Wisdom Tooth Pain: When It Needs Removal, What to Expect and How to Recover

Wisdom tooth pain usually means the tooth does not have enough room to come through, and the gum around it has become infected. Not every wisdom tooth has to come out. One that has come through fully, bites properly and can be cleaned can stay. Removal is recommended when a wisdom tooth keeps getting infected, is decayed, or is damaging the tooth in front of it. The procedure is done under local anaesthesia, takes 30 to 60 minutes per tooth, and most people are back to their normal routine within two to three days.

Key takeaways

• Wisdom teeth usually appear between the ages of 17 and 25. Many never cause trouble.
• The commonest cause of pain is infection of the gum over a partly erupted tooth.
• A healthy wisdom tooth with no symptoms does not automatically need removing. It needs watching.
• Repeated infection, decay, or damage to the neighbouring tooth are the main reasons for removal.
• Swelling peaks at about 48 hours, and most people recover within 3 to 5 days.
• Pain that gets worse one to three days after removal, instead of better, needs a visit.

Why do wisdom teeth cause pain?

Wisdom teeth are the third molars, the last teeth to come through, usually between 17 and 25. By then the jaw often has no space left for them. A tooth that cannot come through fully because it is blocked by the tooth in front, by bone or by gum is called impacted.

Impacted and partly erupted wisdom teeth cause pain in a few ways:

• Gum infection (pericoronitis). When a tooth is only partly through, a flap of gum sits over it. Food and bacteria collect underneath, and the gum becomes swollen, sore and sometimes infected. This is the commonest cause of wisdom tooth pain.
• Decay. Wisdom teeth are so far back that they are hard to clean. Decay can develop in the wisdom tooth itself, or on the back of the tooth in front of it where the two meet.
• Damage to the neighbouring tooth. A wisdom tooth that leans into the second molar traps food between them and can lead to decay or gum and bone loss around that tooth.
• Cysts. Occasionally a fluid-filled sac forms around an impacted tooth. This is uncommon and is usually found on an X-ray.

What your symptoms may mean

Difficulty swallowing or breathing, or swelling that spreads towards the eye or down the neck, is an emergency. Go to a hospital emergency department straight away.

Do all wisdom teeth need to be removed?

No. The UK's National Institute for Health and Care Excellence advises against removing impacted wisdom teeth that are free of disease, and recommends surgery only where there is evidence of a problem. A Cochrane review of the research found there is not enough evidence to show that removing symptom-free, disease-free impacted wisdom teeth is better than keeping them, and advised that teeth which are kept should be checked at regular intervals.

So a wisdom tooth that is healthy, causing no symptoms and not harming its neighbour can be left alone and reviewed at your routine check-ups.

Do wisdom teeth push the front teeth out of line?

They are often blamed for it, but the trial evidence reviewed by Cochrane did not find that removing wisdom teeth made a meaningful difference to crowding. Preventing crowding is not, on its own, a good reason to remove a healthy wisdom tooth.

When is wisdom tooth removal recommended?

• Repeated gum infection. A second or later episode of pericoronitis, or a first episode that is severe.
• Decay that cannot be repaired, or an infection of the tooth's nerve that cannot be treated.
• Damage to the tooth in front, such as decay or bone loss caused by the wisdom tooth.
• An abscess or spreading infection.
• A cyst or other change around the tooth.
• A wisdom tooth that is in the way of jaw surgery or other planned treatment.

The decision is made tooth by tooth. It is common for one wisdom tooth to need removal while the others are left in place.

What can you do for wisdom tooth pain at home?

These steps ease symptoms while you wait for your appointment. They do not treat the cause.

• Rinse with warm salt water several times a day, especially after meals.
• Keep the area clean. Brush gently around the tooth with a small, soft brush even if it is tender.
• Take an over-the-counter painkiller as directed on the pack, if it is safe for you.
• Do not place aspirin or any tablet on the gum. It burns the tissue and does not help.
• Do not take leftover antibiotics. Antibiotics are only needed in some cases, and they calm an infection without removing its cause, so it tends to return.

For pain that is severe or keeping you awake, see our guide on what to do about severe tooth pain.

How is a wisdom tooth removed?

1. X-ray assessment. A panoramic X-ray shows the position of the tooth, the shape of its roots and how close they lie to the nerve in the lower jaw. Where the roots are very close to the nerve, a 3D scan may be advised.
2. Local anaesthesia. The area is made fully numb. You will feel pressure and movement, but you should not feel pain.
3. Removal. A wisdom tooth that has come through fully is removed like any other tooth. An impacted tooth needs a small opening in the gum. Sometimes a little bone is removed and the tooth is divided into sections so it can be taken out gently. The gum is then closed with stitches. This takes 30 to 60 minutes per tooth.
4. Aftercare. You are given detailed instructions for the first few days and a follow-up appointment.

What is recovery like after wisdom tooth removal?

• The first 24 hours. Bite firmly on the gauze for as long as you are advised, usually 30 to 45 minutes. Slight oozing is normal. Do not rinse, spit forcefully or drink through a straw, because this can dislodge the blood clot that protects the socket. Hold a cold pack against the cheek for short spells, eat soft, cool food and rest with your head raised.
• Days 2 and 3. Swelling and jaw stiffness peak at about 48 hours, then begin to ease. From the day after the procedure, rinse gently with warm salt water after meals.
• Days 3 to 5. Most people are back to work and normal activities within two to three days, and recovered within three to five. Stay on soft food for three to five days, avoiding anything hot, spicy or hard.
• About a week. Stitches are removed if they are not the dissolving kind. The socket carries on filling in over the following weeks.

Throughout recovery, take your medicines exactly as prescribed, brush your other teeth as normal, and avoid strenuous exercise for the first two to three days. Do not smoke or use any tobacco for at least 72 hours, and longer if you can. Tobacco is one of the main causes of healing problems after an extraction.

What are the risks of wisdom tooth removal?

Most removals heal without any problem. The risks worth knowing about are:

• Dry socket. If the blood clot in the socket is lost, the bone underneath is left exposed. The sign is pain that gets worse one to three days after the extraction instead of better, often with a bad taste. It is more common after lower wisdom teeth and in people who smoke. It is treated by cleaning the socket and placing a soothing dressing, and it settles.
• Infection, bleeding and swelling. These are usually mild and short-lived, and are managed with the aftercare you are given.
• Altered sensation in the lip, chin or tongue. The roots of lower wisdom teeth lie near the nerve that supplies feeling to the lower lip and chin. A review of published studies found nerve injury after about 0.35% to 8.4% of lower wisdom tooth removals. Recovery is the usual outcome, and permanent change is very rare. The risk is higher with teeth lying horizontally and in patients over 24, which is one reason the X-ray assessment matters.

Your surgeon will explain which of these apply to your tooth before you decide.

When should you call your dentist after a removal?

• Bleeding that does not slow after biting on gauze for 30 to 45 minutes
• Pain that increases after the second or third day
• Swelling that is still getting bigger after three days
• Fever, or pus or a persistent bad taste from the socket
• Numbness of the lip, chin or tongue that is still present the next day

Is there a best age to have wisdom teeth removed?

When a wisdom tooth does need removing, it tends to be simpler in the late teens and twenties, because the roots are not yet fully formed. Complications and discomfort after surgery are more common in older patients. Age on its own, though, is not a reason to remove a tooth that is healthy.

How much does wisdom tooth removal cost in Indirapuram?

At White Dental Healthcare, wisdom tooth removal costs ₹3,000 to ₹10,000 per tooth. On our price list, removal of a wisdom tooth is ₹5,500, and surgical removal of an impacted wisdom tooth is ₹7,500 to ₹9,500. The cost depends on the position of the tooth and how involved the procedure is. You are told the cost after the X-ray assessment, before any treatment.

Wisdom tooth removal in Indirapuram

At White Dental Healthcare, Aditya City Centre, Vaibhav Khand, wisdom teeth are assessed and removed by Dr. Bharat, MDS Oral & Maxillofacial Surgery, who has over 16 years of experience and handles impacted and difficult wisdom teeth and surgical extractions. Cases are planned with digital imaging, so complex extractions can be managed in the clinic.

If a wisdom tooth is troubling you, book an assessment. We will take an X-ray, show you the position of the tooth, and tell you honestly whether it needs to come out or can be left and watched.

White Dental Healthcare
AF 15 & 16, 1st Floor, Next to Kotak Bank, Aditya City Centre, Vaibhav Khand, Indirapuram, Ghaziabad, UP 201010
Phone: +91-120-4113800  |  WhatsApp: +91 88827 08708
Hours: Monday to Saturday, 10:30 AM to 8:30 PM. Sunday, 11:00 AM to 7:30 PM.

Frequently Asked Questions

Do all wisdom teeth need to be removed?

No. A wisdom tooth that has come through fully, is healthy and can be cleaned can stay. Removal is recommended for teeth that are repeatedly infected, decayed beyond repair, or damaging the tooth in front.

How do I know if my wisdom tooth is impacted?

Signs include pain or swelling of the gum behind the last tooth, a bad taste, food trapping at the back of the mouth and difficulty opening the mouth fully. Some impacted teeth cause no symptoms and are only seen on an X-ray.

Is wisdom tooth removal painful?

The procedure is done under local anaesthesia, so you feel pressure but should not feel pain. Soreness and swelling afterwards are expected, peak at about 48 hours and are managed with the medicines you are prescribed.

How long does it take to recover from wisdom tooth removal?

Most people return to normal activities within two to three days and recover within three to five days. Surgical removal of an impacted tooth can take a little longer.

What can I eat after wisdom tooth removal?

Soft, cool foods for the first day, then soft foods for three to five days. Avoid hot, spicy and hard foods, and do not drink through a straw for the first 24 hours.

What is dry socket?

Dry socket happens when the blood clot protecting the extraction site is lost, leaving the bone exposed. It causes pain that worsens one to three days after the extraction. Not smoking, and not rinsing or spitting forcefully on the first day, lowers the risk. It is treated with a dressing placed by your dentist.

Can wisdom tooth pain go away on its own?

The pain from a gum infection often settles within a few days, but it usually returns if the tooth remains partly erupted. Pain that keeps coming back should be assessed.

Do wisdom teeth cause crowding of the front teeth?

The available trial evidence has not shown that removing wisdom teeth makes a meaningful difference to crowding. Crowding alone is not a good reason to remove a healthy wisdom tooth.

Does a wisdom tooth need to be replaced after removal?

No. Wisdom teeth are not needed for chewing or appearance, so they are not replaced with an implant or bridge.

How much does wisdom tooth removal cost in Indirapuram?

At White Dental Healthcare it costs ₹3,000 to ₹10,000 per tooth, depending on the position of the tooth and whether surgical removal is needed.

Sources

1. National Institute for Health and Care Excellence. Guidance on the extraction of wisdom teeth. Technology appraisal guidance TA1, 2000.
2. Ghaeminia H et al. Surgical removal versus retention for the management of asymptomatic disease-free impacted wisdom teeth. Cochrane Database Syst Rev, 2020;5:CD003879.
3. Blum IR. Contemporary views on dry socket (alveolar osteitis): a clinical appraisal of standardization, aetiopathogenesis and management. Int J Oral Maxillofac Surg, 2002;31(3):309–317.
4. Sarikov R, Juodzbalys G. Inferior alveolar nerve injury after mandibular third molar extraction: a literature review. J Oral Maxillofac Res, 2014;5(4):e1.