Swelling associated with wisdom tooth can develop rapidly. What starts as a dull ache at the back of your mouth can turn into a puffy, tender gum by the next day, making it painful to chew or open wide.
Wisdom teeth usually come through between the ages of 18 and 20 and many people won’t have enough room for them to come through fully.1 When a tooth only partly breaks through, food and bacteria get trapped under the gum and it becomes inflamed. This is called pericoronitis, and it is one of the most common reasons patients come to see me with a swollen gum near wisdom teeth.
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Key Points
- Most wisdom teeth swelling comes from inflamed gum over a partly erupted tooth, trapped food or an infection.
- Warm Salt-water rinses, a cold compress and pharmacy pain relief can ease symptoms while you arrange to see a dentist.
- See a dentist promptly if swelling lasts more than two days, keeps coming back, or comes with a fever or bad taste.
- Swelling near your eye or neck, or difficulty breathing or speaking, needs emergency care. Call 000.
- After removal, swelling usually starts to ease after the first day or two.
How to ease wisdom tooth swelling at home
These steps can make you more comfortable while you wait for your appointment. Healthdirect recommends:2
- Rinsing with warm salt water after meals, then spitting it out rather than swallowing.
- Holding a cold compress wrapped in a cloth against your cheek to ease swelling and pain.
- Asking your pharmacist about pain relief, such as paracetamol or ibuprofen, and following the packet directions.
- Keeping the area clean with a soft toothbrush, eating soft foods and resting with your head propped up.
When patients come to see me with a swollen wisdom tooth, I remind them not to place pain-relief tablets, such as aspirin, directly on the gum. “It won’t ease the swelling, and aspirin can burn the gum tissue.” Home care can settle the symptoms for a while, but if food and bacteria keep collecting under the gum, the swelling tends to come back.
When is a swollen wisdom tooth an emergency?
Most wisdom tooth swelling can be managed with a dental appointment with a dentist in Sydney in the next day or two. Some signs mean you shouldn’t wait.2
Call 000 or go to your nearest emergency department if you have:
- difficulty breathing
- difficulty speaking
- swelling spreading towards your eye or down your neck.
See a dentist as soon as possible if:
- the pain and swelling last more than two days or don’t improve with pain relief
- you have a fever (a temperature over 38°C) or feel unwell
- you notice a bad taste, pus or trouble swallowing
- it is hard to open your mouth or bite down.
We see dental emergencies at our Sydney clinics. Book online or call (02) 8007 6727 and let our team know your gum is swollen.
What causes wisdom tooth swelling
Wisdom teeth are the last teeth to come through, and by then there often isn’t much room left. Swelling usually comes from one of four things.
Inflamed gum over a partly erupted tooth
When a wisdom tooth only partly breaks through, a flap of gum can sit over it. Food and bacteria get trapped underneath, where a toothbrush can’t easily reach, and the gum becomes red, sore and swollen. This is called pericoronitis of the wisdom tooth, and it can flare up again whenever food gets trapped.
An impacted tooth
An impacted wisdom tooth is blocked by bone, gum or the tooth in front of it. It may sit at an angle and press against the neighbouring tooth, causing pressure, pain and swelling. Less commonly, a cyst can form around an impacted tooth.
An infection
If bacteria keep building up, an wisdom tooth infection or abscess can develop. Signs include throbbing pain, a bad taste, pus and swelling that spreads into the cheek or jaw. An infection needs dental treatment and won’t fully clear with home care alone. If pain is your main concern, read our guide to wisdom tooth pain.
Healing after wisdom tooth removal
Swelling after an extraction is the body’s normal response to surgery as the area begins to heal. It is expected, and it usually settles with time and good aftercare.
How long does wisdom tooth swelling last?
It depends on the cause.
If the tooth hasn’t been removed, a flare-up of gum swelling may settle within a few days once the area is kept clean. If it keeps returning, have the tooth assessed rather than waiting for the next flare-up.
After wisdom tooth removal, swelling usually starts to improve after the first one or two days, although some swelling and stiffness can last up to two weeks.3 How much swelling you have depends on how complex the extraction was.
Contact your dentist if the swelling is getting worse rather than better after a few days, or if you develop a fever, a bad taste or a firm lump along your jaw. If patients aren’t sure, I always encourage them to call. “I’d much rather check swelling that turns out to be normal healing than have someone wait at home with an infection that’s getting worse.”
Will my wisdom tooth need to come out?
Not always. I examine the area and usually take an X-ray to see the position of the tooth, how much room there is and whether it is affecting the tooth in front.
Removal may be recommended if a wisdom tooth keeps causing gum infections, has decay that can’t be treated, is damaging the neighbouring tooth or is involved with a cyst.1 Patients are often relieved to hear that a swollen wisdom tooth doesn’t automatically mean surgery. “Sometimes cleaning the area and monitoring it is enough. If it keeps flaring up, we’ll talk through whether removal is the right option for you.”
Learn more about wisdom teeth removal at No Gaps Dental.
Frequently asked questions
Can a swollen wisdom tooth go away on its own?
Mild gum swelling can settle within a few days with salt-water rinses and careful cleaning. If the tooth is still partly covered by gum, the swelling often comes back. Swelling that lasts more than two days or keeps returning should be checked by a dentist.
Should I use ice or heat on a swollen wisdom tooth?
Use cold. A cold compress wrapped in a cloth helps reduce swelling. Avoid heat packs on a swollen face unless your dentist has advised them. After an extraction, follow the aftercare instructions you’re given, as some dentists suggest warm compresses after the first 48 hours.
Do I need antibiotics for wisdom tooth swelling?
Not always. Antibiotics may be prescribed when there are signs of a spreading infection, but they don’t remove the cause. If food and bacteria are still trapped under the gum, the swelling can return once the course finishes. Your dentist will decide whether antibiotics are appropriate.
Can a swollen wisdom tooth cause a sore throat or earache?
Yes. Discomfort from a lower wisdom tooth can be felt in the jaw, ear or throat. If swallowing becomes difficult or the swelling spreads down your neck, seek urgent care.
Book a wisdom tooth assessment
Swollen or painful wisdom tooth? Book an assessment with our dentist today, or visit any of our 18 Sydney clinics.
Book online | Call (02) 8007 6727
Important Information
General information only. This article does not replace a dental examination. Whether a wisdom tooth needs monitoring, treatment or removal depends on your individual circumstances, which your dentist will assess.
Any surgical or invasive procedure carries risks. Before proceeding, dentist will explain all the risks so that you can make an informed decision. Sometimes specialist referral may be required if the risk is too high.
Sources & References
- Australian Dental Association — Wisdom teeth
- Healthdirect Australia — Toothache and gum swelling
- NHS — Wisdom tooth removal
This article is written by Dr Kalyan Nalluri of No Gaps Dental Blacktown, Penrith and Wynyard – Sydney CBD clinics.
