The experience of pain that disappears and then suddenly reappears is common when the third molars, known as wisdom teeth, attempt to emerge into the mouth. These teeth are the last to develop and often lack enough space, leading to impaction. The intermittent discomfort reflects the biological and mechanical processes occurring as the tooth interacts with surrounding tissues and bone. This fluctuation signals that the teeth are either moving in stages or that an underlying infection is cycling between flare-up and remission.
Pressure and Positional Changes
The slow and staggered movement of a wisdom tooth is a primary mechanical reason for the on-again, off-again nature of the pain. Unlike other teeth, third molars emerge in gradual, stop-and-start phases over months or even years, rather than in one smooth push. During an active phase, the tooth exerts pressure on the adjacent second molar, overlying gum tissue, and the jawbone, causing temporary inflammation and discomfort.
When the tooth pauses its movement, the pressure temporarily subsides, allowing inflamed tissues to recover slightly, and the pain seems to vanish. This sensation is also heavily influenced by how the jaw is used; activities like clenching the teeth (bruxism) or chewing tough foods can temporarily exacerbate the existing pressure. A slight shift in the tooth’s angled position can relieve pressure on a nerve or a sensitive spot on the adjacent tooth, contributing to the feeling of remission.
Fluctuations in biting pressure or jaw alignment can trigger a flare-up of pain that subsides once the jaw muscles relax. When a wisdom tooth grows horizontally or at an irregular angle, the physical force it exerts on neighboring teeth causes discomfort that varies with jaw movement. These mechanical stressors are not constant, creating the pattern of pain that appears to resolve itself until the next episode of pressure or movement occurs.
Cycles of Infection and Inflammation
The most frequent biological cause for intermittent wisdom tooth pain is pericoronitis, a localized infection and inflammation distinct from mechanical pressure. This condition occurs when a wisdom tooth is only partially erupted, meaning a flap of gum tissue, called an operculum, still covers a portion of the tooth crown. The space beneath this gum flap is extremely difficult to clean effectively with normal brushing and flossing.
This sheltered area becomes a stagnation zone where food particles, debris, and bacteria accumulate, leading to a rapid multiplication of microorganisms. This bacterial buildup initiates an acute inflammatory response, causing the gum tissue to swell, become red, and produce severe pain, sometimes accompanied by pus or a bad taste. This marks the “on” phase of the pain cycle.
The pain then enters a “remission” or “off” phase as the body’s immune system partially manages the infection or as the area temporarily drains. The inflammation can reduce naturally, or symptoms might temporarily ease with improved hygiene or home remedies, giving the false impression that the issue is gone. However, because the physical flap and the underlying cause—the trapped bacteria—remain, the cycle is highly prone to repeating, often triggered again by biting down or inadequate oral hygiene.
This biological cycle can range from chronic pericoronitis, which involves only mild, persistent inflammation, to acute exacerbations associated with severe pain, swelling, and sometimes difficulty opening the mouth (trismus). The pain will continue to cycle between these states until the tooth fully erupts to eliminate the flap or until the source of the infection is professionally treated or removed.
Action Steps for Persistent Discomfort
While the pain may be intermittent, it signals that a professional dental evaluation is necessary to determine the underlying cause and the tooth’s position. For temporary relief during a flare-up, over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, can help manage both the pain and the surrounding inflammation. A simple home remedy is rinsing the mouth three to four times a day with a warm saltwater solution, made by dissolving about half a teaspoon of salt in eight ounces of warm water.
Applying a cold compress to the outside of the cheek in 15 to 20-minute intervals can also help reduce localized swelling and numb the area. Avoiding hard, sticky, or crunchy foods can also prevent further irritation to the already sensitive gum tissue. However, these measures only address the symptoms and do not resolve the mechanical or infectious issues that cause the pain to return.
It is important to seek immediate professional attention if the intermittent discomfort progresses to more serious symptoms. Signs that suggest the infection is spreading or worsening include:
- Persistent, severe pain.
- Noticeable swelling in the face or jaw.
- Difficulty swallowing.
- An inability to fully open the mouth.
Ignoring the “off” cycles can allow a localized infection to potentially spread, making prompt consultation with a dentist the appropriate next step for recurring wisdom tooth pain.