Infected Wisdom Tooth Symptoms and What to Do

Overview: Wisdom Teeth (Third Molars)

Wisdom teeth, or third molars, are teeth that emerge behind the back molars, usually in mid-to-late adolescence or adulthood.

Wisdom teeth are often impacted (stuck below the gumline) or only partially erupted, and may come in at odd angles. This can lead to pain, complications, and ultimately, removal.

What Causes Wisdom Tooth Infections?

Because of their location in the far back of your mouth, wisdom teeth can be hard to see and difficult to keep clean. This can provide an opportunity for infection.

Wisdom tooth infections can begin in various ways:

• Impacted wisdom teeth are difficult to clean. This allows bacteria to fester and accumulate. 
• Pericoronitis occurs when the soft tissue surrounding a partially erupted wisdom tooth becomes infected.
• Periodontitis occurs when the gum tissue around a fully erupted tooth becomes infected, causing bone and tissue loss.
• A cavity in the wisdom tooth may cause an infection.

All of these causes create easy places for bacteria to accumulate.

Pericoronitis is an especially common complication of impacted or partially erupted wisdom teeth. The gingival (gum) tissue around the tooth forms a flap or protrusion that can collect bacteria.

As many as 1 in 4 people with impacted but otherwise asymptomatic wisdom teeth may have some form of gum disease.¹ The number of wisdom teeth that become infected, however, may be lower.

Other Causes of Tooth Pain

Wisdom tooth pain occurs for reasons other than infection. These reasons include:

• A decaying, abscessed, or broken molar directly in front of the wisdom tooth
• Excessive tooth grinding or jaw clenching (bruxism)
• Wisdom tooth eruption, even if uninfected

If you’re concerned about pain or discomfort, consult your dentist. They’ll be able to diagnose and treat the underlying problem.

Signs of an Infected Wisdom Tooth

Common signs of an infected wisdom tooth include:

• Painful tooth
• Pain around gums, jaw,  and the surrounding area
• Swelling around the face or jaw
• Swollen lymph nodes
• Foul taste or smell in mouth
• Ear pain or headache

Complications of Infected Wisdom Teeth

Infected wisdom teeth, especially if left untreated, may cause complications such as:

• Spreading or “rampant” tooth decay
• Cysts
• Crowding and even damage to other teeth, especially if the wisdom tooth is impacted
• Infection spreading to the gums
• Infection entering the bloodstream, resulting in sepsis
• Overcrowding or damage to other teeth

What to Do if You Have an Infected Wisdom Tooth

Wisdom teeth don’t always cause problems and may not need to be removed. But an infected wisdom tooth will rarely heal on its own, and may cause other problems

If you’re concerned that one or more of your wisdom teeth are infected, visit your dentist as soon as possible.

1. Visit Your Dentist

At your appointment, tell your dentist about your pain and any other symptoms you’re experiencing. They’ll examine the area to diagnose the problem.

If they diagnose a wisdom tooth infection, they’ll likely recommend having the teeth removed. Even if only one wisdom tooth is infected, having all of them removed at once will spare you any future complications.

Dental imaging is needed to determine the location of the wisdom tooth in relation to other teeth and nerves. Intraoral x-rays, panoramic x-rays, and Cone Beam imaging are commonly used. 

If your wisdom teeth are fully erupted, your dentist may be able to remove them without help from a surgeon. This is because removing fully erupted wisdom teeth is similar to removing regular teeth.

However, it’s likely that at least one of your wisdom teeth will be impacted or only partially erupted. In this case, your dentist may refer you to an oral surgeon to have them removed.

2. Get Your Wisdom Teeth Removed

Your dentist or oral surgeon will provide you with detailed instructions for your removal appointment. Be sure to follow them carefully.

Wisdom tooth removal is a common and routine procedure and has a low rate of complications. The removal usually takes less than an hour and involves anesthesia.

You shouldn’t experience any pain during or immediately after the procedure. After the anesthesia wears off, though, you might feel pain where the wisdom teeth were.

3. Pursue Other Treatments

If your wisdom teeth have fully erupted but aren’t causing any other problems, you might not need to get them removed.

If you have a cavity in a fully erupted wisdom tooth, your dentist can repair the tooth with a filling.

They may also prescribe antibiotics to fight the infection and pain medication to reduce pain.

4. Use Home Remedies for Pain Relief

If you have an infected wisdom tooth, you’ll need to see your dentist for prompt treatment. In the meantime, or if you’ve chosen a different, conservative approach, you can take steps at home to ease your pain.

These include:

• Eating soft foods (avoid anything hot, cold, or spicy that may irritate the tooth)
• Taking over-the-counter (OTC) pain medication, such as ibuprofen, aspirin, or acetaminophen
• Rinsing your mouth with warm saltwater
• Rinsing your mouth with equal parts water and hydrogen peroxide solution
• Applying a small amount of clove oil to the area with a cotton ball or swab

These home remedies shouldn’t replace professional dental care. Your dentist or oral surgeon will likely recommend these remedies if you get your wisdom teeth removed.

Wisdom Teeth Removal Aftercare

After having your wisdom teeth removed, follow your dentist or oral surgeon’s instructions carefully.

The spaces, or sockets, where your wisdom teeth used to be will form blood clots after surgery. These blood clots will need time and gentle care to heal properly and form new, healthy tissue.

Your oral surgeon will likely prescribe antibiotics to keep infection at bay while your mouth heals. Take the medication as directed. They may also give you a pharmaceutical-grade mouthwash, such as chlorhexidine.

You may be in pain for a few days once the anesthesia wears off. In some cases, your dentist or oral surgeon might prescribe you a pain medication.

Your dentist or oral surgeon will probably advise you to avoid the following during recovery:

• Strenuous exercise
• Smoking or vaping
• Drinking through a straw
• Eating hard or crunchy foods

Take these and any other instructions seriously. Otherwise, you’ll risk disturbing the blood clots in the back of your mouth.

If the blood clot in a tooth socket is damaged or dislodged, you may develop a painful condition known as a dry socket. This causes the underlying bone and nerves to be exposed to air, which can lead to infection.

A dry socket is treatable. Still, you can avoid it altogether by following your doctor’s post-surgical instructions.

A week or so after your wisdom tooth removal, pain should subside. You will have a follow-up appointment with your dentist or oral surgeon around this time.

After a few weeks, the blood clots will fully heal and begin to form new tissue. Your dentist or oral surgeon will advise you on when and how to resume regular eating and other habits.