Wisdom Tooth Inflammation: Symptoms and Treatment Options

Q: Wisdom Tooth Inflammation: Symptoms and Treatment Options

Hello： <br>1. <br>The inflammation around the crown caused by the upper left wisdom tooth has worsened after local scaling, with increasing pain and swelling of pus. <br>There is limited mouth opening and a foul odor, which may indicate acute cellulitis. <br>It is recommended to

Inflammation around the wisdom teeth?

Dear Dr.
Tseng,
Since last year, I have experienced occasional pain in the gum tissue on the outer side of my upper left wisdom tooth.
At first, I didn't think much of it and assumed it was due to excessive heat in my body causing some irritation, which would resolve itself in a few days.
However, in late December, the discomfort escalated to the point where it became difficult to open my lower jaw.
I visited a dentist, who diagnosed me with inflammation around the wisdom tooth.
After a dental cleaning and rinsing with an anti-inflammatory solution, the condition was expected to improve, and I was prescribed a five-day course of pain relief and anti-inflammatory medication.

Unfortunately, the pain intensified after the treatment, and upon returning home, it became increasingly severe, with noticeable swelling in my face.
Although the anti-inflammatory medication provided slight relief the next day, the pain was even worse than before the cleaning, and my face was more swollen, making it difficult to open my mouth.
I also noticed a foul odor.
On the third day, I returned for a follow-up, and the dentist indicated that my condition had progressed to an acute state due to the dental cleaning, and only a minimal amount of cleaning was performed during that visit.

Now, on the fourth day, while the swelling in my face has decreased somewhat, the gum tissue on the outer side of my upper left wisdom tooth remains swollen and painful.
I am unsure of what to do next.

I would like to ask you, Doctor:
1.
Could this be caused by another condition? Is there a need for further examination at a larger hospital?
2.
Is it possible that the inflammation of the gums is severe enough that extracting this wisdom tooth would also be very painful? Is this tooth close to a nerve?
3.
If I do not feel any discomfort in the molars in front of the wisdom tooth, does that mean they are not affected by the inflammation from the wisdom tooth?
I apologize for the lengthy message and appreciate your time and guidance.

Xiao Xiao, 30~39 year old female. Ask Date: 2014/01/05

Dr. Zeng Guanghui reply Dentistry

Hello:
1.
The inflammation around the crown caused by the upper left wisdom tooth has worsened after local scaling, with increasing pain and swelling of pus.
There is limited mouth opening and a foul odor, which may indicate acute cellulitis.
It is recommended to consult an oral surgeon at a major hospital for further evaluation and treatment.

2.
It is advisable to wait until the symptoms of cellulitis resolve and the infection and inflammation subside before extracting the wisdom tooth.

3.
If there is no sensation in the anterior molars, it is possible that the wisdom tooth has not affected the adjacent molars.

Wishing you good health.

Reply Date: 2014/01/05

More Info

Wisdom tooth inflammation, also known as pericoronitis, is a common dental issue that can lead to significant discomfort and complications if not addressed properly. Based on your description, it seems that you are experiencing a severe case of inflammation around your upper left wisdom tooth, which has resulted in pain, swelling, and difficulty opening your mouth. Let's break down your concerns and provide some insights into the symptoms, potential complications, and treatment options.

Symptoms of Wisdom Tooth Inflammation
The symptoms you are experiencing are typical of pericoronitis, which can include:
1. Pain and Discomfort: This can range from mild to severe, often worsening when chewing or applying pressure to the affected area.

2. Swelling: Inflammation can cause swelling of the gums around the wisdom tooth, leading to a noticeable bulge.

3. Difficulty Opening the Mouth: This is often due to swelling and pain, which can restrict jaw movement.

4. Bad Breath: The presence of infection can lead to a foul odor emanating from the mouth.

5. Fever and General Malaise: In some cases, systemic symptoms like fever may occur if the infection spreads.

Potential Complications
1. Spread of Infection: If left untreated, the infection can spread to surrounding tissues, leading to more severe complications such as cellulitis or abscess formation.

2. Impact on Adjacent Teeth: The inflammation can affect nearby teeth, potentially leading to decay or other dental issues.

3. Jaw Issues: Severe inflammation can lead to trismus (lockjaw), making it difficult to open the mouth.

Treatment Options
1. Antibiotics and Pain Relief: It’s common for dentists to prescribe antibiotics to combat infection and pain relievers to manage discomfort. It seems you have already been prescribed these, but if symptoms persist or worsen, it may be necessary to revisit your dentist for a reassessment.

2. Dental Cleaning: Professional cleaning can help remove debris and bacteria from around the wisdom tooth, which may alleviate some symptoms. However, if the inflammation is severe, additional cleaning or treatment may be required.

3. Surgical Intervention: If the wisdom tooth is impacted or if conservative treatments fail, extraction may be necessary. While extraction can be painful, it is often the most effective way to resolve ongoing issues related to wisdom teeth. The pain associated with extraction can be managed with anesthesia and post-operative care.

Addressing Your Concerns
1. Other Conditions: While it is possible for other dental issues to cause similar symptoms, the acute nature of your pain and swelling suggests that the wisdom tooth is the primary culprit. However, if symptoms do not improve or worsen, further evaluation at a dental clinic or hospital may be warranted to rule out other conditions.

2. Extraction Pain: The pain associated with wisdom tooth extraction can vary based on the tooth's position and proximity to nerves. Dentists typically perform imaging (like X-rays) to assess the tooth's position relative to nerves before extraction. If the tooth is deeply impacted, the dentist will take extra precautions to minimize discomfort.

3. Impact on Adjacent Teeth: The absence of symptoms in your molars does not necessarily mean they are unaffected. However, it is a good sign that the inflammation is localized. Regular dental check-ups can help monitor the health of all your teeth.

Conclusion
It’s crucial to follow up with your dentist, especially since your symptoms have not fully resolved. If the pain persists or worsens, or if you develop new symptoms such as fever or increased swelling, seek immediate dental care. Wisdom tooth issues can escalate quickly, and timely intervention is key to preventing complications. Your dentist can provide a tailored treatment plan based on your specific situation, ensuring the best outcome for your dental health.

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