Wisdom tooth pain: what helps tonight, and when removal is needed

Why does a wisdom tooth hurt like this?

Wisdom teeth arrive last, usually between 17 and 25, and often there's no room left for them. A tooth that's only partly through leaves a flap of gum over it where food and germs collect. The gum gets inflamed and swollen, that's the deep ache at the back that gets worse at night, when you chew, or when the tooth opposite bites down on the swollen gum.

It typically flares for a few days, settles, and comes back weeks later. The pattern repeats because the cause, the trapped tooth, hasn't gone anywhere.

What you can do right now, at home

• Warm salt-water rinse. Half a teaspoon of salt in a glass of warm (not hot) water. Swish gently around the sore area for 30 seconds, several times a day and after eating. It genuinely helps flush the gum flap and calm inflammation, this is the single most useful thing you can do tonight.
• Cold compress on the cheek. Ice wrapped in a cloth, 15 minutes on, 15 minutes off, against the outside of the cheek. Numbs the ache and reduces swelling.
• A painkiller, as advised by a pharmacist or doctor. An over-the-counter painkiller taken as directed on the pack can take the edge off for the night. If you have stomach, kidney, liver or heart conditions, or you're pregnant, check with a pharmacist or doctor before taking anything.
• Soft food, other side. Chew away from the sore side and keep the area as clean as you can with gentle brushing.

What NOT to do

• Don't place an aspirin (or any tablet) on the gum. It doesn't work that way, it burns the gum tissue and adds a chemical burn to your problems.
• Don't use a hot compress or hot water bottle on the cheek. Heat on the outside of the face can draw an infection outward and make swelling worse. Warm rinses inside the mouth: yes. Heat on the face: no.
• Don't start leftover antibiotics on your own. The wrong drug at the wrong dose helps the germs more than it helps you.
• Don't keep poking the area with your tongue, a toothpick or a pin. It's tempting. It makes things worse.

Signs it's more serious, come in or call

Home care buys you comfort; it doesn't fix the cause. And a few signs mean the infection is spreading and you should not wait it out:

• 🌡️ Fever alongside the tooth pain
• 😶 Swelling that is spreading, into the cheek, jawline or towards the neck or eye
• 🔒 You can't open your mouth properly (it feels locked or opens only a finger's width)
• 🟡 Pus or a foul taste coming from the area
• 😮‍💨 Any difficulty swallowing or breathing, this one is an emergency, go to a hospital or see our emergency page now

If any of these apply, contact us the same day, an infection near the jaw can spread quickly, and treating it early is far simpler.

What the clinic will do

First, an examination and an X-ray, that shows exactly how the tooth is sitting and whether it can come through properly or is stuck. Then one of three honest answers:

1. Settle the infection first. If the gum is acutely infected, we clean the area and may prescribe medication, removal, if needed, is calmer and more comfortable once the flare-up is down.
2. Remove the tooth. If the X-ray shows it will keep causing trouble, removal takes the problem out at the source. It's a 30-60 minute procedure under local anesthesia, here's exactly what that involves, including honest recovery answers.
3. Leave it alone. If the tooth is positioned fine and this was a one-off gum irritation, we'll tell you that too. Not every wisdom tooth needs removal.

Quick questions

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