What to do if a wisdom tooth is cutting and hurts

Wisdom teeth, or third molars, usually begin to erupt between the ages of 17 and 25. However, the eruption period of wisdom teeth can vary depending on individual characteristics. The number of third molars can also differ: some people may have all four teeth erupt, others – only two, and there are cases when wisdom teeth are not genetically present at all.

The presence of third molars is due to the fact that ancient human ancestors needed to chew tougher food. However, dietary changes and evolutionary changes in the jaw have led to the fact that “eights” are no longer necessary. Moreover, sometimes the jaw structure causes wisdom teeth to lack sufficient space and erupt atypically.

Symptoms of wisdom tooth eruption

When a wisdom tooth is erupting, the symptoms can indicate either physiological or atypical eruption. At the same time, pain when a wisdom tooth is erupting is not an absolute indicator that the process is not physiological.

A wisdom tooth erupts physiologically (normally) if behind the last teeth (second molars) the following appear:

• swelling;
• puffiness;
• the crown of the tooth is visible;
• there is minor pain.

It is often said that if a wisdom tooth is erupting and it hurts, this is normal. And indeed, pain during wisdom tooth growth can occur even during physiological eruption. However, it is very important to properly differentiate the level of pain. If the pain is such that you can forget about it or be distracted from it, then this level can be considered acceptable.

VAS Pain Scale

If the pain during wisdom tooth eruption on the VAS scale is no higher than three, there is no reason for particular concern. However, it still makes sense to see a dentist for examination and diagnostics. It is important to take an X-ray and make sure that the third molars are positioned correctly and will not interfere with other teeth. The dentist may also decide to perform an operculectomy to ease the eruption.

Symptoms of atypical wisdom tooth eruption

There are many variants of atypical wisdom tooth positioning. Quite often, “eights” can lie at various angles, press their crown against the neighboring tooth, erupt only partially, or be tilted towards the palate, tongue, or cheek. In such cases, severe pain during wisdom tooth eruption is inevitable.

Symptoms of atypical eruption:

• intense pain above four on the VAS scale;
• general weakness, malaise;
• elevated body temperature;
• headache, less commonly – neck pain.

If a wisdom tooth is erupting and hurts quite severely, it is necessary to immediately see a dentist. The doctor will take an X-ray, and if atypical positioning of the “eight” is confirmed, the tooth will need to be extracted.

It is important to note that you should not wait for full eruption before extraction. An atypically positioned wisdom tooth can and should be removed while still unerupted. This will help avoid bone and neighboring tooth damage, and will also relieve the patient of pain.

If the doctor has determined that a wisdom tooth is erupting in an atypical position, extraction (removal) is performed:

• the mucosa is incised;
• the tooth is sectioned into several parts;
• the tooth parts are removed;
• the wound is sutured.

Sectioning of the tooth is necessary for atraumatic extraction, although in some cases this can be avoided. At “Osadchyi Dental Clinic” we use a piezotome (a device that uses ultrasound to affect only tooth and bone tissues without injuring the gums, blood vessels, and nerves), which allows us to section the tooth without damaging soft tissues. The procedure is performed under local anesthesia – painlessly.

We recommend our patients to address third molars proactively. Even before a wisdom tooth begins to erupt, an X-ray can be taken and the clinical picture assessed – this is safer and less traumatic.

Conclusions:

1. Do not wait for the wisdom tooth to start erupting. You can see a specialist long before pain occurs.
2. If a wisdom tooth is already erupting and hurting, this is not a reason for panic. You should assess the level of pain and see a specialist.
3. If a wisdom tooth is erupting and the pain is moderate, eruption can be eased with an operculectomy.
4. Wisdom tooth extraction is possible even before full eruption, and it is a painless and less traumatic procedure.