Infected Wisdom Tooth: Signs, Symptoms, and Treatment
Infected Wisdom Tooth: Signs, Symptoms, and Treatment
Wisdom teeth, also known as third molars, are the last set of teeth to emerge in the back of your mouth. Typically appearing between the ages of 17 and 25, these teeth were useful for our ancestors who needed extra chewing power for a coarse diet. Today, however, many people don't have enough room in their jaws for these teeth, leading to complications such as impaction, crowding, and most concerning—infection.
An infected wisdom tooth is a common dental issue that can cause significant discomfort and even lead to more serious health problems if left untreated. Understanding the signs, symptoms, and treatment options for a wisdom tooth infection is essential for timely intervention and improved oral health. This comprehensive guide will walk you through everything you need to know about infected wisdom teeth, from early warning signs to recovery after treatment.
What Is a Wisdom Tooth Infection?
A wisdom tooth infection, medically referred to as pericoronitis, occurs when the tissue surrounding a partially erupted or impacted wisdom tooth becomes inflamed and infected. This usually happens when bacteria and food particles become trapped under a flap of gum tissue covering the tooth. The result is swelling, pain, and sometimes pus formation.
Pericoronitis is most common with partially erupted wisdom teeth—those that have broken through the gums but not fully emerged. This creates a pocket where debris and bacteria can accumulate, making cleaning difficult and increasing the risk of infection.
Common Causes of Infected Wisdom Teeth
Several factors contribute to the development of a wisdom tooth infection. These include:
- Impaction: When a wisdom tooth is unable to fully emerge due to lack of space, it may grow at an angle or remain trapped beneath the gum line. Impacted teeth are more prone to infection because they are harder to clean.
- Poor oral hygiene: Inadequate brushing and flossing around the back teeth allow bacteria to thrive, increasing infection risk.
- Partially erupted teeth: A tooth that has only partially broken through the gum creates a perfect environment for food and bacteria to collect.
- Weakened immune system: Illness, stress, or poor nutrition can lower your body’s ability to fight off infections, making you more susceptible.
- Food impaction: Trapped food particles can irritate the gums and promote bacterial growth.
In some cases, a wisdom tooth infection can lead to more severe complications such as abscess formation, cellulitis (a spreading skin infection), or even systemic infections if bacteria enter the bloodstream.
Early Signs and Symptoms of an Infected Wisdom Tooth
Recognizing the early symptoms of a wisdom tooth infection can help you seek treatment before the condition worsens. Common signs include:
- Pain and tenderness: A dull or sharp ache around the back of the mouth, especially when chewing or biting down.
- Swelling: Puffiness in the gum tissue around the affected tooth, which may also extend to the jaw or cheek.
- Redness and inflammation: The gum tissue may appear redder than normal and feel warm to the touch.
- Bad breath (halitosis): Bacteria buildup can cause persistent bad breath or a foul taste in the mouth.
- Difficulty opening the mouth: Swelling and pain may make it hard to fully open your jaw.
- Swollen lymph nodes: Lymph nodes under the jaw or in the neck may become tender and enlarged as your body fights the infection.
- Fever: In more severe cases, a low-grade fever may accompany the infection.
- Pus discharge: A visible pocket of pus near the tooth is a clear sign of infection.
Some people may also experience headaches, earaches, or pain that radiates to the jaw, neck, or throat. These symptoms can mimic other dental or medical conditions, so it’s important to get an accurate diagnosis from a dentist.
When to See a Dentist
If you’re experiencing any of the above symptoms, especially persistent pain, swelling, or pus, you should see a dentist as soon as possible. Delaying treatment can lead to worsening pain and potentially serious complications.
Seek emergency dental care if you experience:
- High fever
- Difficulty breathing or swallowing
- Severe swelling that affects your face or neck
- Spreading redness or warmth in the skin
These symptoms could indicate a spreading infection that requires immediate medical attention.
How Dentists Diagnose a Wisdom Tooth Infection
A dentist will typically begin with a thorough oral examination to assess the affected area. They will look for signs of swelling, redness, pus, and gum flaps around the wisdom tooth. In many cases, a dental X-ray is necessary to determine the position of the tooth and whether it is impacted.
The X-ray also helps the dentist evaluate:
- Whether the tooth is fully or partially erupted
- The angle at which the tooth is growing
- Damage to adjacent teeth
- Potential cysts or tumors (rare)
Based on the clinical findings and imaging, the dentist will diagnose pericoronitis and determine the best treatment approach.
Treatment Options for an Infected Wisdom Tooth
Treatment for an infected wisdom tooth depends on the severity of the infection and whether the tooth can be saved or needs to be removed. Options include conservative management for mild cases and surgical intervention for more severe or recurrent infections.
1. At-Home Care and Medications
For mild infections, your dentist may recommend the following at-home remedies to manage symptoms and reduce inflammation:
- Warm saltwater rinses: Rinsing your mouth with warm salt water (1/2 teaspoon of salt in 8 ounces of warm water) several times a day can help reduce swelling and flush out debris.
- Antibacterial mouthwash: Over-the-counter rinses containing chlorhexidine or hydrogen peroxide may help control bacterial growth.
- Over-the-counter pain relievers: Medications like ibuprofen (Advil) or acetaminophen (Tylenol) can help manage pain and reduce inflammation.
- Good oral hygiene: Gently brushing and flossing the area can help prevent further buildup of bacteria.
These measures are temporary and only effective for mild cases. They do not eliminate the underlying cause and are not substitutes for professional care.
2. Antibiotics
If the infection is more advanced or spreading, your dentist may prescribe antibiotics to clear the infection before proceeding with further treatment. Commonly prescribed antibiotics include:
- Amoxicillin
- Clindamycin (for patients allergic to penicillin)
- Metronidazole (often used in combination with other antibiotics)
It’s crucial to complete the full course of antibiotics as prescribed, even if symptoms improve early. Stopping antibiotics prematurely can lead to antibiotic resistance and recurrent infection.
3. Surgical Procedures
In most cases, especially with recurrent infections or impacted teeth, the definitive treatment is extraction—the surgical removal of the wisdom tooth.
Wisdom tooth extraction is one of the most common dental surgeries. The procedure typically involves:
- Local anesthesia to numb the area
- Incision in the gum tissue to expose the tooth
- Removal of bone if necessary
- Extraction of the tooth (sometimes in pieces for impacted teeth)
- Cleaning of the socket and placement of gauze to control bleeding
- Suturing the wound (in some cases)
For more complex cases, a referral to an oral surgeon may be necessary. The entire procedure usually takes less than an hour per tooth.
4. Operculectomy (Gum Flap Removal)
In some instances, if the wisdom tooth is expected to fully erupt and there’s no impaction, the dentist may recommend an operculectomy. This minor surgical procedure involves removing the flap of gum tissue covering the tooth to eliminate the pocket where bacteria can collect.
While this can relieve symptoms temporarily, it does not address impaction and may not prevent future infections. Extraction is often still recommended in the long term.
Recovery After Wisdom Tooth Extraction
Recovery time after wisdom tooth removal varies depending on the complexity of the extraction and individual healing factors. Most people recover within 3 to 7 days, but full healing of the gums and bone may take several weeks.
Immediate Post-Operative Care
After surgery, follow your dentist’s instructions carefully to promote healing and prevent complications such as dry socket.
- Bite on gauze: Apply gentle pressure to the extraction site for 30–45 minutes to control bleeding.
- Avoid rinsing for 24 hours: Do not brush, spit, or use mouthwash for the first day to protect the blood clot that forms in the socket.
- Use ice packs: Apply ice to your cheek for 15 minutes at a time during the first 24 hours to reduce swelling.
- Eat soft foods: Stick to soups, yogurt, mashed potatoes, and smoothies for the first few days.
- Avoid straws and smoking: The suction from straws or smoking can dislodge the blood clot, leading to dry socket.
Pain Management
Your dentist may prescribe pain medication or recommend OTC options. Follow dosage instructions and take medications with food to avoid stomach upset.
When to Contact Your Dentist
Contact your dentist if you experience:
- Severe pain that doesn’t improve with medication
- Swelling that worsens after 2–3 days
- Pus or foul odor from the extraction site
- Signs of fever or chills
- Difficulty breathing or swallowing
These could be signs of infection, dry socket, or other complications.
Complications of Untreated Wisdom Tooth Infections
Ignoring a wisdom tooth infection can lead to serious health issues. Potential complications include:
- Dry socket (alveolar osteitis): A painful condition that occurs when the blood clot at the extraction site dissolves or dislodges, exposing the bone and nerves.
- Abscess formation: A pocket of pus that can destroy surrounding bone and tissue.
- Cellulitis: A bacterial skin infection that can spread rapidly and may require hospitalization.
- Sepsis: A life-threatening systemic infection that occurs when bacteria enter the bloodstream.
- Cysts or tumors: Rarely, fluid-filled sacs or growths can form around impacted teeth, damaging the jawbone and adjacent teeth.
- Tooth decay and gum disease: Infection and poor hygiene around the wisdom tooth can affect neighboring teeth.
Early treatment is key to avoiding these complications and preserving your overall health.
Preventing Wisdom Tooth Infections
While not all wisdom tooth issues can be prevented, there are steps you can take to reduce your risk of infection:
- Regular dental check-ups: Visit your dentist every 6 months for cleanings and evaluations. Early detection of wisdom tooth problems allows for timely intervention.
- Good oral hygiene: Brush twice a day, floss daily, and use an antibacterial mouthwash. Pay special attention to the back of your mouth.
- Use a water flosser: A water flosser can help clean hard-to-reach areas around partially erupted wisdom teeth.
- Follow dentist recommendations: If your dentist suggests removing your wisdom teeth, don’t delay. Proactive extraction can prevent future infections.
- Healthy diet: A balanced diet