Wisdom tooth pain that comes and goes is often due to the tooth partially erupting or gum inflammation. See a dentist.
Why it comes and goes
- Partial eruption: the gum flap repeatedly gets irritated (pericoronitis).
- Food trapped.
- The tooth pushing on neighboring teeth.
- Infection that flares and calms.
Relief
- Warm salt water rinses.
- Ibuprofen.
- Clean thoroughly.
See a dentist
For X-rays and a removal plan.
Emergency
Swelling, fever or difficulty swallowing.
Why third molar pain fluctuates
Wisdom teeth erupt between about ages 17 and 25 and often lack space. Pain comes and goes with pericoronitis (inflamed gum flap over a partly erupted tooth), pressure from impaction, food trapped under the gum, or movement of the tooth through bone. Flare-ups often last a few days and settle, then return.
- About 5 to 6 in 10 young adults have at least one impacted wisdom tooth, according to dental surveys.
- Cysts or infections can form around impacted teeth.
- Referred pain may reach the ear, jaw and head.
Relief and treatment
Rinse with warm salt water (half a teaspoon in a cup), take ibuprofen or acetaminophen as directed and keep the area clean with an irrigating syringe. A dentist may prescribe antibiotics for infection and recommend extraction. Surgery recovery typically takes 3 to 7 days, and dry socket occurs in about 2 to 5 percent of extractions. Seek urgent care for swelling that affects swallowing or breathing, fever, or a swelling spreading to the neck.
Why the pain fluctuates
Wisdom tooth pain may come and go because of partial eruption, trapped food, gum inflammation (pericoronitis) and pressure from neighboring teeth. Flares occur and settle.
Relief
Rinse with warm salt water, use over the counter pain relievers as directed and see a dentist. Extraction is common for impacted wisdom teeth, and recovery takes about 3 to 7 days. Swelling or fever needs prompt attention.
Eruption and infection
Wisdom teeth erupt over months to years. Gum flaps over partially erupted teeth trap bacteria, causing pericoronitis flares that recur every few weeks. Pain may also arise from pressure on the second molar or from a cyst. Impaction rates are highest for lower third molars.
Treatment guidelines
Mild flares: warm salt water rinses, chlorhexidine rinse for a short time, analgesics and cleaning under the flap. Antibiotics are used if fever, swelling or trismus. Extraction is recommended after repeated infection. Recovery includes swelling peaking at 48 to 72 hours, and dry socket occurs in 2 to 5 percent of extractions, more with smoking.
Based on data from the American Association of Oral and Maxillofacial Surgeons
