How Wisdom Teeth Cause Nerve Pain
Wisdom teeth can exert pressure on nearby nerves, primarily the inferior alveolar nerve and the lingual nerve. The inferior alveolar nerve provides sensation to the lower teeth, gums, lip, and chin, while the lingual nerve governs sensation and partial taste for the tongue and floor of the mouth. Their close proximity makes them susceptible to irritation.
A common cause is impaction, where the wisdom tooth fails to fully emerge or grows at an angle. This misalignment can press directly against these nerves or surrounding bone, disrupting normal nerve function. Deeply embedded or horizontally impacted teeth, where roots may intertwine with nerves, pose a particular risk.
Inflammation and infection, often termed pericoronitis, can cause nerve pain. This occurs when gum tissue around a partially erupted wisdom tooth becomes inflamed from trapped food and bacteria. The swelling and infection can then spread, irritating adjacent nerves or forming an abscess that exerts pressure.
Less commonly, cysts or tumors can develop around impacted wisdom teeth. These fluid-filled sacs or growths expand within the jawbone, gradually damaging surrounding bone, teeth, and nerves by exerting continuous pressure. Such formations can weaken the jaw and intensify nerve compression.
Recognizing Nerve Pain Symptoms
Nerve pain from wisdom teeth often presents with specific characteristics that differentiate it from a typical toothache. Individuals may experience sharp, shooting, throbbing, or burning sensations that can be constant or intermittent. This discomfort frequently radiates beyond the tooth, extending into the jaw, ear, temple, or neck.
A distinct indicator of nerve involvement is altered sensation, such as numbness or tingling. This can affect the lower lip, chin, or tongue, particularly on the side of the problematic wisdom tooth. Some individuals might also notice changes in taste perception. These neurological symptoms arise from the disruption of nerve signals caused by pressure or inflammation.
Other symptoms may accompany wisdom tooth-related nerve issues. Swelling and redness of the gums around the affected tooth are common. There might also be difficulty opening the mouth fully, known as trismus, or tenderness in the jaw. A persistent bad taste in the mouth or bad breath can indicate an underlying infection. Headaches, especially on the side of the impacted tooth, can also occur due to nerve compression extending to surrounding muscles.
Diagnosis and Treatment Options
If nerve pain symptoms persist or worsen, professional dental evaluation is important. A dentist will conduct a thorough physical examination, assessing the affected area and discussing the specific nature of the discomfort. Imaging plays a significant role, typically starting with panoramic X-rays, which provide a two-dimensional view of the teeth and jaw structure.
For a more detailed assessment of the wisdom tooth’s relationship to surrounding nerves, particularly the inferior alveolar nerve, Cone Beam Computed Tomography (CBCT) may be used. CBCT offers a precise view of the nerve’s proximity to the tooth roots, helping to identify potential compression or damage. This advanced imaging allows for careful planning of treatment to minimize risks.
Treatment aims to alleviate symptoms and address the underlying cause. Initial pain management may involve over-the-counter pain relievers such as ibuprofen or acetaminophen, or prescription medications for more severe discomfort. Applying cold compresses to the jaw can also help reduce swelling and numb the area. If an infection is present, antibiotics will be prescribed.
Often, the definitive solution is removing the problematic wisdom tooth. Extracting the tooth eliminates the source of pressure or infection, allowing the irritated nerve to recover. In cases where tooth roots are extremely close to the nerve, a coronectomy might be considered, where only the crown is removed, leaving roots behind to reduce nerve injury risk. Following successful treatment, nerve symptoms typically resolve gradually, though complete resolution can take time.