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Wisdom Teeth Pain

Description:  Wisdom teeth pain is seen in people of all ages, but it is most common in people in their 20's.  In the early stages of wisdom tooth infection the pain is only felt when a person bites, however in later stages people suffering from wisdom teeth pain often describe a constant deep ache in their jaw often spreading to the ear and the side of the head.  When the infection becomes more severe, swelling of the face in the region of the wisdom tooth  and  a fever can also occure.

Wisdom teeth are the very last teeth to erupt, usually between the ages of 18 and 28.
There are four wisdom teeth; one for every four corners of the mouth and they are

located at the very back of the dental arch.  Not everybody has wisdom teeth; in fact some people have 3, some have 2 and some have none.  In the normal eruption process, a tooth first breaks the surface of the gums, then continues to grow until the crown of the tooth has fully emerged through the gums.  In some people there is no space left at the very back of the dental arch and the wisdom tooth will not be allowed to erupt normally.  In many cases the tooth stays in a 'dormant' state; it stays beneath the level of the gums without ever erupting and without ever causing any problems.  In some cases however the wisdom tooth starts to erupt and breaks the surface of the gums but then gets stuck and it therefore fails to continue to grow in its correct position. 
Wisdom teeth painThe xray image shows an example of such a wisdom tooth (the tooth to the right). When this happens there is often a flap of gums visible in the mouth covering the submerged part of the tooth.  This flap is often difficult to keep clean and tends to serve as a food trap allowing food debris and dental plaque full of bacteria to get stuck beneath it.  When stagnant debris is left stuck beneath the gums for a prolonged time an infection of the gums surrounding the entire wisdom tooth often occures; this infection is technically known as pericoronitis.  As a result of the infection the flap of gums over the wisdom tooth swells up, increases in thickness, and starts hitting the tooth in the opposing dental arch; this is the reason why one of the very first symptoms of wisdom 
teeth infection is pain when a person bites.  Constant biting on this swollen flap of gums leads to the creation of a gum ulcer which further increases the pain.  As time passes the infection starts to spread leading to an aching pain in the region of the ear, swelling of the face in the region overlying the wisdom tooth, swelling of the lymph nodes located in the throat as well as fever.

Treatment  of Wisdom teeth pain

Visiting your dentist is highly advisable, as is the case with all dental infections.  Your dentist will carry out a clinical examination together with xrays to make a diagnosis of wisdom tooth infection. 

The first line of treatment that is always advised to imporve oral hygiene in the area of the infected wisdom tooth; remember that the infection starts with debris getting suck beneath the flap of gums covering the partially erupted wisdom tooth.  Failure to remove this debris will make it much more difficult to rapidly cure the infection.  Many people with a healthy mouth already find it difficult to clean the teeth at the very back of their mouth because they may find it cumbersome to maneuver the toothbrush to this part of their mouth.  Couple this fact with the swollen and tender gums seen in the initial stages of wisdom teeth infection and people tend to find it even much less pleasant to clean this part of their mouth; an ugly cycle starts where even more debris starts getting stuck beneath the gums and hence the infection gets even worse.  What we dentists therefore recommend is that patients suffering from wisdom tooth infections start to gently clean the infected area with a toothbrush.  There are extra-soft bristle toothbrushes on the market known as post-surgical toothbrushes which will do an excellent job of cleaning the area without causing extreme discomfort.  Brushing inflamed gums often causes a small ammount of bleeding, so do not be alarmed.  Brushing two to three times a day is recommended.

When it comes to toothpaste a specially formulated toothpaste with an antiseptic such as chlorhexidine is recommended.  Your dentist will advise you on which products to use.  In association with the toothpaste many dentists will also advise the use of mouth rinses and gels which also contain an antiseptic to help speed up the healing process.  If the infection has advanced and there are signs that the infection is starting to spread, such as a swollen face, swollen lymph nodes and difficulty with swallowing, the dentist will prescribe an antibiotic to systemically combat the infection.  If you follow your dentist's instructions the infection and the pain should start to subside after two to three days; until then pain killers prescribed by your dentist can be taken to help alleviate the pain.

The last decision to be taken is whether or not the wisdom tooth should be removed once the infection has healed.  If the wisdom tooth has enough space to erupt it would be wise not to remove the tooth to see if the wisdom tooth erupts in its correct position with time.  If it is partially erupted and does not have enough space to erupt into its normal position then removal is highly advised.  Removing a wisdom tooth is not as simple as removing any other tooth because trapped wisdom teeth have to be surgically removed.  This involves a minor operation which can be carried out under local anaesthesia or general sedation.  The procedure is most often accompanied by post-operative pain; your dentist will guide you through the procedure advising what precautions to take before and after the operation.

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