Why have I got Pain with my Wisdom Teeth? What could it be?

There are a number of common complaints that we get with wisdom teeth. It is however, just a tooth like any other, so is susceptible to any problem that could affect your other teeth such as dental decay, gum disease, sensitivity, wear, fracturing or cracking- you get the picture?

The most common complaints about pain are:

• Ache or pressure. It is rare that wisdom teeth totally surrounded by bone and without any sign of obvious infection give much trouble, but some patients can get an ache or pressure at the back of their mouth, along the same lines as children who are teething. I often say- ‘sounds like your teeth are on the move’. The main part of the trouble comes from not knowing what’s going on, or expecting severe pain and wanting to go in and sort it out, before it does cause ‘pain’. It is important to see your dentist and rule out pulpitis, periodontal pain, TMJD or any infection associated with other teeth.

• Pericoronitis. Severe pain associated with an infection under the gum of a partially erupted tooth. We have devoted a section to this alone because it is a very common problem.

• Pain on biting. This can be because of a swelling from pericoronitis or simply that the tooth is growing and you are biting on the gum at the back of your mouth. Perhaps, the opposite wisdom tooth hasn’t come through yet, or has been taken out, so there is nothing to balance it and prevent it from over-erupting.

• Nerve pain. Because the wisdom tooth is often impacted, there tends to be a space just behind the second molar in which food can become packed and is not easily cleaned. Add this to the fact that your wisdom tooth is the most difficult tooth to brush and floss meaning more plaque collects there than anywhere else and it is not surprising that wisdom teeth frequently get decay in them. This can affect just your wisdom tooth or your second molar as well, so it is important to see a dentist if you notice food getting stuck there or any symptoms of pain or sensitivity. The longer it is left, the more damage it will do to your useful tooth and the more difficult the wisdom tooth extraction will become.

• Pushing/cutting the cheek. It is common for a wisdom tooth (top or bottom), to start coming through out of position due to the lack of space. This can happen with both upper and lower wisdom teeth, but it is more common with the upper ones. You may also find that your wisdom tooth is causing you to bite your cheek or perhaps you are it catching as you chew.

Other Common Wisdom Tooth Complaints Include:

• Crowding

There is a common perception that as your wisdom teeth come through, they will push all the other teeth forward if there isn’t space and this will cause crowding or bunching up of the front teeth. We often get the complaint, ‘I think my wisdom teeth are causing my other teeth to move because they aren’t straight anymore!’

It is particularly your bottom front teeth that are a problem here. Now, there is actually very little evidence to suggest that wisdom teeth do this and logically the thought of one tooth having the strength to push the roots of the seven teeth in front through solid jaw bone is quite a task wouldn’t you say. That’s not to say your teeth haven’t moved, just that your wisdom tooth probably isn’t the cause. The only way to ensure this doesn’t happen is with orthodontic retention- having a little metal band fixed behind your teeth, or by wearing a removable clear plastic retainer at night.

• Worry

People associate the word wisdom teeth with lots of PAIN, and then an awful extraction followed by lots more PAIN. So the slightest squeak out of them (the wisdom teeth that is) and it’s a rush to the dentist to get them checked. Yes, unfortunately on occasions, if you get really unlucky this may be how it pans out… but the horror stories you hear, are in reality quite rare. Of course it is going to be a bit sore afterwards, you are having a tooth removed and not all that many people like going to the dentist anyway. I am just saying that like root canals (and many other things) the reality often isn’t as bad as you think.

Your friends don’t really want to hear that you had your wisdom teeth taken out and it was fine… they want a face book post like,’OMG- just had my wisdom teeth out, I look like a hamster and want to die!’. That’s bound to get a bit more interest don’t you think?

The sooner you get them checked though, the sooner you will know what’s going on with your wisdom teeth. Once they are gone (extracted), they are gone, and they won’t be coming back, so if it’s necessary and the benefits outweigh the risks, bite the bullet, stop putting it off and worrying and get it all over and done with.

What can be done to treat the Pain?

What can be done for the pain depends totally on what is wrong i.e. the diagnosis- is it |irreversible pulpitis? Periconitis? Or because the tooth is biting into your cheek?…. for this you will need to see a dentist. In the mean time, painkillers (analgesics) and warm salt rinses can help somewhat, but they are not going to solve the problem. Massaging some clove oil may provide a bit of temporary relief.

The majority of the time, the treatment of choice for wisdom teeth, is having them removed. But this is not always the case and will depend on your individual circumstances. Sometimes wisdom teeth are left alone or just filled if the prognosis is good and they are useful to you, or if taking them out could cause unwanted complications. Sometimes, if there is considerable swelling and you have limited jaw opening, antibiotics may be needed to get the infection down before the tooth can be extracted. This is expanded on in risks and complications of wisdom teeth