Wisdom Tooth Pain? Ease It Now, Then Find the Cause.
Wisdom teeth usually come in between about 17 and 25, and not always smoothly. Wisdom tooth pain can come from a swollen flap of gum over a tooth that’s only partly through, from an infection, or, after an extraction, from dry socket, when the blood clot in the socket doesn’t form or comes out. Some of it you can ease at home, and some of it can’t wait. We keep time open every weekday for emergencies here in Spring Hope, so call or text (252) 478-3422 and we’ll do our best to see you the same day.
Written by the Spring Hope Family Dentistry team and reviewed by Dr. Elie Abboud, DDS, based on guidance from Cleveland Clinic, Mayo Clinic, the UK’s National Health Service (NHS) and the American Association of Oral and Maxillofacial Surgeons.
What to Do Right Now
Find your situation below. Not sure which one fits, or it’s getting worse? Call us.
If the gum around a back tooth is sore and swollen
- Rinse 3 to 4 times a day with half a teaspoon of salt in a cup (8 ounces) of warm water. Swish for about 30 seconds, then spit.
- Use an alcohol-free antibacterial mouthwash.
- Keep brushing, gently, all the way to the back.
- Take ibuprofen or acetaminophen as the label directs.
- Call us so we can check it rather than waiting for it to settle, and call right away if you have a fever, pus or trouble opening your mouth.
- Trouble swallowing or breathing, or swelling under your jaw? Call 911.
After a wisdom tooth was pulled
- Bite on gauze over the spot for at least 10 minutes. A little oozing the first night is normal.
- For at least the first 24 hours, don’t rinse hard or brush right next to the spot.
- Hold ice, wrapped in a towel, against your cheek.
- Stick to soft foods.
- Skip straws, smoking, alcohol and very hot drinks.
- Take ibuprofen or acetaminophen as the label directs, unless we’ve told you otherwise.
If it’s getting worse a few days after an extraction
Normal soreness peaks in the first few days and then eases. If the pain gets worse instead, and it’s severe, it may be dry socket, which usually starts 1 to 3 days after the extraction.
Call us rather than waiting it out. With treatment, the symptoms are likely gone within a few days.
About pain medicine: ask a pharmacist or your dentist before combining ibuprofen and acetaminophen. Check with your doctor before taking ibuprofen if you take blood thinners, have had stomach ulcers or bleeding, a heart attack or a stroke, or have heart or kidney disease or asthma. If you’re pregnant or have liver disease, ask your doctor before taking either one. With acetaminophen, use only one product that contains it at a time, and don’t take it if you have three or more alcoholic drinks a day. Don’t give aspirin to anyone under 16 unless their doctor says to. Numbing gels with benzocaine are linked to a rare but serious blood condition, so ask your pharmacist or dentist before using one, and never use them on a child under 2.
Pain in a different tooth, or a swollen face? See our guides to toothache relief and tooth abscesses, or our emergency dentistry page for broken teeth, lost crowns and more.
What Not to Do
After an extraction, the socket should fill with a dark blood clot, and losing it is what causes dry socket. The first few rules protect that clot. The last few are about not waiting on the wrong things.
- Don’t use a straw. Advice ranges from 1 to 2 days to at least a week, so about a week is the safer choice.
- Don’t smoke or use tobacco for at least 48 hours, and longer if you can. Smoking raises your risk of dry socket.
- Skip alcohol and very hot drinks while the socket heals.
- Don’t poke at the socket or the gum flap. And never try to pop a swollen spot on your gum.
- Don’t put aspirin or any painkiller on the gum. It can burn the tissue.
- Don’t reach for clove oil. It can burn the gums, it’s toxic to children if swallowed, and it affects blood clotting.
- Don’t wait on swelling under your jaw or down your neck. Call 911.
- Don’t wait out a fever. A fever of 100.4°F or higher with wisdom tooth pain or after an extraction needs an urgent visit, or the ER if your face is swelling.
ER, Urgent Care or Dentist?
Call 911 or go to the emergency room now if:
- You’re having trouble breathing, swallowing or speaking
- Swelling is spreading under your jaw, down your neck or toward your eye
- You’re drooling, or the floor of your mouth (under your tongue) is swelling
- Your face is swollen and you can’t open your mouth
- You have facial swelling and a fever of 100.4°F or higher
- You feel confused
- Bleeding won’t slow down with firm pressure
- Your jaw won’t close normally, or you think it may be broken
- Jaw pain comes with chest discomfort, shortness of breath or light-headedness. Call 911, since it can be a heart attack.
An infected gum flap over a wisdom tooth can lead to Ludwig’s angina, an infection in the floor of the mouth. It’s rare, but it’s serious. If you’re that sick, don’t drive yourself. Have someone take you, or call 911.
Call us for an urgent visit if:
- Pain or swelling is getting worse instead of better
- Pain comes with a bad taste in your mouth
- You have a fever of 100.4°F or higher, or you just feel unwell
- You see pus around the tooth or the socket
Calling or texting first is fastest, but if you walk in, we’ll fit you in as the day allows. Can’t reach us? If your face is swelling or you have a fever, go to the ER. If it’s pain that medicine isn’t helping, urgent care or the ER can help until we open.
After hours or on a weekend? We’re open Monday 7:30 to 4:30, Tuesday and Wednesday 7:30 to 5:30, and Thursday and Friday 7:30 to 3:30. Outside those hours, text us at (252) 478-3422 and we’ll reply as soon as we’re open. The ER can give you medicine but can’t treat the tooth, so come see us once we open.
Why Do Wisdom Teeth Hurt?
A wisdom tooth that’s stuck and can’t come all the way in is called impacted. Signs include:
- Swollen or bleeding gums at the back of your mouth
- Pain or swelling in your jaw
- Bad breath or a bad taste in your mouth
- Trouble opening your mouth
The swollen gum flap (pericoronitis). When a wisdom tooth is only partly through the gum, a flap of gum can sit over part of it. That flap can get inflamed, and it’s often infected. It usually happens around a lower wisdom tooth, often in your 20s. A bad flare-up can bring severe pain, fever, swelling, pus, pain when you swallow and lockjaw (a jaw that won’t open all the way). Call us right away for any of these. If you can’t swallow, you’re drooling or it’s hard to breathe, call 911.
Will it settle on its own? It may, while the tooth is still coming in. But left untreated it can turn serious, so have it checked if it isn’t settling or keeps coming back.
Dry Socket or Normal Healing?
Some pain after an extraction is normal. Dry socket, the most common problem after one, feels different. Here’s how to tell them apart.
| What you notice | What to do |
|---|---|
| Soreness that peaks in the first few days, then easesNormal healing | Keep up your home care. Full recovery usually takes 1 to 2 weeks. |
| A little oozing of blood the first nightNormal healing | Bite on gauze over the spot for at least 10 minutes. |
| A dark, scab-like clot in the socketNormal healing | Leave it alone. That’s how a healing socket should look. |
| Severe pain starting 1 to 3 days after the extraction, which can spread to your ear, eye, temple or neckPossible dry socket | Call us. This is how dry socket usually starts. |
| A whitish layer over the socket after a few days, with pain that’s easingNormal healing | Leave it alone. That’s healing tissue. |
| Severe pain, plus a socket that looks empty with bone showing, or a bad tastePossible dry socket | Call us. With that kind of pain, these are signs of dry socket. |
| A fever of 100.4°F or higher, pus, or swelling that keeps getting worseNeeds to be seen | Call us for an urgent visit. For anything on the 911 list above, go to the ER. |
Dry socket affects about 2 to 5% of extractions and is more common after wisdom teeth. Smokers are over 3 times as likely to get it. It usually heals in 7 to 10 days, but you don’t have to wait that long. We flush the socket and place a medicated dressing, and the symptoms are likely gone within a few days.
Sources: Mayo Clinic on dry socket, and Cleveland Clinic on dry socket and tooth extraction.
How We Treat Wisdom Tooth Pain
Every case is a little different, but a visit for wisdom tooth pain here usually goes like this.
- 1
We find the cause
We check the tooth and gum and take an X-ray. When a wisdom tooth may sit close to a nerve or the sinus, a 3D scan from our cone beam (CBCT) scanner helps show how close.
- 2
We calm a flare-up
For an infected gum flap, we flush out the space under it and may give you an antibacterial rinse. Antibiotics are an option when needed, and sometimes the flap is removed. A flare-up usually clears in a week or two.
- 3
We take the tooth out when that’s the real fix
If a wisdom tooth keeps causing trouble, we’ll talk with you about removing it. Dr. Abboud and Dr. Hilary usually do wisdom tooth removal right here in the office, and the removal itself often takes just a few minutes, though a harder one takes longer.
- 4
We keep you comfortable
We numb the area before we start. If you’re nervous, laughing gas (nitrous oxide) or oral sedation can help you relax. Our page for nervous patients explains more.
- 5
We help you heal
We’ll go over home care before you leave. Pain usually starts to improve after 1 to 2 days, and full recovery takes about 1 to 2 weeks.
Do Wisdom Teeth Always Have to Come Out?
Not always. Experts disagree about removing wisdom teeth that aren’t causing problems. The NHS in the UK says they’re usually left in place and checked at your regular visits, and Cleveland Clinic says you probably don’t need to remove them. The American Association of Oral and Maxillofacial Surgeons says a wisdom tooth may not need to come out if it’s:
- All the way in
- Doing its job when you bite and chew
- Not causing pain
- Free of cavities and disease
- Surrounded by healthy gums
Even then, it still needs regular cleanings, a yearly checkup and X-rays from time to time. A wisdom tooth that hurts, keeps getting infected or can’t come all the way in doesn’t meet that bar, and that’s when we’ll talk about taking it out. Either way, we’ll tell you plainly what we see.
Frequently Asked Questions
Will wisdom tooth pain go away on its own?
Sometimes. A swollen gum flap over a wisdom tooth may settle while the tooth is still coming in, but left untreated it can turn serious. Dry socket usually heals in 7 to 10 days, though with treatment the symptoms are likely gone within a few days. If the pain lasts more than a day or two, or comes with a fever, pus or swelling, call us.
How do I know if my wisdom tooth is infected?
Watch for a swollen or bleeding gum around the tooth, a bad taste or bad breath, pus, a fever, pain or swelling in your jaw, or trouble opening your mouth. Any of these is a reason to call us. Trouble swallowing or breathing, or swelling under your jaw or down your neck, means call 911.
What does dry socket feel like?
Severe pain that starts 1 to 3 days after an extraction and can spread to your ear, eye, temple or neck. You may notice a bad taste, and the socket may look empty, with bone where the dark clot should be. A whitish layer with pain that’s easing is usually normal healing.
When am I safe from dry socket?
Dry socket usually starts 1 to 3 days after an extraction. According to Cleveland Clinic, if you haven’t had symptoms by day five, you’re likely in the clear. Keep following your aftercare until the spot has healed.
How long should I avoid straws after a wisdom tooth extraction?
Advice varies. The American Association of Oral and Maxillofacial Surgeons says 24 to 48 hours, while Mayo Clinic and Cleveland Clinic say at least a week. The safer choice is about a week, unless we tell you otherwise. Hold off on smoking for at least 48 hours, and as long as you can after that.
Will I be awake for wisdom tooth removal?
Yes. We don’t offer IV sedation or general anesthesia, so we don’t put patients to sleep. If that worries you, you’re not alone. We numb the area first, and we offer laughing gas (nitrous oxide) and oral sedation, a calming medicine you take by mouth, to help you relax. Tell us you’re nervous when you call.
How long does it take to recover from wisdom tooth removal?
Pain usually starts to improve after 1 to 2 days, and full recovery takes about 1 to 2 weeks. Numbness of the lip, tongue or chin can happen. It usually improves, but it can last weeks or months. If your pain gets worse instead of better, call us so we can check for dry socket.
What does it cost to treat wisdom tooth pain?
It depends on what’s causing the pain. For new patients, the emergency exam and X-ray is $99, and VIP Plan members get one emergency exam a year included. If you need treatment, you’ll get the exact price in writing before we start, and we’ll file your insurance for you. Payment plans are available through Cherry, Sunbit and CareCredit.
Do I have to be a patient of yours to be seen?
No. Whether it’s a flare-up or a problem after an extraction, call or text (252) 478-3422, tell us what’s going on, and we’ll do our best to see you the same day. We see emergency patients from Spring Hope, Nashville, Rocky Mount, Wilson and the towns around them.
Wisdom Tooth Pain Treatment for Spring Hope and Nearby Towns
We see wisdom tooth problems from Spring Hope, Nashville (about 10 minutes), Rocky Mount (about 15), Wilson (about 20), Zebulon, Bailey and Middlesex, Bunn, Louisburg, Castalia, Elm City and Lake Royale. Call ahead and we’ll have a room ready.
Wisdom Tooth Flaring Up? Call Us First.
We keep time open every weekday for emergencies, and we’ll do our best to see you the same day.