A sore, swollen spot behind your back teeth is hard to judge from the outside, so you are left guessing whether it can wait or needs a dentist today. If you have been putting off the dentist, that is common, and there is no judgment here. In this guide, Dr. Xhelo Shuaipaj of Dentique Dental Care sorts wisdom tooth pain and swelling into three groups: book soon, call today, or go to the ER. Here is the short answer on urgency first.
So how urgent is it?
Most wisdom tooth pain comes from a trapped or partly erupted tooth, and it is urgent enough to see a dentist within a few days. Call a dentist the same day for pus, fever, a bad taste, or growing swelling. Go to the ER for trouble breathing or swallowing, or swelling spreading to the face, neck, or jaw.
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Which wisdom tooth signs mean you should book a dentist visit soon
The most common wisdom tooth signs, an ache, pressure, or tenderness in the gum behind your last molar, mean you should book a dentist visit in the next few days, not wait for it to go away. These signs are uncomfortable, but on their own they are not an emergency.
Mayo Clinic lists these signs of a problem wisdom tooth, also called a third molar:
- Red or swollen gums near the back of your mouth.
- Tender or bleeding gums around the tooth.
- Jaw pain, or swelling around the jaw.
- Bad breath or an unpleasant taste in your mouth.
- A hard time opening your mouth wide.
Mayo Clinic’s advice is simple: see your dentist if you have symptoms in the area behind your last molar.
Pain that comes and goes can mean a wisdom tooth is pushing through, or the gum over it is flaring up. Cleveland Clinic notes that some flare-ups settle for a while. Even so, an impacted wisdom tooth can press on the second molar next to it, so a dentist should check its position on an X-ray instead of waiting months to see if the pain returns.
Most people fit in this group. A smaller group of signs cannot wait days, and those come next.
Which signs mean call a dentist today, and which mean go to the ER
A smaller group of signs point to an infection around the wisdom tooth, and they mean you should call a dentist the same day rather than wait for an opening.
Call a dentist today if you have:
- Pain along with a fever or bleeding gums.
- Pus, or a bad taste that keeps coming back.
- Facial swelling, or swelling of the gum or cheek that is growing.
- Pain that over-the-counter pain relief does not ease.
Cleveland Clinic advises seeing a dentist right away for pain, fever, or bleeding gums around a wisdom tooth. These signs often point to pericoronitis, an infection of the gum around a partly erupted wisdom tooth. Left untreated, pericoronitis can turn into an abscess, and the infection can spread. Cleveland Clinic states that in severe cases it can be life-threatening. A dentist can treat the infection and prescribe antibiotics if you need them.
Go to the emergency room, or call 911, if you have:
- Trouble breathing or trouble swallowing.
- Swelling in your neck or under the jaw.
- Swelling spreading across your face.
- A high fever with a toothache.
Hospital guidance, including Baptist Health, lists these as signs that need emergency care before a dental visit.
To reach Dentique Dental Care, call the Downers Grove office at (630) 454-9299 or the Lemont office at (630) 685-0017. Call, and the team will do everything it can to get you seen as soon as possible.
Knowing the signs is one part. Knowing why a wisdom tooth causes them makes the rest easier to follow.
What usually causes wisdom tooth pain and swelling
Wisdom teeth, also called third molars, are the last adult teeth to come in, usually between ages 17 and 26, and they often have too little room, so they get stuck. That is what “impacted” means.
According to Mayo Clinic, an impacted wisdom tooth is one without enough room to come in or develop normally. It is partially impacted if some of the crown shows through the gum, and fully impacted if it never breaks through.
The pain and swelling usually come from one of these:
- A trapped tooth can push against the second molar in front of it, damage that tooth, or raise the chance of infection there (Mayo Clinic).
- With pericoronitis, a flap of gum called an operculum sits over a partly erupted tooth, usually a lower one, and traps food and bacteria underneath (Cleveland Clinic).
- Because wisdom teeth are hard to clean, they are more prone to tooth decay and gum disease than other teeth (Mayo Clinic).
Less often, the sac around a wisdom tooth fills with fluid and forms a cyst, which can damage bone, teeth, and nerves. Mayo Clinic describes this as uncommon, and a tumor, usually noncancerous, as rare.
Pain is the usual way people find out about a wisdom tooth. That raises a fair question: what if the tooth is not hurting at all?
Does a wisdom tooth that is not hurting still need to come out
A wisdom tooth that is not hurting does not automatically need to come out. If an exam and X-ray show it is healthy and low-risk, the standard advice is to keep watching it with regular checkups.
That is the position of the American Association of Oral and Maxillofacial Surgeons (AAOMS). AAOMS says wisdom teeth with disease, or at high risk of it, should be treated with surgery. Without disease or a real risk of it, AAOMS advises that you and your dentist monitor the tooth with exams and X-rays.
Age plays a part too. Surgery tends to get harder as you get older, so AAOMS advises deciding whether to remove a wisdom tooth or keep watching it before your mid-twenties.
The other side is also true: a quiet tooth can still have hidden problems. An impacted wisdom tooth can harm the roots of the tooth next to it, or form a cyst, without causing pain. That is why a checkup and an X-ray tell you more than how the tooth feels.
At Dentique Dental Care, treatment planning is no pressure. Patients often tell us, without being asked, that they did not feel upsold.
Whether you end up watching the tooth or treating it, there are safe things you can do tonight while you wait to be seen.
What can you safely do right now, before your visit
A warm saltwater rinse, along with gently cleaning around the sore tooth, can ease a mild flare-up while you arrange to be seen.
Steps that are safe right now:
- Rinse with warm salt water to soothe the gum and wash out trapped food (Medical News Today).
- Brush gently around the tooth, including the gum at the back, so food does not sit under the gum flap.
- Take over-the-counter pain relief and follow the label. If it does not ease the pain, treat that as a call-today sign.
Home care does not replace a dentist. A rinse can calm minor gum swelling, but it cannot clear an infection. If mild symptoms have not improved after about five days, see a dentist (Medical News Today), and call sooner if any call-today sign appears. A dentist can prescribe antibiotics if you need them, so do not take leftover antibiotics or ones prescribed to someone else.
Once the call is made, the next worry for many people is the visit itself.
What happens when you come in, and what if dental visits make you anxious
Your first visit for a wisdom tooth starts with a conversation, an exam, and an X-ray, so the dentist can see the tooth’s angle and room before anyone talks about treatment.
Here is how that visit goes at Dentique Dental Care, in Downers Grove or Lemont:
- You tell Dr. Xhelo Shuaipaj what you are feeling and how long it has been going on. There is no judgment about how long it has been since your last visit.
- He looks at the tooth and the gum around it.
- An X-ray shows the tooth’s angle, the space it has, and its health.
- He explains your options, including watching the tooth when that makes sense.
- You decide what happens next. You get your price in writing before any treatment.
If dental visits make you anxious, you are far from alone. Sedation is a routine option here, not an upsell. You can choose nitrous oxide, often called laughing gas, or oral conscious sedation, which is a pill to relax you. Dr. Shuaipaj is a Fellow of DOCS Education (FDOCS), a sedation fellowship.
People who get this far usually still have a few specific questions.
Frequently asked questions
What does it feel like when wisdom teeth need to be removed?
When wisdom teeth need to be removed, it often feels like a dull ache or pressure behind your last molar, with a sore or swollen gum, a bad taste, or stiffness when you open wide (Mayo Clinic). Many wisdom teeth that need attention cause no pain at all, which is why an X-ray matters more than how the tooth feels.
Is 25 too old for wisdom teeth removal?
No, 25 is not too old for wisdom teeth removal. AAOMS notes that surgery tends to get harder with age, so it advises deciding whether to remove wisdom teeth or keep monitoring them before the mid-twenties. At 25, a dentist can still check the teeth and talk through your options.
Why do experts now say not to remove your wisdom teeth?
Experts say not to remove some wisdom teeth because healthy, well-placed wisdom teeth with no symptoms can be monitored instead. AAOMS advises regular exams and X-rays when there is no disease or real risk of it. Wisdom teeth that are diseased or at high risk are a different case.
How can I tell if my pain is dry socket?
You can tell pain might be dry socket if it gets worse a few days after a wisdom tooth is removed, instead of better. Dry socket happens when the blood clot in the socket is lost and the bone is left exposed (Cleveland Clinic). Normal pain peaks around the third or fourth day, so pain that climbs after that is a reason to call the dentist who did the extraction.
