Your wisdom teeth don't normally bother you but they've been feeling swollen since yesterday. What could've caused that and is there anything that you could do to help bring the swelling down? Is this pain going to go away on its own or do you need to seek professional help?
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Why do wisdom teeth swell up?
The primary reason for wisdom teeth swelling is usually due to food that is trapped or lodged around the gums. Stuck food that is unable to be removed will eventually to inflammation, swelling, and possible infection.
After all, food is a foreign body and is not a natural part of your mouth. Imagine if you had dirt that was stuck to your body for days. That could very well lead to some sort of an infection and the food in your mouth is no exception.
This is why practicing good oral hygiene is of utmost importance. However, there are a couple of reasons as to why wisdom teeth have a propensity to swell up a little bit more often than your regular teeth.
Difficult to clean
Your wisdom teeth are literally the last teeth to erupt into your mouth. Consequently they're also positioned as the furthest back most teeth in your mouth. That only complicates your oral hygiene since it means that they'll be more difficult to clean due to their positioning and that increases their risk in swelling up.
Here is a picture showing the upper arch where the upper wisdom teeth are located:
In case you weren't completely convinced, here is a photo showing how far back the lower wisdom teeth are:
The point that we're trying to make with these two photos is that the wisdom teeth are positioned so far back in your mouth that they're difficult to see. If they're difficult for even your dentist to see, it's probably even more difficult for you to see and reach.
When you can't really see the teeth too well, you're probably not cleaning them thoroughly enough. Brushing will be a challenge but flossing will be an even greater challenge. Most people have enough trouble flossing their regular teeth as is but you add in how far back they are, it makes it nearly impossible for those with less adept manual dexterity to do it!
You know what they say, out of sight means out of mind. It's not uncommon for people to accidentally skip brushing their wisdom teeth because they're just not aware of how far back they are. What happens is that they don't push their toothbrush far back enough to reach them.
That just makes them all the more prone to trapping food that gets stuck in the gums for days. Eventually the gums become inflamed or infected, thus leading the gums to become swollen around the wisdom teeth.
Fully erupted wisdom teeth are already difficult to keep clean due to how far back they are positioned in the mouth. Partially impacted wisdom teeth are even more difficult to clean. There is the added challenge of the tooth being partially submerged underneath the gums since they're impacted.
Here is a picture of a partially impacted third molar. The gums on the back portion of the tooth are still covering the top of the crown. The front half of the tooth is fully erupted though.
If you have a situation like the photo above, it is quite easy for food to sneak in underneath the gums towards the back of the tooth. That makes it prone to trapping not only food but also plaque. If you don't manage to clean out any debris that may be trapped there, you will experience some wisdom tooth swelling if the situation drags on for long enough.
Here is a picture of an upper wisdom tooth that is partially impacted. In this picture, the back half of the tooth is fully erupted but the front portion of it is not. The front part is still partially covered by some of the gums.
The photo above is just to show you that it can happen to the top and bottom wisdom teeth. The position of where the gums cover the teeth may also vary. However, it is usually due to the portion of the gums which are covering the impacted tooth which ends up being the main culprit for the swelling. After all, that is where the food and plaque gets trapped and that eventually leads to inflammation.
Gum flap over wisdom tooth
Impacted wisdom teeth do tend to trap more food and plaque but there are times where the gums which cover the back portion of it become very loose. If your wisdom teeth have this, we call it a gum flap (operculum) since the gums can literally flap over the tooth if you try to manipulate the tissue.
Here is a picture of what a gum flap over a wisdom tooth looks like:
In the picture above you can see that the gum flap over the wisdom tooth is already swollen. The gums look red and very inflamed looking as is. The reason is because when the gums are loose and flap over the tooth, it becomes particularly prone to trapping food and plaque. The risks of your wisdom tooth becoming inflamed and swollen increases drastically if you have this condition.
Learn more: If you wanted to see more pictures of real wisdom teeth, we have an entire collection of them here! They were all taken at our long island city dental practice.
Just so that you know, normal teeth don't typically develop a gum flap. Only partially impacted wisdom teeth have the potential to develop it. Although not all impacted ones end up developing it so it really depends on your specific situation. If you do happen to end up getting it, it is definitely worse and more prone to swelling than regular impacted ones.
In case you thought only fully erupted and partially impacted wisdom teeth can cause problems, you'll be quite surprised that fully impacted ones are of no exception. When they're fully impacted inside of your jaw bone, there is a potential for the wisdom teeth to develop a cyst (dentigerous cyst) and that causes your entire jaw to become swollen.
Here is what a dentigerous cyst looks like on a panoramic x-ray. It is a big dark circle that surrounds the impacted molar.
This type of wisdom tooth swelling involves more than just the gums surrounding the tooth. The entire jaw bone will swell up in addition to the gums over that area. If left untreated it will make the affected side of the face become swollen as well. After all it is cyst.
It is a much more serious condition than the wisdom teeth swelling that is associated with erupted and partially impacted wisdom teeth.
In order to treat this, a general dentist will not be able to help you. You must see a specialist, an oral surgeon in order to have this treated. They will not only remove the tooth but most likely biopsy it as well. In other words, do not delay care by trying to wait it out to see if it'll go away on its own because it definitely won't.
You must see a dentist immediately.
How to reduce wisdom teeth swelling
The definitive way to get rid of wisdom teeth swelling is by having your dentist extract them. However if you're unable to do that at the moment, here are a couple of ways on how to decrease the swelling that is caused by your wisdom teeth.
How to reduce the swelling from wisdom teeth:
Brush and floss your teeth as best as you can.
Use a water flosser to flush out the gums surrounding the wisdom tooth.
Rinse vigorously with a mouth rinse. Repeat multiple times a day.
Take an NSAID, which is an anti-inflammatory as well as a painkiller like ibuprofen.
Use a cold compress to reduce the swelling and to numb the area.
Avoid eating foods that irritate it and ones which easily gets trapped in the gums.
The basic principle behind getting the wisdom teeth swelling to come down is to first remove the offending agent and then follow up with palliative care to manage the swelling. Of course, you should baby the tooth for awhile so that it doesn't end up happening again. What we mean by that is to avoid offending foods and chew a little less on that side.
A lot of the techniques and principles mimics what you should do whenever you get food stuck in the wisdom tooth hole. That is when you finally get the tooth extracted, that empty socket will become a major food and plaque trap!
Brushing and flossing
One of the simplest and most basic way to remove trapped food or plaque around your wisdom tooth is with a toothbrush and some floss. That has always been and always will be the standard for maintaining good oral hygiene.
Make sure you can visualize the third molar and brush it as best as you can. You should also aim the toothbrush towards the gumline and brush there as well. That is actually where the food gets trapped so you should focus your attention towards the gumline. It'll offer the highest chance of getting out the stuck food.
If you can't see the tooth, you'll have to do it by feel. Our only advice is to try to push the toothbrush a little bit further back even if you think you've got far back enough. We tend to see a lot of cavities on the back most portion of the molar since people tend to miss that spot.
The flossing will be difficult but try your best to floss in between the wisdom tooth and the molar in front of it. We understand that it's really far back and difficult to reach. If the string is not working for you, you can try the floss picks instead.
Water flosser - oral irrigation
The water flosser can work wonders for flushing out the gums since it shoots high pressured water. It is great for removing plaque and food which may be trapped in the gums around the molar.
It is particularly effective if you have a gum flap over the wisdom tooth because you can literally aim the water flosser underneath that flap of gum. Then all you have to do is hit the button to flush it out a couple of times.
Of course that all depends on whether or not you're able to see the wisdom tooth. It may be a little difficult due to its positioning and how far back it is. If you can't see it nor reach it, this technique may not be as effective for you.
Rinsing vigorously with a mouthwash of your choice can help dislodge food and plaque that may be trapped around your swollen wisdom tooth. This is actually the primary way for preventing food from being stuck in a wisdom tooth hole after an extraction.
The photo above is what the wisdom tooth hole looks like immediately after an extraction. The preferred method for preventing food from being stuck in there is with a vigorous salt water rinse. If rinsing can remove food that is stuck that deep down into the hole, it will certainly be able to remove food that may be stuck on a fully erupted tooth that is above the gum line.
Types of mouthwashes you can try:
Chlorhexidine - RX mouthwash
Those are just some of the mouth rinses you can use but there are a lot more. You can use whatever rinse you want. Some people prefer an essential oil rinse and will make their own using either oregano, thyme, cloves, etc.
Which rinse you use is not as important as making sure you rinse VIGOROUSLY. It is rinsing forcefully that makes it effective. A gentle rinse will not be able to effectively dislodge any stuck food.
Take an NSAID
In addition to trying to remove any stuck food or plaque, you can also take an over the counter NSAID. This medication is a non-steroidal anti-inflammatory and as its name states, it will fight inflammation. A commonly used NSAID for dental problems is ibuprofen.
Since the wisdom teeth swelling stems from inflammation around the gums, the NSAID will help to reduce some of it. In addition to that it'll also help relieve some of the tooth pain so you'll be killing two birds with one stone.
Please be aware that pain medication should not be taken long term so if your wisdom tooth swelling is lasting more than a few days you really should seek help. In fact, if you can see your dentist right away you'll be able to get rid of the swelling a lot faster rather than trying to DIY at home. We recommend seeking professional help first and foremost.
One of the most basic first aid care is to use a cold compress for any type of swelling or bruising. Your swollen wisdom teeth are no exception to this rule. You can easily pick up an ice pack or a compress. If you can't, you can just make your own as well.
How to make your own cold compress:
Place a couple of ice cubes inside a plastic bag.
Wrap a paper towel around the plastic bag.
How to use a cold compress:
Place cold compress on affected side of the face for 10-15 minutes.
Remove for 10-15 minutes.
Repeat steps 1-2 as needed.
The pressure from applying the cold compress helps to control and bring down the swelling. While it is doing that, the cold will also help to numb the area thus offering you some temporary pain relief.
In lieu of using a compress you could also use some ice cubes or ice chips. You can try to apply it directly around the inflamed gums around your wisdom tooth to see if it helps Although if the cold is too much, you can just stick with the compress!
Avoid irritating foods
You may find that certain foods will irritate the swollen gums around the wisdom tooth more than others. You should avoid or at least minimize the consumption of such offending foods.
In our experience, it tends to be the really acidic foods that will aggravate the swelling such as sweet, spicy, hot, or sour.
You should also avoid foods that are small, hard, and sharp that can get lodged in your gums. This will only exacerbate the wisdom teeth swelling if it happens.
Common foods that may get lodged:
Tortilla chips or any type of hard chips
When to seek professional help
If you're worried or unsure about your wisdom teeth swelling, you should find a dentist immediately. It makes no sense to wait on a problem while hoping that it'll go away on its own. The truth is that problems rarely if ever go away on their own. Thus, you should just make an appointment with your dentist and it'll at least assuage all of your fears.
If you're certain that your wisdom tooth swelling stems from lodged food or plaque... you may attempt to dislodge it yourself. Feel free to give the methods above a try but if it still feels swollen after 2-3 days, you should definitely go see a dentist.
If it is not improving it makes no sense to let the problem persist and fester for an entire week. Having chronic inflammation in your mouth is not healthy for your mouth nor your body. Your dentist will be able to get rid of the swelling much more effectively and efficiently than you'll ever do. It's time to go in to see them.
It is fairly common for wisdom teeth to swell up because they're so far back in the mouth that it makes it difficult to keep them clean. They also develop conditions such as a gum flap if they're impacted and that only exacerbates the potential for trapping food, which makes it even worse.
Last but not least, if your wisdom teeth tend to become swollen quite often it may mean that it'll be more beneficial for you to have them removed. If you happen to be around the NYC area, our office does offer wisdom teeth removal in Long Island City, NY. If not, you should find a dentist close by to you!