Wisdom tooth pain: when removal may be needed

Signs a wisdom tooth may need attention

• Pain or swelling behind the last molar
• Difficulty opening the mouth fully
• Food getting trapped, bad breath or a bad taste
• Repeated episodes of gum infection around a partly erupted tooth
• Decay in the wisdom tooth or the tooth in front of it

Not every wisdom tooth needs removal

Whether a wisdom tooth should be removed depends on its position, how much trouble it is causing, and its relationship to nearby nerves and teeth. A healthy wisdom tooth that has come through fully and can be cleaned may simply be monitored. An OPG X-ray is usually needed to plan any removal.

Easing a flare-up while you arrange care

• Rinse gently with warm salt water after meals
• Clean around the area carefully with a soft brush
• Choose soft foods and chew on the other side
• Seek care promptly if swelling increases, you cannot open your mouth, or you develop fever

Questions to ask if removal is advised

• Why does this tooth need to come out, and what happens if I wait?
• Is it a simple extraction or a surgical one, and who will do it?
• How close is the root to the nerve on the X-ray, and is any further scan needed?
• What recovery should I expect, and how much time off might I need?

Recovery after removal, in general

• Some swelling and stiffness for a few days is common and usually peaks around the second or third day
• Follow your dentist's instructions on rinsing, eating and avoiding smoking, which slows healing
• Increasing pain several days later, a bad taste or fever can mean the socket needs to be checked

Keeping a wisdom tooth you do not remove

If you and your dentist decide to keep a wisdom tooth, clean it carefully with a small-headed brush angled towards the back, and have it checked at routine visits. Problems such as decay on the tooth in front can develop quietly, so occasional X-rays may be advised.