Wisdom teeth, or third molars, are the last teeth to emerge, typically appearing between the ages of 17 and 25. While some individuals experience no issues with their wisdom teeth, many encounter discomfort and complications as these teeth try to come through. The pain associated with wisdom teeth often comes and goes, leaving many to wonder about its fluctuating nature. Understanding its root causes helps in managing the situation effectively.
Underlying Reasons for Intermittent Wisdom Tooth Pain
One common reason for intermittent wisdom tooth pain is partial impaction. This occurs when a wisdom tooth cannot fully emerge through the gum line, often because there isn’t enough space in the jaw or another tooth is blocking its path. A partially erupted tooth creates an opening where food particles and bacteria can become trapped beneath a flap of gum tissue, making the area prone to irritation and infection. Pressure from chewing or changes in swelling can then cause the pain to flare up or subside.
Pericoronitis, an inflammation and infection of the gum tissue surrounding a partially erupted wisdom tooth, is a frequent cause of fluctuating pain. Bacteria and food debris can accumulate in the gum flap, leading to infection that can intensify and then temporarily lessen, creating a cycle of discomfort, swelling, and sometimes an unpleasant taste. The pain may become particularly noticeable during chewing or when consuming hot or cold substances, as these activities can irritate exposed nerves.
A growing wisdom tooth can also intermittently press against the adjacent molar or nearby nerves. This pressure can cause discomfort that fluctuates depending on the tooth’s movement, any inflammation in the surrounding tissues, or activities like chewing. When wisdom teeth attempt to shift or find their position in a jaw that lacks adequate space, they can exert pressure on other teeth, leading to varying degrees of pain.
Dental caries, or cavities, in a wisdom tooth or an adjacent molar affected by the wisdom tooth, can also lead to intermittent pain. Wisdom teeth are often difficult to clean due to their position at the very back of the mouth, making them more susceptible to decay. The sensitivity and pain from a cavity can be triggered by temperature changes from food and drinks or pressure from chewing. Untreated decay can progress, affecting nerves and leading to more persistent issues.
Recognizing When Professional Intervention is Needed
Certain symptoms indicate a need for professional dental attention. Increasing frequency or intensity of pain is a significant warning sign that the issue may be worsening. If the discomfort becomes severe enough to disrupt daily activities, eating, or sleep, a dental visit is advisable.
Other symptoms warranting immediate dental consultation include difficulty opening the mouth fully, a condition known as trismus, or swelling in the jaw or face. These signs can point to a spreading infection or inflammation. Swelling that extends to the cheek or jawline, particularly when accompanied by fever or general malaise, suggests a serious issue requiring prompt care.
A persistent bad taste in the mouth or bad breath can signal an infection around the wisdom tooth. Visible pus or discharge from the gum area around the tooth also indicates an active infection. Pain radiating to the ear or head, or persistent bleeding gums around the wisdom tooth, also necessitate a dental examination.
Dental Assessment and Management Strategies
A dental professional will conduct a thorough assessment to determine the underlying cause. This typically involves an oral examination, where the dentist visually inspects the affected area and discusses the patient’s symptoms and medical history. A crucial diagnostic tool is the panoramic X-ray, also known as a Panorex, which provides a comprehensive view of the entire mouth, including the wisdom teeth, jaws, and surrounding structures. This X-ray helps to visualize the exact position of the wisdom teeth, identify any impaction, and detect issues like cysts or decay.
Initial management strategies aim to provide temporary relief and address any immediate concerns. For cases involving pericoronitis or other bacterial infections, a dentist might prescribe antibiotics to control bacterial growth. Pain medication, such as over-the-counter anti-inflammatories, or specific mouth rinses like warm saltwater, may also be recommended to help manage discomfort and inflammation. These temporary measures are designed to alleviate symptoms until a definitive treatment plan can be established.
The most common definitive treatment for problematic wisdom teeth is surgical extraction. This procedure is often recommended when wisdom teeth are impacted, causing recurrent pain, infection, damage to adjacent teeth, or other oral health complications. During the extraction, the dentist or oral surgeon numbs the area with local anesthesia, and in some cases, sedation may be used. The tooth may be removed in one piece or, if deeply impacted or at an awkward angle, it might be sectioned into smaller pieces for easier removal. While not all wisdom teeth require removal, extraction is a common and effective solution for preventing future issues and maintaining overall oral health.