In this article:
- Typically, people have four wisdom teeth, one in each corner of the mouth. However, not everyone develops them.
- Wisdom teeth usually erupt between the ages of 18 and 25 years. And due to evolution, the jaws may not develop to be large enough for them to erupt completely.
- Due to inadequate space, wisdom teeth may erupt partially (partially impacted wisdom teeth) or may not erupt at all (fully impacted wisdom teeth).
- Partially impacted wisdom teeth are the most challenging. In most cases, removing partially impacted wisdom teeth and erupted wisdom teeth are more beneficial for patients than retaining them.
- Impacted wisdom teeth can cause problems and may need to be removed.
Wisdom teeth, or the third molars, are the hind teeth that grow on the ends of the lower and upper jaws. These teeth, one each at the rear end of the four mouth quadrants, grow at 18-20 years of age or even later. (1)
The third set of molars is an evolutionary response to the rough diet consumed by our ancestors. Their diet included nuts, meats, roots, leaves, and reed plants. Consuming such coarse foods led to excessive wearing of teeth, causing them to fall off, and wisdom teeth acted as substitutes.
However, since the modern diet consists of softer foods, jaws do not develop to have adequate space for wisdom teeth to erupt. Additionally, the use of culinary tools and oral hygiene practices prevents the weakening of teeth. Consequentially, wisdom teeth are not needed and are now considered to be vestigial organs.
Wisdom teeth have been rightly named so, as they appear at a mature age. However, due to their late growth, they often face a lack of space. As a result, wisdom teeth may emerge partially through the gum or may be misaligned.
In some cases, the wisdom teeth may not emerge altogether. Nevertheless, they can still induce problems by growing into the molars, causing damage.
Wisdom teeth that fail to grow correctly are called “impacted.” These teeth may be partially or fully impacted.
Partially impacted wisdom teeth may cause decay, gum infections, and food lodgement. Fully impacted wisdom teeth may cause resorption of adjacent teeth and nerve damage.
Causes of Wisdom Tooth Pain
Wisdom teeth that grow in the correct alignment do not usually cause any pain. Impacted teeth, however, can lead to pain and infection in some cases.
The common causes of wisdom tooth pain include:
- The tooth grows partially through the gums:
- A flap of gum tissue may develop over the tooth, wherein food particles get trapped easily. This acts as a breeding ground for cavity-causing bacteria, which eventually enter the gum tissue and lead to an infection known as pericoronitis. (1)
- It may erupt at a tilted angle, causing damage to the jawbone, nerves, or adjoining teeth.
- It may be crooked or grow in the wrong direction, causing cheek biting in some cases. This is more common when the upper wisdom teeth erupt outward toward the cheek
- The tooth does not break through the gums: (2)
- It can cause pain along with swelling and inflammation in the gums.
- It may push the adjoining teeth, thus building up the strain.
- The wisdom teeth may be awkwardly positioned, making it difficult to brush around them and the adjacent molars, leading to poor oral hygiene.
- A wisdom tooth trapped between the gum and jaw can result in cyst formation. These fluid-filled pockets often result in permanent damage to other teeth and the jaw.
Signs Your Wisdom Tooth is Surfacing
The following symptoms indicate a growing wisdom tooth:
- Pain at the back of the mouth, near the second molars
- Painful gums or jaw
- Swelling and redness in the gums
- Stiffness in the jaw
- Hard bump in the gum
- Bad breath
- Difficulty in chewing and biting
- Sinus pain, congestion, or pressure in the upper jaw
- Tip of the tooth visibly emerging from the gums
The dentist will examine your symptoms and take a look at your mouth and jaw. This is followed by an X-ray of the teeth called panorex (which is a full-mouth X-ray) to examine their position. Such procedures help in predicting whether the wisdom teeth will come out normally or may cause problems.
Impacted teeth can cause infection, fever, sore lymph glands, and pus oozing out the gum line. The infection may be treated with extractions. Wisdom teeth may be extracted by an oral surgeon or general dentist
Medical Treatment for Painful Wisdom Tooth
It is recommended to visit a dentist if you experience any pain or other symptoms associated with impacted wisdom teeth.
Keep in mind that infections caused by wisdom tooth problems can lead to severe complications in people with low immunity or other health problems.
Generally, the doctor will suggest wisdom tooth extraction to remove the source of pain and prevent other complications. However, in the case of infection, the doctor may prescribe painkillers and antibiotics as the first line of treatment before operating.
You may also get your wisdom teeth removed before any symptoms appear, as they can cause problems with time, making it more challenging to extract them.
As the wisdom tooth grows, its roots may become longer and press on the sensory nerves of the sinus area of the upper jaw or lower jaw. Therefore, it is recommended to get your teeth checked when you reach 16-19 years of age, as some experts recommend extraction before you are 20 to prevent complications.
The benefits of extracting wisdom teeth versus the risk of postoperative complications are evaluated by your dentist to make a decision.
Post Surgical Care
The postoperative period is as essential as the surgery. Take the following measures to prevent infection, pain, and swelling:
- Apply a cold compress externally for 20 minutes on and 20 minutes off to aid in clot formation and to reduce inflammation and swelling.
- Consume easy-to-chew soft foods for a few days.
- Abstain from smoking cigarettes for at least 1-week post-extraction to avoid a dry socket. The most common reason for a dry socket is smoking.
- Avoid consumption of alcohol.
- Do not perform strenuous activities for some days.
- Refrain from having hot drinks for 24 hours after extraction as this may increase bleeding from the extraction site.
- Refrain from touching the extraction socket with your tongue or finger as this will dislodge the clot.
- The day after surgery, mildly rinse your mouth with saltwater after meals to help remove stuck food particles.
- Ask your doctor to prescribe a pain-reliving medication in case you experience unbearable pain.
- Maintain appropriate oral hygiene to prevent delayed healing.
Tips to Help Relieve Pain
The following measures can help control the pain and inflammation after surgery:
1. Cold therapy
Putting an ice pack on your cheek for 15-20 minutes can help reduce postoperative swelling, inflammation, and discomfort.
Mix 1 cup of water with 1 tsp salt, and use this solution to rinse your mouth gently. Use cold water for the first 24 hours after surgery and warm water thereafter. (3)
3. OTC medications
Taking paracetamols and analgesics, such as naproxen or ibuprofen, can help relieve the pain. Refrain from using aspirin if you are under the age of 20 years.
While ibuprofen is preferred for wisdom teeth pain due to its anti-inflammatory properties, both paracetamol and ibuprofen can be effective. They can be taken together if required. It is essential to follow your doctor’s instructions for proper use.
4. Home remedies
The following home remedies are believed to help ease the pain associated with wisdom tooth:
- Clove: It has analgesic and anesthetic properties that can provide relief from wisdom tooth pain and other toothaches as well. Additionally, it carries antibacterial and antiseptic properties that help prevent infection. For this purpose, both the oil and buds can be used. (4)
- Garlic: It possesses many medicinal properties, including anti-inflammatory, antibiotic, and antioxidant properties, which can help reduce wisdom tooth pain. Garlic can also aid in the delay or prevention of bacterial infections. (5)
- Turmeric: It has been used as an Ayurvedic medicine against toothache for long. It acts as an anti-inflammatory and antibacterial agent that aids in preventing tooth decay from bacterial infection and improves gum health. Turmeric can be used as a mouthwash and a sealant for pit and fissure. (6)
It is vital to note that the use and efficacy of these home remedies still need to be determined with further extensive studies. You may consult your doctor before trying any of these remedies.
Note: Needless to say, avoid the use of these remedies if you are allergic to any of these substances.
Preventing Wisdom Tooth Problems
Taking good care of emerging wisdom teeth can help prevent infection, pain, and decay. Follow these tips to avoid any wisdom tooth problems:
- Floss your teeth properly, especially between the wisdom teeth and teeth adjacent to them.
- Make sure to brush your wisdom teeth at the back of your mouth.
- Follow a proper oral health care regimen.
Potential Side Effects of Wisdom Tooth Extraction
Wisdom tooth extraction may cause:
- Nerve and blood vessel damage, leading to numbness in the tongue or face and bleeding
- Swelling around the mouth
- Trouble in opening the mouth for a few hours or days after surgery
- Infection in the wound, characterized by pain returning in 4-5 days, along with bad breath and swelling
- Dry socket
- Delayed healing
When Does the Pain Subside?
The duration of pain associated with wisdom tooth eruption varies among people.
For some, the pain may manifest even before there are physical signs of the eruption of the tooth. Others may experience sensitivity and soreness when the crown starts to appear.
The pain will last until the tooth grows and breaks through the gum completely, which may take several weeks or months. However, if the tooth is impacted or misaligned, it may continue to hurt.
When to Visit the Dentist
Consult your dentist if you experience any of the following symptoms:
- Oral infection
- Inflammation in the gumline at the back of the mouth
- Swollen face
What you may ask your doctor before surgery:
- How many of my wisdom teeth need to be extracted?
- What type of anesthesia will you put me under?
- How long is the operation?
- Is the procedure going to be complicated?
What your doctor may ask you before surgery:
- How old are you?
- Since when did you experience pain?
- What other symptoms are you experiencing?
- Have you undergone any oral surgery in the past?
Wisdom teeth are the last molars that help grind your food. While these are the widest and toughest teeth, not everyone develops them. Being the last teeth to come through, they often do not have enough space to grow, as a result of which they may be impacted.
Wisdom tooth impaction can affect other teeth, causing pain and increasing the chance of infection. However, proper self-care measures can help alleviate the pain. It is advised to visit your dentist, as wisdom teeth are often extracted to prevent any future complications.