When a third molar, commonly known as a wisdom tooth, begins to erupt and rubs or cuts into the soft tissues of the cheek, it causes significant irritation. This trauma often leads to painful sores or ulcers on the inner cheek lining, making simple actions like chewing or speaking difficult. The presence of a sharp or angled tooth surface constantly grazing the delicate oral mucosa defines this specific dental issue. Addressing this irritation requires understanding the mechanical cause and employing temporary relief measures alongside professional dental intervention.
Why Wisdom Teeth Cut the Cheek
The primary reason a wisdom tooth causes cheek trauma is a lack of space within the jaw to accommodate its eruption. As the last teeth to emerge, usually between the ages of 17 and 25, the third molars often encounter a crowded environment because the human jaw has evolved to be smaller. This limited space forces the developing tooth to grow at an angle instead of vertically, a condition known as impaction.
Impaction means the tooth is trapped, either partially or completely, by the jawbone or adjacent teeth, directing its sharp chewing surface, or cusp, toward the cheek. For example, a mesial impaction angles the tooth toward the front of the mouth, while a horizontal impaction means the tooth is lying completely on its side. This angled growth directs the tooth’s surface to continuously scrape or bite the cheek lining, leading to abrasions and chronic irritation.
The issue is complicated when the tooth is only partially erupted, leaving a flap of gum tissue, called an operculum, overlying the tooth. This gum flap can become inflamed and infected, a condition known as pericoronitis. This condition is often exacerbated by being repeatedly bitten or irritated. Swelling from the inflamed tissue can push the cheek further into the path of the tooth’s sharp edges.
Immediate Steps for Pain Relief and Protection
While waiting for a dental appointment, several temporary measures can help manage the pain and prevent further damage. One effective step is performing warm salt water rinses multiple times a day to soothe the irritated area. Dissolving about half a teaspoon of salt in warm water and swishing it gently helps reduce localized swelling and maintain cleanliness, which is important for healing the cut.
For managing discomfort, taking over-the-counter anti-inflammatory medications, such as ibuprofen, can reduce pain and inflammation. These medications calm the body’s inflammatory response, lessening the tenderness around the cheek injury. Alternatively, applying a cold compress to the outside of the cheek provides a temporary numbing effect and helps reduce swelling.
To protect the cheek lining from the tooth’s sharp edges, a physical barrier is beneficial. Dental wax, often used for braces, or a similar temporary soft dental material can be placed directly over the exposed cusp of the wisdom tooth. This creates a smooth surface, minimizing friction and trauma until a dentist addresses the underlying problem. Focus on soft foods and chew on the side opposite the irritation to give the injured cheek time to heal.
Professional Assessment and Treatment Options
A professional assessment is necessary because home remedies only provide temporary relief and do not resolve the mechanical issue causing the trauma. The dentist will first perform a thorough oral examination to inspect the area for signs of irritation or infection. The next step involves taking dental X-rays, such as a panoramic radiograph, to determine the exact angle, position, and depth of the wisdom tooth relative to the jawbone and surrounding teeth.
This imaging classifies the type of impaction and assesses the risk of damage to adjacent structures. Based on this diagnosis, the dentist recommends the most appropriate long-term treatment pathway. The most common and definitive solution for a misaligned or severely impacted tooth causing recurrent trauma is surgical extraction. Removal eliminates the source of the mechanical irritation and prevents future complications like infection or damage to the neighboring second molar.
Non-Surgical Options
In cases where the tooth is expected to fully erupt soon, and the main issue is a persistent gum flap, a minor procedure called an operculectomy might be considered to remove the overlying gum tissue. For wisdom teeth that are only slightly misaligned or partially erupted, a dentist may opt for dental contouring. This involves smoothing the sharp cusp that is cutting the cheek. If the tooth is asymptomatic or only mildly impacted, the dentist may recommend periodic monitoring to observe the tooth’s progression.