Quick answer
Wisdom tooth pain usually means the tooth is erupting, impacted against its neighbour, or the gum flap over a partly erupted tooth has become infected (pericoronitis). At home: rinse frequently with warm salty water, clean the area gently but thoroughly, and take paracetamol or ibuprofen as directed. Pericoronitis often flares and settles, but recurring flare-ups are the classic reason wisdom teeth come out. Swelling of the face or jaw, difficulty opening or swallowing, or fever mean spreading infection: same-day dental care, or an emergency department if breathing or swallowing is affected.
Why wisdom teeth hurt
- Normal eruption. The last teeth arrive into a crowded room, and some pressure and tenderness while they push through can be normal in the late teens and twenties.
- Impaction. When there's no room, the tooth wedges against its neighbour and pushes. The ache radiates along the jaw and can flare with chewing.
- Pericoronitis. The most common emergency version: a flap of gum over a partly erupted tooth traps food and bacteria, then swells. It hurts to bite because the opposing tooth lands on the swollen flap.
- Decay. Half-erupted wisdom teeth are nearly impossible to clean properly, so they decay quietly, and sometimes take a bite of the tooth in front too.
Getting through the next 48 hours
- Warm salt-water rinses several times a day, swished firmly around the back
- Clean the area anyway, gently; leaving it undisturbed makes the infection happier, not you
- Paracetamol or ibuprofen as directed on the packet
- Soft foods, chewing on the other side
- Cold compress outside the jaw for ten minutes at a time if it's swollen
Flare-ups lie when they settle
Pericoronitis characteristically calms down after a few rough days, which persuades people the problem has passed. The anatomy that caused it (a gum flap over a half-erupted tooth) is still there, and the next flare is usually closer than the last. One episode can be bad luck; recurring episodes are how the removal decision usually makes itself.
What happens when you come in
An examination and an X-ray show how the tooth sits and what it's doing to the neighbourhood. Infection gets settled first: professional cleaning under the flap, sometimes antibiotics if it's spreading. Then an honest conversation about the tooth's future, with written costs; the removal cost guide explains how those numbers are built. Wisdom teeth that are through, cleanable and behaving get left alone; we'll tell you which kind you have.