Wisdom tooth pain
what's normal and when to worry
Wisdom tooth pain is one of the most common reasons people book an urgent dental appointment. It can start as a dull ache at the very back of your mouth. It can also arrive suddenly, with a swollen gum, a bad taste and a jaw that will not open properly.
The tricky part is knowing which of those is a normal grumble and which needs a dentist soon. This guide helps you tell the difference. It covers the usual causes, what you can safely do at home, and the signs that mean you should not wait.
Why wisdom teeth cause pain
Wisdom teeth are the last teeth to arrive. They usually start coming through between the late teens and early twenties. But problems can begin at any age, and some people never get any.
The main issue is space. By the time wisdom teeth arrive, the rest of your teeth are already in place. A wisdom tooth may come through at an angle, only partly emerge, or stay trapped under the gum. The NHS explains that wisdom teeth are hard to clean, which makes them prone to infection, decay and gum problems.
The most common causes of wisdom tooth pain are:
- Pericoronitis. This is an infection of the gum flap that sits over a partly erupted tooth. Food and bacteria get trapped underneath. It is the most frequent reason wisdom teeth cause trouble. Guy’s and St Thomas’ reports that up to six in ten people with wisdom tooth problems have it.
- An impacted tooth. The tooth is stuck against the tooth in front or buried in the gum or bone. It can press on neighbouring teeth and cause a deep, dull ache.
- Decay. Wisdom teeth are hard to brush, so cavities form easily. They can also form in the tooth next to them.
- Gum disease. Plaque builds up around the back teeth and the gum becomes inflamed and sore.
- Food trapping. A small gap between the wisdom tooth and its neighbour collects food and causes repeated irritation.
Less often, a fluid-filled sac called a cyst forms around an impacted tooth. This is rare, but it is one reason we like to take an X-ray rather than guess.
What normal wisdom tooth pain feels like
Not every twinge means trouble. Mild discomfort can happen while a tooth is moving through the gum. It usually looks like this:
- A dull ache at the back of the jaw
- Tenderness that comes and goes over a few days
- Slight gum soreness, with no swelling you can see in your face
- Pain that eases with simple painkillers and a salt water rinse
If this is you, keep the area very clean and watch it. Mention it at your next check-up, so we can look at the tooth and take an X-ray if needed.
How to tell what needs attention
This table is a rough guide. It does not replace an examination, but it shows how we think about wisdom tooth pain in practice.
|
What you notice |
What it may mean |
What to do |
|---|---|---|
|
Dull ache that comes and goes, no swelling |
Tooth moving through the gum |
Keep clean, mention it at your next check-up |
|
Sore, red gum over the tooth, bad taste |
Early pericoronitis |
Book an appointment within a few days |
|
Pain when biting, swelling that returns |
Recurrent infection or decay |
Book soon, as it will not settle on its own |
|
Trouble opening your mouth, swollen cheek |
Active infection |
Same-day dental appointment |
|
Swelling spreading to the face or neck, fever |
Infection spreading |
Urgent care today |
|
Trouble swallowing or breathing |
Serious infection |
Call 999 or go to A&E |
Trouble swallowing or breathing is rare, but it is an emergency. Do not wait for a dental appointment if you have either.
What you can do at home
Home care will not cure the cause. It can make you more comfortable while you arrange an appointment.
Rinse with warm salt water. Dissolve half a teaspoon of salt in a glass of warm water. Swish gently, especially around the back tooth, then spit it out. Do this a few times a day, particularly after meals. It helps flush out trapped food and soothes the gum.
Use simple painkillers properly. Paracetamol or ibuprofen can take the edge off, if they are safe for you. Follow the instructions on the packet. Ibuprofen is not suitable for everyone, so check with a pharmacist if you have asthma, stomach problems or other health conditions.
Try a cold compress. Hold a cold pack wrapped in a cloth against your cheek for 10 minutes at a time. It can reduce swelling and numb the area.
Clean carefully. Keep brushing, but be gentle around the sore area. A small-headed toothbrush reaches the back of the mouth more easily. Floss or an interdental brush helps with food trapped between the teeth.
Avoid chewing on that side. Stick to softer foods for a day or two.
Do not place aspirin directly on the gum, which can burn the tissue. Avoid poking at the gum flap with sharp objects. And do not rely on home remedies for more than a couple of days. If the pain is getting worse, the cause needs treating.
How long does wisdom tooth pain last?
It depends on the cause. Discomfort from a tooth erupting tends to come in short waves and settles within a few days. An infection of the gum flap can flare for several days, ease off, then return. That pattern is a clue. When wisdom tooth pain keeps coming back, the underlying problem is still there.
Painkillers and rinses may get you through a flare-up. They do not stop the next one. That is why repeated episodes are the point at which we usually talk about whether the tooth should come out.
What we do at the practice
When you come in with wisdom tooth pain, we start by finding out what is causing it. We examine the area, check the gum and look at how the tooth sits. We usually take an X-ray, because most of a wisdom tooth is hidden below the gum.
From there, treatment depends on what we find:
- Cleaning and flushing under the gum flap to remove trapped debris and ease infection
- Medication such as antibiotics, only when there are signs of spreading infection, and alongside treating the cause
- A filling, if the tooth is decayed and can be restored
- Extraction, if the tooth is causing repeated problems or cannot be saved
Dentists in the UK follow national guidance on wisdom teeth. Healthy wisdom teeth with no symptoms are generally left alone. Removal is usually recommended for repeated infections, decay that cannot be repaired, or damage to the neighbouring tooth. So we will not suggest taking a tooth out just because it exists. We explain why we recommend what we do, and you can ask questions at every step.
What wisdom tooth removal involves
If extraction is the right answer, you will know what to expect. Our tooth extraction page covers the detail. In short:
- The area is numbed with local anaesthetic, so you feel pressure but not pain
- Sedation is available for patients who are anxious about treatment
- Some teeth come out in minutes. Others need to be sectioned, which takes longer
- You go home with clear aftercare instructions
Afterwards, expect some swelling, tenderness and stiffness for a few days. The NHS lists dry socket, infection and temporary numbness as possible complications. Dry socket happens when the blood clot in the socket is lost early. It causes a severe, throbbing pain a few days after the extraction. If that happens, call us. It is easy to treat once we see you.
When it is an emergency
Some wisdom tooth problems cannot wait for a routine slot. Call us the same day if you have:
- Swelling in your face or jaw
- Severe pain that painkillers do not touch
- A fever alongside tooth pain
- A very limited ability to open your mouth
- Pain that is stopping you sleeping or eating
We offer emergency dentist appointments from just £30, seven days a week. You can also book an emergency consultation online in a couple of minutes. If you have difficulty swallowing or breathing, go straight to A&E or call 999.
Keeping an eye on wisdom teeth before they cause trouble
Many wisdom tooth problems build up quietly. A regular dental check-up lets us watch how the teeth are coming through, spot decay early and use X-rays when they are needed.
Cleaning matters too. A dental hygienist can clean the hard-to-reach areas around partly erupted teeth. They can also show you how to brush and floss the back of your mouth. That cuts the risk of pericoronitis flaring up.
Why patients come to us
At Nottingham Dental Care, we want you to be seen quickly when you are in pain, and to understand what is going on. Our principal dentist, Dr Zeinab Attarwala, explains each option plainly and does not push treatment you do not need. We are at 473 Mansfield Road, Carrington, and you can reach us on 0115 962 3432.
Cost
The cost depends on whether you need a check and X-ray, a clean, or an extraction. A simple extraction costs less than a surgical one. We explain the price before any treatment starts. You can see our current charges on the fees page.
Medically reviewed by Dr Zeinab Attarwala, Principal Dentist at Nottingham Dental Care, GDC number 177583.
Disclaimer
The information in this article is intended for general educational guidance only and does not constitute personalised dental advice. For concerns about tartar, tooth sensitivity or gum health, please book an appointment with a qualified dental professional.
Nottingham Dental Care is a private dental practice at 473 Mansfield Rd, Carrington, Nottingham NG5 2DR, open seven days a week. We offer dental check-ups, dental hygienist appointments, emergency dental appointments from £30, Invisalign, composite bonding, porcelain veneers, teeth whitening, dental crowns and smile makeovers. Call 0115 962 3432 or book an emergency consultation directly online.
Frequently asked questions
How do I know if my wisdom tooth pain is serious?
Mild, occasional aching is common while a tooth comes through. Pain is more serious if it is constant, comes with swelling, a bad taste or trouble opening your mouth, or keeps coming back. Swelling that spreads, a fever, or trouble swallowing or breathing need urgent attention.
How long does wisdom tooth pain last?
Discomfort from a tooth erupting tends to last a few days at a time. A gum infection can flare for several days and then return. If the pain keeps recurring, the cause still needs treating.
What is the fastest way to relieve wisdom tooth pain?
Warm salt water rinses, a cold compress and suitable painkillers can ease symptoms in the short term. They do not fix the cause, so book an appointment if the pain lasts more than a day or two.
Do all wisdom teeth have to be removed?
No. Wisdom teeth that come through properly and cause no problems are usually left in. Removal is advised when a tooth causes repeated infection, decay, damage to a neighbouring tooth, or other problems.
Can a wisdom tooth infection go away on its own?
A mild flare-up may settle, but the cause is still there, so it tends to come back. An infection that spreads can become serious. If you have swelling, a fever or a limited ability to open your mouth, get it seen the same day.