Most wisdom tooth pain comes from a sore, swollen flap of gum over a tooth that hasn’t fully come through. It’s called pericoronitis, and while it’s painful, it usually isn’t dangerous. You should see a dentist within a day or two. But if swelling spreads towards your eye or down your neck, or you’re struggling to swallow, breathe or speak, go to A&E straight away.

Between those two ends there’s a lot of grey. This guide will help you work out which side of the line you’re on.

Key Takeaways

  • Wisdom teeth usually arrive in your late teens or early twenties, but they can cause trouble at any age.
  • A swollen, tender gum at the very back of the mouth is the classic sign of pericoronitis.
  • Swelling near the eye or neck, or difficulty breathing, swallowing or speaking, means A&E. Don’t drive yourself.
  • Pain, a bad taste, fever or struggling to open your mouth means an urgent dental appointment.
  • Not every wisdom tooth needs to come out. Repeat infections are one of the main reasons it’s recommended.

Why Do Wisdom Teeth Hurt?

Wisdom teeth are the last of your adult teeth to come through, right at the back. Often there isn’t quite enough room. The tooth comes through partly, or at an angle, or stays stuck under the gum and bone. Dentists call this impacted.

A partly erupted tooth leaves a flap of gum sitting over it. Food and bacteria get trapped underneath, and you can’t reach them with a brush. The gum gets inflamed, then infected. That’s pericoronitis, and it’s the most common reason people come to us with wisdom tooth pain.

Wisdom teeth can also cause:

  • Decay in the wisdom tooth itself, or in the tooth in front, where food gets packed between the two
  • Gum disease around the back teeth
  • A dental abscess
  • Occasionally, a fluid-filled cyst around a tooth that’s stuck in the bone

Signs Your Wisdom Tooth Needs Attention

  • A sore, swollen gum behind your last molar
  • Pain when you bite down, sometimes because the opposite tooth is hitting the swollen gum
  • A bad taste or smell, or pus coming from the gum
  • Pain spreading to your ear, jaw or throat
  • Difficulty opening your mouth fully
  • Swollen glands under your jaw
  • Feeling generally unwell or running a temperature

Is It An Emergency? A Simple Way to Decide

Go to A&E now if:

  • The area around your eye or your neck is swollen
  • Swelling in your mouth or neck is making it hard to breathe, swallow or speak

These are signs an infection is spreading, and it needs hospital treatment. Don’t drive. Ask someone to take you, or call 999.

Call us for a same-day or next-day appointment if:

  • The pain is severe or getting worse, and painkillers aren’t touching it
  • You have a bad taste in your mouth along with a high temperature or feeling unwell
  • You can’t open your mouth properly
  • Your face is starting to swell, even slightly

We hold same-day appointments for most dental emergencies, and our emergency fee is £71. If you can’t reach us out of hours, NHS 111 can advise you.

Book a routine appointment if:

  • The gum is a little sore, but it’s improving
  • The tooth ached for a day or two and settled
  • You’ve noticed food getting stuck behind your back teeth

Mild flare-ups often calm down, but they tend to come back. It’s worth getting the tooth checked and X-rayed so you know what you’re dealing with before the next one.

What You Can Do at Home While You Wait

  • Take paracetamol or ibuprofen as directed on the pack, if they’re safe for you. A pharmacist can advise.
  • Rinse with warm salt water a few times a day, especially after eating. This helps flush food from under the gum.
  • Keep brushing right to the back, gently. A small-headed or single-tufted brush helps.
  • Stick to soft food and chew on the other side.
  • Avoid smoking, as it slows healing and makes infection worse.

Don’t put aspirin directly on the gum. It burns the tissue and doesn’t help the pain.

What Happens at Your Emergency Appointment

Your dentist will examine the area and usually take an X-ray to see the position of the tooth and its roots. Most of the time, the first step is a thorough clean under the gum flap to wash out trapped food and bacteria. That alone often brings quick relief.

Antibiotics aren’t usually needed for pericoronitis. UK guidance reserves them for infections that are spreading or making you unwell, so don’t be surprised if your dentist doesn’t prescribe them. Cleaning the area is what fixes the problem.

If the opposite upper tooth is biting into the swollen gum, we may smooth it or suggest removing it.

Does My Wisdom Tooth Need to Come Out?

Not automatically. If a wisdom tooth isn’t causing problems, it’s usually left alone and checked at your routine appointments.

Removal is more likely to be recommended if you’ve had repeat bouts of pericoronitis, if the tooth is decayed beyond repair, or if it’s damaging the tooth in front. Your dentist will talk you through the X-ray and the options, including the risks, before anything is decided.

At The Care Dental Practice, wisdom tooth removal is carried out in-house. Wisdom tooth extraction is priced from £550. If you’re anxious about having a tooth out, ask us about our Enjoyable Dentistry Technique™, designed for nervous and phobic patients.

Wisdom Tooth Pain FAQs

How long does wisdom tooth pain last?

A mild flare-up of pericoronitis often settles within a few days once the area is cleaned. If pain lasts longer than two or three days, or is getting worse, see a dentist.

Can a wisdom tooth infection spread?

Yes. Untreated, infection can spread into the tissues of the face and neck. That’s why swelling, fever or difficulty swallowing need prompt attention.

Why does my wisdom tooth pain spread to my ear?

The nerves in your lower jaw and ear are closely connected, so pain from a back tooth often feels like it’s coming from your ear or throat.

Can I have a wisdom tooth removed while it’s infected?

Usually, your dentist settles the infection first and removes the tooth once it has calmed down. It makes the extraction more comfortable and healing more predictable.

Is it normal to be in pain after wisdom tooth removal?

Some pain and swelling for a few days is normal, and it should start improving after a day or two. Pain that gets worse a few days later can be a sign of dry socket. Call us if that happens.

Get in Touch

If your wisdom tooth is flaring up, call us on 0208 846 8534 or contact us any time. We’re at 118-120 Hammersmith Road, London W6 7JP, open six days a week, with evening appointments until 8pm and a limited Saturday service.