or Extractions 3 (60%) 2 vote
Sources Mouth Healthy: Wisdom Teeth. Consulted 18th June 2019. Medical News Today: Ways to relieve painful wisdom teeth. Consulted 13th May 2019. 0 Shares

Symptoms that may Indicate you need your Wisdom Teeth Removed

Sooner or later, most people will need to get their wisdom teeth removed. It might just be a matter of time before you need to get your own taken out – but how do you know when to say goodbye to those pesky teeth? Often it is a dentist who will decide when you need to get them extracted, by looking at x-rays to determine whether they will cause problems or are at risk of decay.

But first, it is important to know the warning signs of a troublesome wisdom tooth so you can identify the issue as early as possible. Here’s some of the main symptoms to look out for that could signal it is time to see your dentist and have them removed.

What are Wisdom Teeth?

Your wisdom teeth are the teeth found at the back of your gums often referred to as your third molars. Most adults have 32 teeth, including 4 wisdom teeth, one in each corner of your mouth and are the last adult teeth to come through, if they come through at all.

They normally grow through (erupt) during the late teens or early 20s and can often cause issues because there’s simply not enough room in the mouth for them to come in properly. Due to the lack of space the teeth can come through at an angle or only partially through the gum. This is what is known as impacted wisdom teeth and more often than not are the wisdom teeth that need to be removed.

Impacted wisdom teeth can cause pain, damage to other teeth and other dental problems, including overcrowding of the existing teeth and impaction, either into the neighbouring teeth or into the gum. However, not all wisdom teeth will cause immediate problems and even if they are impacted it might be painless.

Signs & Symptoms

When your wisdom teeth come through, it is usually accompanied by some discomfort. There are a number of side effects that would make it necessary to have your wisdom teeth removed. Here are some of the signs and symptoms you may experience that can be problematic until the tooth is extracted:

Persistent Pain & Infection

One of the most noticeable signs that you need your wisdom teeth taken out is the pain and irritation both at the tooth site and when you open your mouth. Your wisdom teeth usually erupt between the ages of 17 and 21, making them the last to emerge in your mouth and therefore the most common teeth to become wedged-in or impacted. As there is not enough room in the jaw or mouth for them to emerge, instead of coming in straight they can come in sideways, tilted or misaligned in the jaw, pressing up against the teeth in front of it.

An impacted tooth can be painless and you may not even realise that it is there, however when it tries to erupt, the overlying gum may swell and cause pain, which may be felt in nearby teeth or the area on that side. This pain may occur for several days and then disappear for weeks or months before returning. But typically, the pain increases the longer you leave them untreated.

A partially erupted tooth can then collect food, plaque and other debris, which can lead to gum swelling, tooth decay and an infection called pericontis. Pericontis is an infection wherein bacteria from food, plaque and other debris becomes trapped in between the space of the impacted tooth and the gum. If untreated, this infection can spread toward the throat or into the neck.

Stiffness in Jaw & Swollen Gums

As your wisdom teeth come in, they can push against your other teeth and make them move. This in turn can cause discomfort in your jaw, so it feels stiff, sore and difficult to open. This can also cause swelling of both the gum in the back of the mouth or on the side of the jaw.

Red and swollen gums are caused by the flap of extra of gum tissue which resides next to the tooth as a result of the wisdom teeth partially erupting. As mentioned above, this infection is known as pericontis and is caused when particles of food and bacteria get trapped in the tissue and become infected and inflamed over time because it is difficult to clean.

Wisdom teeth can also lead to gum disease at the back of the mouth. Some signs of gum disease and/or infection includes:

  • Tender and bleeding gums
  • Pain and swelling
  • Pus coming from the gum
  • The lymph glands under the jaw becoming swollen and sore
  • Difficult to open the mouth and swallow
  • Fever

Cysts & Cavities

If wisdom teeth are ignored, they can cause cysts and other benign (harmless) jaw tumors, which is a sac of fluid that gets accumulated and will infect the area nearby. As a result, it will damage the roots of your nearby teeth. This can lead to bone destruction – however this is rare.

Impacted teeth can also cause problems such as cavities and tooth decay. If they push on the neighbouring molar, this can lead to tooth movement, which leaves gaps and spaces between our teeth that cannot be easily cleaned while brushing. As a result, they have the potential to collect food and bacteria, which eventually can cause cavities in your teeth.

Sinus Issues & Eating Difficulty

You may be able to tell if your wisdom teeth are coming through if you experience sinus pain, congestion and pressure, especially in the upper jaw area. The growth of teeth and development of its roots can push against the sinuses located right above and behind. Due to this pressure, it can cause headaches and sinus pain.

Misalignment due to your wisdom teeth can also make it difficult to open and close your mouth. As a result, you may experience pain while chewing or biting. Another sign your wisdom teeth are coming through is bad breath and an unpleasant taste in your mouth.

Wisdom Teeth Removal at St John Dental

If you are experiencing any of these signs and symptoms it may be associated with an impacted wisdom tooth and you should visit your dentist. He or she will examine the area and take x-rays if needed to see where your wisdom teeth are and if they are impacted. If the wisdom teeth are indeed problematic, they may need to be extracted.

At St John Dental, we provide an effective wisdom teeth removal service. If they don’t need to be removed, we will tell you, but if they do, our professional and caring team of experienced St John Dental practitioners will make the process of removing your wisdom teeth as pain free as possible.

Don’t let your wisdom teeth impact on your health. Remember, prevention is better than cure. If you think you need your wisdom teeth removed, contact your nearest St John Dental today and let us take a look.

Pericoronitis

Wisdom teeth do not always emerge (erupt) into the mouth properly because there may not be enough room in the mouth for them to fit. Sometimes, a part of the tooth may remain covered by a flap of gum. Food particles and bacteria can get trapped under this flap and cause a mild irritation, a low-grade infection called pericoronitis and swelling. This usually happens with the lower wisdom teeth.

What You Can Do

You cannot treat pericoronitis at home. Do not use warm compresses on your face. If you recognize the symptoms, get treatment right away. The symptoms may include:

  • A bad taste in the mouth — This often happens when there’s an infection.
  • Bad breath (halitosis)
  • Pain in the area around your back teeth — Pericoronitis usually occurs around the wisdom teeth.
  • Swelling behind the very back teeth — If you have pericoronitis, you’ll notice that the gum tissue in the back of your mouth is swollen. This swelling may not allow you to bite comfortably without pinching the swollen tissues between your teeth.
  • Not being able to open your mouth fully

What Your Dentist Will Do

Pericoronitis can be tricky to treat because the overlying flap in the tissue won’t go away until the wisdom tooth fully emerges naturally — which is unlikely to happen — or is removed by an oral surgeon.

Your dentist, however, may try to treat the problem without extensive procedures. He or she will clean the area thoroughly to remove damaged tissue or pus. If the area is infected, you’ll be given oral antibiotics as well.

Your dentist will tell you how to keep the area clean, which is the best way to prevent the problem from coming back. You will have to brush and floss every day and also rinse your mouth with water several times a day. This will help to prevent food particles from building up in the area.

If the condition returns, your dentist probably will send you to an oral surgeon, who will remove the tooth. Once the tooth is out, you should not have the problem again. If the problem is caused by an upper wisdom tooth biting the gum covering a lower wisdom tooth, the upper one may be removed first.

Pericoronitis (Infection Near Wisdom Tooth)

What Is It?

Your wisdom teeth (third molars) usually start to erupt (enter your mouth) during late adolescence. Sometimes, there’s not enough room for them, and they come in partially or not at all. This condition can lead to pericoronitis, inflammation of the tissue surrounding the tooth. When only part of the tooth has erupted into the mouth, it can create a flap of gum tissue that easily holds food particles and debris and is a hotbed for bacteria. Pericoronitis also can occur around a wisdom tooth that has not erupted at all and is still under the gums.

Symptoms include:

  • Painful, swollen gum tissue in the area of the affected tooth, which can make it difficult to bite down comfortably without catching the swollen tissue between your teeth
  • A bad smell or taste in the mouth
  • Discharge of pus from the gum near the tooth

More serious symptoms include:

  • Swollen lymph nodes under your chin (the submandibular nodes)
  • Muscle spasms in the jaw
  • Swelling on the affected side of the face

Diagnosis

Pericoronitis is diagnosed during a clinical exam. Your dentist will see inflamed gum tissue in the area of the unerupted or partly erupted wisdom tooth. The gums may be red, swollen or draining fluid or pus.

Expected Duration

Pericoronitis can be managed with antibiotics and warm salt water rinses, and the condition should go away in approximately one week. However, if the partially erupted tooth fails to completely enter the mouth and food debris and bacteria continue to accumulate under the flap of gums, pericoronitis will more than likely return.

Treatment

Pericoronitis can be tricky to treat because the flap of gum tissue won’t go away until the wisdom tooth emerges naturally or until the tissue is removed.

Your dentist will clean the area thoroughly to remove damaged tissue or pus. If the area is infected, you’ll be given oral antibiotics.

Your dentist will give you instructions for keeping the area clean, which is the best way to prevent the problem from returning. This usually involves brushing and flossing daily and rinsing your mouth with water several times a day. This will help prevent food particles from accumulating in the area.

In some cases, your dentist may suggest you have your tooth extracted once pericoronitis is under control. If your dentist thinks the tooth may erupt fully into the mouth without problems, he or she may leave it alone. However, if pericoronitis recurs, the tooth may be extracted.

Pericoronitis that causes symptoms should be treated as soon as possible. If it is not, the infection can spread to other areas of your mouth. The most severe cases are treated in a hospital and may require intravenous antibiotics and surgery.

When To Call A Professional

If you are experiencing symptoms of pericoronitis, make an appointment to see your dentist. If your wisdom teeth are coming in, visit your dentist at least twice a year for regular checkups. During those visits, he or she can check on the progress of your wisdom teeth.

Prognosis

Pericoronitis does not cause any long-term effects. If the affected tooth is removed or erupts fully into the mouth, the condition cannot return. For advanced cases requiring hospitalization, antibiotics usually will treat the infection, after which the tooth can be removed.

Additional Info

Can Wisdom Teeth Grow Back After Extraction?

The wisdom teeth are the last molars to erupt and are located in the very back of the mouth. In about 1 to 2 percent of the population, supernumerary — or extra — wisdom teeth are present. These surprise extra teeth can erupt after the original teeth are extracted. Can wisdom teeth grow back? Not really, but some people have more than just the standard four.

What Are Wisdom Teeth?

Wisdom teeth are the last or often referred to as third molars. They usually erupt in a person’s late teens or early twenties. Because this period coincides with the beginning of adulthood are referred to as wisdom teeth.

Scientists and dentists aren’t sure why we have wisdom teeth. Because they’re usually extracted, the teeth seem like an unnecessary evil. However, according to the Smithsonian Institution, at some point in our evolutionary past, wisdom teeth might have been important to our survival. Humans once ate exceedingly tough, difficult-to-chew food and continue to be prone to tooth decay and gum problems. This susceptibility was especially true for our ancestors, who had yet to learn the importance of oral hygiene. It’s likely that many early humans lost several molars due to decay or injury before they reached their late teens. The wisdom teeth could easily move into the empty spaces and allow our distant ancestors to continue to chew their food.

In those days, the third molars could be lifesavers. Today they’re considered a vestigial organ, made obsolete by evolution.

What If I Have More than Four Wisdom Teeth?

Whereas most people have four wisdom teeth, some people actually have more or even fewer. If you have more than the typical four, your dentist will probably see these teeth on digital X-rays. The chances that you’ll have extra wisdom teeth are fairly slim. About one or two people in every 100 will face this dilemma. Supernumerary teeth can occur elsewhere in the mouth, too. It’s possible to have extra incisors, canines and other duplicate molars.

Why Are Most Wisdom Teeth Pulled?

By the time the third molars arrive, there is typically no longer enough room in the jaw to accommodate them. Many wisdom teeth try to move into position but can’t because other teeth are in the way. It’s also common for wisdom teeth to be aligned horizontally in the jaw or to be otherwise misplaced. In this type of situation, they can’t emerge from the jawbone, and they become impacted.

If you have an impacted wisdom tooth, it’s important to see your dentist as soon as possible. Symptoms of impaction include the following:

  • Stiffness or pain in the jaw.
  • Swelling, inflammation and infection of gum tissue.
  • A partially erupted tooth that is painful or sensitive.

If the tooth coming in is irritating parts of your mouth or causing other teeth to move out of position, this is a sign that you should have it removed. Some dentists recommend removal long before the tooth begins to erupt. This decision is based on X-rays that show where and how the wisdom tooth is positioned.

Can wisdom teeth grow back, then? Although the condition is rare, it is possible to have more than the usual four wisdom teeth. If you do have extra third molars, you’ll probably require additional extractions after the first set has been removed.

Soreness Near Wisdom Tooth Years After Removal

Q1. I had my wisdom teeth removed two years ago and unfortunately experienced dry sockets. Since then, the area where one wisdom tooth was removed becomes swollen from time to time. When this happens, the area under my chin feels very sore to the touch, although the feeling usually goes away in a day or two. What could this be?

— Lisa, Florida

It’s rare to experience problems from a wisdom tooth extraction much later on. The most common problem that occurs after such an extraction has healed is that a little piece of the root of the tooth that was inadvertently left behind starts working its way out of the bone and soft tissue. It feels very similar to a baby tooth growing in. Alternatively, a small piece of bone might break off during an extraction — without blood supply, it becomes a foreign object that works its way through the tissue. But either of these complications would normally occur in the aftermath of the extraction rather than two years later.

You need to seek the advice of a dental professional, preferably a periodontist or oral surgeon, who does this kind of work, and have him or her take an X-ray, either a CT scan or Panorex. The image should be not only of your teeth but also your jawbone. This will allow you to rule out any kind of infection, cyst, or problem at the extraction site that could account for the recurring swelling. It’s possible that there’s a problem with the tooth adjacent to the extraction socket. The tooth might have a cavity or need a root canal treatment, which would makes it feel as though it’s affecting the socket area. Teeth are very close together, and often neither the patient nor the dentist can tell exactly which tooth is causing a problem.

Q2. Is it wise to remove wisdom teeth? What are the pros and cons?

In my opinion, wisdom teeth, or third molars, that grow into your arch with normal alignment and function should be left alone because they may become useful later in life.

However, wisdom teeth can grow into the arch in a poor position, causing:

  1. Bite problems
  2. Bone loss and pockets around other teeth
  3. Infections
  4. Decay

These problems are often the result of a jaw that is too small to accommodate the wisdom teeth as they attempt to grow into the arch. If these problems do occur, then the wisdom teeth should be removed if the person is in a generally healthy state. Wisdom teeth can also be a source of bacterial infections and cysts, and can cause problems in oral hygiene. Their removal, however, must be analyzed on a case-by-case basis.

A dentist who believes that all wisdom teeth should be removed is either not knowledgeable or misinformed, or has a personal preference in the matter. One must seek a dentist with good judgment to go over the pros and cons of extraction and determine whether your overall general and dental health warrants the removal of these teeth.

If a wisdom tooth is causing a problem for other teeth — whether your bite is involved or just the tooth adjacent to the wisdom tooth — and constant infections occur, then it is advisable to remove the wisdom tooth. It is also important to analyze the anatomy of the roots of the wisdom teeth to see if they are near a nerve that runs to the lower jaw. If the nerve is wrapped around the bottom of the roots, removal might cause long-term numbness. All of these factors must be taken into consideration in determining whether removal of the wisdom teeth is the best course of action.

Q3. My dentist recommends that my 17-year-old daughter have all of her wisdom teeth removed. She is not having any problems. Is this necessary?

– Donna, North Carolina

Third molars (“wisdom teeth”) normally erupt around 18 years of age, but the eruption can range from 17 years to 21 years of age. Dentists have different philosophies regarding removal of third molars based on their experience in practice and the type of dentist they are, e.g. oral surgeon, general dentist, periodontist, orthodontist, etc.

I am a periodontist and for the most part, I favor saving teeth, even third molars. If there is pathology, decay, poor eruption pattern leading to bone loss, a cyst, or chronic infection, then I would agree there is a reason to extract third molars. Of course, there are some exceptions to all guidelines, so each situation must be handled individually.

Third molars that are preserved can help keep a patient’s bite or vertical dimension of their face intact. They can act as a back abutment tooth for a permanent fixed bridge in places that implants sometimes can’t be placed. And they are perfectly fine teeth to chew with as long as they erupt in proper alignment.

Premature extraction of third molars can be an option, but I would want to know what the justification is before I would agree with that plan of action. One can always seek a second opinion from another dentist if unsure. As a general rule, I would not perform pre-emptive extractions of third molars except on an individual basis. In other words, I would not do this to my patients or my children unless there was a clear indication for it.

Learn more in the Everyday Health Dental Health Center.

Once you’ve moved into your late teen years, you may think the teeth you see are the only teeth you’ll ever get. But there’s a strong possibility that isn’t true.

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Your wisdom teeth can still break through, or erupt, even in early adulthood.

Knowing more about your wisdom teeth and how they behave can make it easier to deal with problems that arise and the need for extraction, says oral surgeon Michael Horan, MD, DDS, PhD. Here, he answers common questions his patients ask about wisdom teeth:

Q: Does everyone have wisdom teeth?

A: No, not everyone is born with a full complement of teeth. In fact, the wisdom teeth are the most common congenitally missing teeth, Dr. Horan says.

Q: How do you know when there’s a problem with your wisdom teeth?

A: Pain in the upper or lower jaw can often be the first sign that your wisdom teeth are causing problems. You may feel a sensation of pressure in the back of your mouth. Also, the gum tissue around the erupting wisdom tooth often becomes sensitive, swollen and inflamed.

However, you may also feel no pain at all. But absence of pain doesn’t necessarily mean there isn’t a problem. “A lot of folks don’t have any symptoms,” says Dr. Horan. “That’s why you should have your wisdom teeth examined by a dentist to determine if extraction is appropriate.”

Q: Is removal always necessary?

A: If your wisdom teeth are impacted, thereby preventing adequate oral hygiene, it’s often best to have them removed.

Teeth that erupt in an upright and functional position often don’t need to be removed, Dr. Horan says, as long as they cause no pain and aren’t associated with decay or gum disease.

However, even wisdom teeth that come in correctly can develop problems over time because they are so far back in the mouth and difficult to clean. So if you keep your wisdom teeth, be sure to brush and floss them well, and see your dentist regularly.

Q: What happens when a wisdom tooth is impacted?

A: It’s common for people to have impacted wisdom teeth. These teeth are buried, either partially or completely, in the soft tissue or jaw bone, and are more susceptible to disease and other problems.

The problem is you can’t clean impacted wisdom teeth properly, so they can start to decay, and you can develop gum disease. Although less common, cysts or tumors can also develop around impacted teeth, says Dr. Horan.

Dentists generally evaluate impacted teeth on a case-by-case basis to determine whether to remove them, he adds. If a tooth is fully impacted in bone and X-rays show that eruption is unlikely, your dentist will often recommend removal to prevent future problems.

Q: What problems can occur after removal?

A: Mild to moderate pain is normal and expected after an extraction, but a few other complications are also possible. Here’s a rundown of what you can expect and how your doctor would likely treat each possibility:

  • Pain. Some pain and swelling is likely to occur with all extractions, says Dr. Horan. In most cases, non-steroidal anti-inflammatories paired with a limited dose of narcotic medications can help control most pain. Ice is recommended for the first 24 hours to minimize swelling.
  • Dry socket. Though rare, this is one of the most common true complication following surgery. It typically occurs four to seven days after a tooth is extracted when the blood clot needed for healing dissolves too soon. Your dentist likely will treat it with an oral antiseptic solution or a specialized dressing depending on the severity of pain.
  • Subperiosteal abscess. This is a pus pocket that develops when bone and tissue debris are trapped between the healing extraction socket and the tissue covering the bone. Your dentist can drain the abscess and provide you with antibiotics to help clear up any infection.
  • Bacterial infections. Postoperative bacterial infections are rare, occurring in fewer than 6 percent of all cases, says Dr. Horan. Your dentist may give you a dose of antibiotics before surgery to sidestep problems with infection. After surgery, antiseptic mouth rinses or additional antibiotic regimens are sometimes needed.

Q: Is there any way to avoid problems with your wisdom teeth?

A: Ultimately, you have little control over your wisdom teeth. “Other than keeping up with oral hygiene and going to the dentist on a regular basis, there’s not much patients can or need to do,” says Dr. Horan.

Dry socket: A common—and painful—complication of wisdom teeth surgery

Having wisdom teeth surgery can be a real pain, but if your healing regimen goes awry, you can find yourself in a world of hurt. An expert from the Texas A&M College of Dentistry explains this uncomfortable complication and how to avoid it.

What is dry socket?

When a tooth is extracted, a blood clot forms and fills the extraction site to help protect the area as it heals. However, once in a while, if you’re not careful, that blood clot can be displaced, which leaves the bone and nerve high and dry.

“The blood clot is there to protect the wound,” said Michael Ellis, DDM, clinical associate professor with the Texas A&M College of Dentistry. “If the clot is broken down prematurely, then the bone is exposed and the area becomes a ‘dry socket.’”

The blood clot has its own “life cycle,” which can last for about a day or two. It forms naturally, then the body breaks it down once the socket starts filling with soft tissue to help the healing process.

“We typically see dry socket after the removal of lower impacted third molars, or wisdom teeth,” Ellis said. “The pain can last anywhere from a few days to a week.”

Symptoms and treatment

There are not many symptoms of dry socket, but there is one that stands out above the rest, and that’s pain.

“When someone has a dry socket, the first thing they’ll notice is a moderate to severe amount of pain,” Ellis said. “The exposed bone is sensitive, and that is the source of pain, which can be dull or throbbing and even radiate up to the patient’s ear.”

A dry socket can also have a foul odor, and this can lead to the patient experiencing a bad taste in the mouth.

While many people may think that their dry socket is infected or that having one increases the chances of infection, that may not be the case. “There’s not a lot of swelling or fever with a dry socket,” Ellis said. “An infection can happen, but it’d be unrelated to the dry socket.”

The treatment for dry socket is pretty straightforward, and is almost the same as cleaning out any other painful wound. “You want to clean the wound, irrigate it with saline and then dress the wound with medicated gauze,” Ellis said. “Treating the wound doesn’t speed up the healing process: It just deals with the amount of discomfort that the patient is in—whether you treat it or not, it will get better.”

Risk factors and how to prevent a dry socket

After surgery, a surgeon will provide directions to help decrease the odds of developing dry socket. Some of the instructions include avoiding carbonated or warm beverages, keeping the mouth relaxed and avoid messing with the area. Also avoid using a straw, as the suction can dislodge the blood clot.

Clots break down naturally, but some people may have factors that causes them to break down prematurely, a condition called secondary fibrinolysis. This process can be induced by medication, stress or an underlying medical condition.

People who smoke can also see an increase risk of dry socket, especially if they smoke within three to five days after surgery. Women who take birth control also see a slight increase in risk for dry socket.

If you begin to notice an unpleasant discharge, severe pain or fever, call your surgeon right away. Also, if your swelling gets worse instead of better, or if your bleeding doesn’t subside with pressure, contact your health care provider. Complications after surgery are rare, but they are real.

— Dominic Hernandez

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