Wisdom tooth pain
Synonyms
Dens serotinus, Dens sapiens
introduction
Wisdom teeth have a variety of shapes and roots, they can have up to five cusps and several roots, some of which are fused together.
Wisdom tooth pain can arise from various causes, which will be discussed below. With wisdom teeth that have already erupted, oral hygiene is often difficult because of the deep position. Crowned wisdom teeth are therefore not uncommon.
Causes - an overview
These causes can lead to wisdom tooth pain:
- Breakthrough of the wisdom teeth
- Inflammation of the wisdom tooth
- Caries
- Inflammation of the gums in the area of the wisdom tooth
- Wrong position in the jaw
- Displacement of teeth due to lack of space
Read more on the topic:
- Causes of Toothache
- Caries on the wisdom tooth
Breakthrough of the wisdom teeth
The eruption of a wisdom tooth in the upper jaw usually takes place without problems and pain, in the lower jaw, however, there can often be difficulties in tooth eruption.
This is mainly due to the fact that they are placed at the end of the jaw, in the area of the lower jaw angle, and for many people there is no space for another tooth. In the course of this problem it can happen that a wisdom tooth can either only partially (partial retention) or not at all (complete retention) emerge from the bony jaw.
In some cases the eruption of a wisdom tooth leads to the displacement of the other teeth, which is primarily perceived as an aesthetic problem, but usually also causes pain.
However, it has not yet been fully clarified whether the displacement of the teeth is really caused by the wisdom tooth or whether there are other causes for this phenomenon. The fact that asymptomatic wisdom teeth are removed purely as a precaution in many patients with very small jaws is therefore mainly based on speculation or potential pain from the wisdom tooth.
Teeth that do not come out of the jaw at all due to the lack of space usually do not cause any problems, they do not cause pain and / or inflammation and can often stay in place.
An only partially erupted wisdom tooth, on the other hand, can lead to serious problems and corresponding pain.
Aching gums on the wisdom tooth
If the wisdom tooth is inflamed or is currently in the eruption, the surrounding gums can also be affected and provide information about the state of health of the wisdom tooth. The most common reaction of the gums is inflammation and swelling in the wisdom tooth area.
Read more on the topic: Discomfort on the wisdom tooth
Furthermore, tooth bags can arise. A tooth pouch is imagined as covering the crown of a tooth, which is a normal condition during tooth development. Later important parts of the tooth (including the dental cement) develop from it. If the wisdom tooth has not yet fully erupted, but only partially, you can usually make out gum pockets in which bacteria accumulate, attack the tooth and cause inflammation.
The probing depth is increased. This is measured with a special periodontal probe, which has a black band for marking and is provided with a small ball on the front. You can easily identify the inflamed area yourself by carefully running your tongue or finger over the area where the tooth is growing. If you look in the mirror, you can see that the gums are reddened at this point. If you see these signs, you should see a dentist.
You might also be interested in: Inflamed wisdom teeth
Jaw pain from the wisdom tooth
There can be many different causes if pain occurs in the jaw. An exact localization of the cause is often difficult and requires a certain skill on the part of the practitioner. In addition to tooth extraction, periodontal disease or TMJ problems, an erupting wisdom tooth can also cause this type of pain.
The pain that occurs when the teeth break through can sometimes also radiate diffusely into the surrounding tissue.
In the worst case, the symptoms can even lead to a jaw clamp. This means that the mouth can no longer be opened properly. The dentist should be visited immediately in order to initiate therapy.
Read more on the topic: Jaw clamp
therapy
How can you relieve the pain on the wisdom tooth?
A wisdom tooth inflammation usually causes great pain for the patient, which makes it impossible to sleep at night. They can radiate all over the jaw and up to the ear. Painkillers are often used to relieve pain. Ibuprofen should be the drug of choice in this case. Paracetamol can alternatively be used.
Read more on the topic: Ibuprofen for toothache
You should not take drugs that contain the substance acetylsalicylic acid, such as in aspirin, as this inhibits blood clotting. If a wisdom tooth is removed, the doctor must be informed about the ingestion, as heavy bleeding can occur during and after the operation.
Read more on the topic: Pain relievers for toothache
However, the pain relievers only relieve symptoms temporarily, should not be used over a long period of time, and a visit to the dentist is advisable if the pain persists as the problem requires treatment. Adequate oral hygiene should also be ensured during the pain period.
As an alternative to painkillers, you can get lozenges from the pharmacy, which have a slight numbing effect. There are also remedies that can be applied directly to the painful area to provide relief.
Read more on the topic: Toothache - What To Do?
Home remedies for aching wisdom teeth
In addition to good oral hygiene, cooling is the most important home remedy for pain. The cold causes blood vessels to contract and the inflammatory effect is slowed down. This also relieves pain. A cold pack held against the cheek from the outside makes the pain a bit more bearable and is also a good choice in the fight against swelling.
Warmth, on the other hand, should be avoided as it allows the bacteria to multiply much better. The cooling should always be applied alternately with an equally long cooling break.
Rinsing with a salt water solution is also extremely popular. Sea salt dissolved in warm water is left in the mouth for 30 seconds and gargles with it. Afterwards, spit out the water and do not swallow it. This also inhibits inflammation.
Therapy with cloves also has a long tradition. This can be bitten as close as possible to the affected area.
Furthermore, relief should occur if you put savoy cabbage leaves in an envelope and press it from the outside onto the painful area.
If you have chamomile or sage on hand, a tea brewed with it can also achieve small successes in combating pain that are also bearable in terms of taste.
The onion has a similar effect. In addition to being anti-inflammatory, it also has an antiseptic effect and can therefore fight bacteria. It is advisable to chew a raw slice of onion so that it works. But also when crushed and wrapped in a cloth, it develops its healing power when pressed against the cheek.
In addition to many other drugs, tea tree oil should also be mentioned here. It has a similar effect to cloves and should be diluted with water as a mouthwash solution.
Read on under: Home remedies for toothache
Which homeopathic remedies help against wisdom tooth pain?
As homeopathic remedies for toothache, there are Schüssler salts on the one hand, and various globules on the other. Silicea D12 is said to be particularly effective against toothache. Pain radiating to the ears can be combated by taking the tablets at a specific interval.
With the globules, arnica helps well against swollen cheeks, belladonna with sudden, throbbing or pounding pain in the gums. These remedies can be tried for a couple of days at the beginning of the pain. If the symptoms and pain do not decrease, a visit to the dentist is strongly recommended.
Wisdom tooth extraction or wisdom tooth surgery
A wisdom tooth is quite often removed before the eruption, in a surgical procedure (OP) with opening of the jaw.
The attachment of third molars, however, is not found in every human being; in many, not all or even none of the wisdom teeth are formed.
You can find more information at: OP on wisdom tooth and pull wisdom tooth
However, it is also possible to remove a wisdom tooth that is still completely or partially within the jaw.
Especially in very young patients, the roots are not yet fully developed and the surgical removal of the wisdom tooth is somewhat more difficult.
In the first few days after surgery on the wisdom tooth, swelling and bruising often occur, but these can be dealt with quickly by carefully cooling the cheeks.
When cooling, you should make sure that a thin towel or something similar is placed around the cold pack.
Read more on the topic: Swelling after a wisdom tooth operation
Pain is also not uncommon after the procedure. The patient can remedy himself with mild pain relievers, but should be careful not to take any blood-thinning painkillers (e.g. aspirin). In general, sport or other physical activity should be avoided after the operation.
In addition, some patients report problems opening their mouths wide.
Pain after the operation
In many cases, the wisdom teeth are removed to relieve the pain and inflammation. But even after such an operation, pain can occur which, as long as it subsides over time, is part of the normal healing process.
The healing time and the associated time in which pain can still occur depends on the degree of difficulty of the procedure performed and also on the patient's sensitivity to pain. However, if the pain persists, it is advisable to consult the attending physician in order to rule out complications after such an operation, such as alveolitis sicca.
Read more on the topic: Inflammation after a wisdom tooth operation
The upper jaw is better supplied with blood than the lower jaw, so that the incidence of pain in the upper jaw is less frequent than in the lower jaw. After such an operation, the patient is often prescribed a joke medicine by the dentist as a preventive measure, which can be taken at home if the pain is too severe and which makes the healing process more bearable. Cooling the cheek from the outside also has a beneficial effect in this case, as does drinking chamomile or sage tea.
Learn more about this in the main article: Pain after wisdom tooth surgery
Jaw pain after wisdom tooth surgery
The difficulty of removing wisdom teeth depends on the individual situation. Some teeth have already erupted completely and are easier to remove, i.e. those that are still in the jawbone.
When removing the teeth from the lower jaw, more bone tissue has to be removed than in the upper jaw, as the bone that covers it is thinner there. The applied incision is also smaller in the upper jaw.
However, the wound closure is somewhat slower in the upper jaw. Usually the amount of bone substance does not regenerate, but this does not cause any further problems. This is especially the case if you had to accept an opening of the maxillary sinus due to the removal.
In the lower jaw, there is more of a risk of nerve damage, so the tongue or lower lip can be numb for a period of time. The wisdom teeth represent a weak point in the lower jaw. A jaw fracture can occur immediately after removal or up to four weeks afterwards. But this is really rare and osteoporosis (bone loss) is often responsible. In order to keep the risk of this as low as possible, food that is too hard should be avoided in the initial period after the operation.
Summary
In summary, a patient who experiences pain in the wisdom teeth area should see a dentist as soon as possible.
This will usually take an X-ray (ortopanthomogram) and assess the position of the wisdom teeth.
As a first aid against pain, the affected patient can take light painkillers and / or cool the jaw. The use of creams containing chamomile can also have an anti-inflammatory effect and in this way relieve pain.
