I’m having pain. How do I know if it’s wisdom teeth?

Image of wisdom tooth with inflamed gum tissue or pericoronitis

Wisdom tooth with inflamed gum tissue or pericoronitis
courtesy of http://en.wikipedia.org/wiki/File:48_clinical_pericornitis.jpg



Wisdom tooth pain comes in several different forms. It can feel like swollen gums. It can be painful when you bite your teeth together because it feels like you’re pinching your gums. Or can be a deep throbbing pain that comes and goes. It could also be painful to move your jaw side to side.  I have included some common symptoms here and the reasons why they might be occurring. But only your dentist can verify this and tell you for sure.

When a wisdom tooth starts to come in it will often cause some gum soreness which is very similar to what a baby or young child would experience when they’re cutting a tooth or teething.  This is the most common complaint heard from my patients.

If the wisdom tooth erupting or coming in is a lower wisdom tooth, the gum tissue often puffs up around and just behind the last tooth in the mouth which is at this age usually a 12 year molar. And with normal chewing activity over a period of several weeks the gum tissue will start to recede and a little bit of the wisdom tooth will be visible. Now the gums around the wisdom tooth are little bit vulnerable. Is the time when food can begin to get stuck between the gums and a tooth very easily.

If some food or debris gets stuck between the wisdom tooth and the surrounding gums at this time you will get swelling. If this happens a solution in most cases is chasing out the food debris.

Graphioc image of wisdom tooth with ideal alignment for eruption

Wisdom Tooth With Ideal Alignment For Eruption Courtesy of Craig Sommer DDS www.springsdentist.com

This is where the orientation of the wisdom tooth makes a big difference.  If it is coming in parallel to the 12 year molar it will usually be the easiest to manage.  After a few weeks of sore gums the wisdom tooth begins to be more and more visible and requires fewer and fewer efforts to remove food from the surrounding gum crevice.  Your dentist may be able to scoop out trapped food with some of the instruments that he has in his office, or he may suggest that a dental laser be used to remove some of the swollen gum tissue and expose the wisdom tooth even sooner than would normally occur to make the eruption easier for you.

The swollen gums around the tooth can become quite irritated and may be labeled a pericoronitis condition (from Greek- peri, around; from Latin-corona, crown; from Latin-itis, inflammation). The remove of the inflamed gum tissue would be called a pericoronectomy (from new Latin-ectomy, cut out).

Graphic image-Mesial Impaction Wisdom Tooth Blocked From Eruption

Mesial Impaction Wisdom Tooth Blocked From Eruption
Courtesy of Craig Sommer DDS www.springsdentist.com

But if the wisdom tooth is tilted toward the 12 year molar and blocked from completely erupting, you will need assistance eventually.  This is the impacted or stuck wisdom tooth with no clear path to erupt into the correct position.  In this situation there is a tendency for the gum tissue to never fully pull back from the top of the wisdom tooth. And as a result you are going to continue to have pain with food getting stuck between the gums around the wisdom tooth and a wisdom tooth itself. You may elect to wait for a while, but there is some risk involved in doing so.

In this instance, food getting stuck between the gum tissue and the wisdom tooth may happen several times over the course of several months. If you’re unfortunate enough to not able to remove the food debris, and you develop swelling, you’ll have to seek professional attention. Deep decay or cavities can form when this condition persists. This condition usually doesn’t resolve by itself and usually forces you to seek care from a dentist to help you with wisdom tooth removal.

If you are not experiencing swelling, you may find comfort rinsing with salt water (1 tsp. table salt in 12oz. of warm water).  Some of my patients have also received relief using an oral irrigating appliance such as the ViaJet Pro or WaterFlosser brand products.  They require a bit of coordination and care in their use, but at low pressure settings, they can be ideal for removing trapped food debris and improving comfort until you see your dentist. Use warm water for comfort. And start off with a very low-pressure setting. If you don’t own an irrigator and choose not to purchase one, your dentist may be able to provide you with a little curved plastic syringe with a plastic tip called a Monoject 412 syringe. Using that, you can manually squirt water back where you are getting food trapped. Your dentist will undoubtedly be able to tell you whether or not it’s worth the effort and if your wisdom tooth will ever come in if you wait sufficient time.

Image of Deep Horizontal Impaction Wisdom Tooth Blocked From Eruption

Deep Horizontal Impaction Wisdom Tooth Blocked From Eruption
Courtesy of Craig Sommer DDS www.springsdentist.com

Another common situation is where the wisdom tooth is impacted or is tilted towards the 12 year molar, but is deep below the surface of the gum tissue and will never result in gum tissue swelling. In this case a deep throbbing pain that hurts for several days and then may disappear for several weeks before returning again, is commonly reported by my patients. Here it is more difficult to tell whether or not the pain is being caused by a wisdom tooth. In the previous two cases you could generally look in your mouth and see swelling or feel it with your tongue or finger. But in this case the pain is deeper, stronger and more difficult to sort out without seeing your dentist. So as a general rule if you have any suspicion of infection or pain, it is generally better to err on the side of safety and see your dentist to evaluate your situation.

There are many different possibilities for mouth or facial pain.  It could be the result of cavities, a broken tooth, a gum abscess, a tooth abscess, TMJ or temporo-mandibular joint dysfunction pain  or other causes. So it’s essential that if you’re having pain that lasts more than a few days you should really check with your dentist to make sure it’s not something serious.

Look for more articles on wisdom teeth in the series: Questions You Must Ask Your Dentist Before Having Your Wisdom Teeth Removed.