How to Identify the Signs of Wisdom Teeth Eruption

Understand that symptoms are not always present. If the wisdom teeth grow fully, emerging straight through the gum with enough space to grow and aligning properly with the other teeth, they typically do not cause pain or inflammation and do not need to be extracted. Wisdom teeth cause problems and require attention when they partially emerge, lack enough space, come in at an angle, and/or become infected.

• Not everyone has fully erupting wisdom teeth. Sometimes they are entirely covered in the gum and bone, or they may only partially break through.
• The American Dental Association recommends that individuals between 16-19 years old visit a dentist to check their wisdom teeth.
• The longer wisdom teeth remain after 18, the more their roots develop, making extraction more difficult if problems arise.

Note on gum and jaw pain. Even when wisdom teeth emerge normally, they can still cause mild symptoms. Pay attention to any mild pain, a feeling of tightness, or a dull ache in the gums near the throat or in the nearby jawbone. Emerging wisdom teeth may irritate the sensitive gum tissue. The pain can worsen when the teeth are crowded or tilted—this can even tear soft gum tissue. Pain intensity varies; some people only experience slight discomfort, while others may have severe pain. However, mild discomfort can be normal during the eruption of wisdom teeth, so it’s recommended to wait a few days (at least) before visiting the dentist.

• The wisdom tooth eruption process isn’t continuous; you may experience similar pain episodes every 3-5 months for a few days. The process affects the positions of other teeth, which may cause them to shift.
• If the wisdom teeth cannot emerge properly, they may become trapped or pressed tightly in the jawbone, increasing the risk of infection (as explained below).
• Pain from wisdom tooth eruption may worsen at night if you grind your teeth.
• Chewing gum can also intensify the discomfort associated with wisdom teeth eruption.

Observe redness and swelling. Wisdom teeth can also cause the gums to become red and swollen (inflammation). You might even feel the swollen gum tissue with your tongue. Chewing food can become more difficult or uncomfortable when your gums are inflamed. You can check with a mirror and a penlight flashlight inside your mouth. Wisdom teeth are the last (farthest) teeth in each jaw. Look at the top of the emerging tooth through the gum and check if the gum tissue is more red or swollen (gingivitis) than other areas. Swelling typically subsides after about a week.

• When looking in the mirror, you may notice a little blood around the emerging wisdom tooth, or your saliva may appear slightly red. While this is not very common, it’s not too rare either. Other possible causes for bleeding could include gum disease, ulcers, or mouth injuries.
• You may spot a piece of “gum flap” over the emerging wisdom tooth, known as the operculum. This is a natural occurrence and generally doesn’t cause issues.
• Swelling at the back of the gums may make it difficult to open your mouth. You may need to drink liquids through a straw for a few days.
• Swallowing may be hard. Your dentist might prescribe anti-inflammatory medication for you to take for a few days.
• The wisdom teeth on the lower jaw, close to the tonsils, may become swollen, leading you to feel like you’re experiencing a cold or sore throat.

Be cautious of infection signs. Partially emerged wisdom teeth (also called impacted teeth) and tilted teeth significantly increase the risk of infection. These teeth can create small pockets beneath the gum flap, where bacteria can thrive. Common signs of infection include: excessive swelling, severe pain, low-grade fever, swollen lymph nodes along the neck and jaw, pus around the inflamed tissue, bad breath, and a foul taste in the mouth.

• Infected wisdom teeth typically cause a dull ache, occasionally accompanied by sharp, shooting pains.
• Pus, which is grayish-white, forms from the white blood cells of the immune system. These cells rush to the infection site to kill bacteria, and as they die, they form pus.
• Bad breath may also result from food being trapped and decaying beneath the gum flap of the tooth.

Check for misalignment of front teeth. Even when wisdom teeth grow tilted or are trapped in the jawbone, they might not cause significant pain or symptoms. However, over time (even in just a few weeks), wisdom teeth can begin to crowd and push other teeth out of alignment. This “domino effect” can eventually affect the entire dental arch, causing noticeable crooked and shifted teeth. If you notice your front teeth suddenly shifting, compare your smile to old photos of yourself.

• If your wisdom teeth push your other teeth out of alignment too much, your dentist might recommend extracting the wisdom teeth.
• Once the wisdom teeth are removed, your other teeth may gradually align back over the next few weeks or months.

Long-term pain and swelling is abnormal. While mild pain and inflammation for a short period is normal during wisdom tooth eruption, chronic pain is unusual. Fully emerged wisdom teeth typically do not cause significant pain or swelling beyond a few weeks. Persistent severe pain and inflammation lasting more than a few weeks often occurs with impacted wisdom teeth. Impacted wisdom teeth lead to severe/chronic symptoms and may need to be extracted.

• People with small mouths and jaws are more likely to have impacted wisdom teeth, which can cause swelling and pain.
• While impacted wisdom teeth may not directly cause symptoms, they can increase the risk of cavities in surrounding teeth or gums, leading to prolonged pain.
• Whether you visit the dentist depends on your pain threshold and endurance. The general rule is: if the pain wakes you up at night (without medication) for more than 3-5 days, you should see a dentist for evaluation.

Massage the gums with your finger or ice. Use a clean finger (washed) to gently massage the painful gums in a back-and-forth motion or small circular movements to temporarily soothe the discomfort. Be careful not to press too hard as it may damage the gum flap around the tooth and cause additional irritation, swelling, or bleeding. A small ice cube can help reduce inflammation and alleviate the dull pain. The cold temperature may feel like a shock at first, but the tissue around the emerging wisdom tooth will numb within about 5 minutes. You can apply ice 3-5 times a day or as needed to fight the pain.

• Remember to trim your nails and disinfect your finger with alcohol to prevent bacteria from spreading to the gums. An infected wisdom tooth can worsen if hygiene is neglected.
• Ask your dentist about creams or ointments designed to reduce gum sensitivity for massaging inflamed gums.
• Cold compresses or sucking on frozen treats (ice pops, frozen fruit pops) can also help soothe gum pain.

Take over-the-counter painkillers or anti-inflammatory medication. Ibuprofen (Advil, Motrin) is an effective anti-inflammatory that can help reduce pain and swelling related to wisdom tooth eruption. Acetaminophen (Tylenol) is a strong pain reliever and fever reducer, but it doesn’t have anti-inflammatory properties. The maximum dose for ibuprofen and acetaminophen for adults is around 3,000 mg/day, but always read the directions on the medication label.

• Taking too much ibuprofen (or long-term use) can irritate and damage the stomach and kidneys, so it’s important to take it with food.
• Acetaminophen, when taken in excess, can lead to poisoning and liver damage. Never drink alcohol with acetaminophen.

Use antibacterial mouthwash. Antibacterial or antimicrobial mouthwashes can help treat or prevent infections, reduce pain in the gums and teeth. For example, mouthwashes containing chlorhexidine can reduce swelling and pain while preventing inflammation in the mouth. Consult your dentist or pharmacist about over-the-counter mouthwashes. Regardless of the brand, you should swish the mouthwash for at least 30 seconds, making sure to rinse deeply inside the mouth, where your wisdom teeth are emerging.

• Rinsing around the gum flap can also help remove food particles, plaque, or debris in the mouth.
• You can create a natural and inexpensive antibacterial mouthwash by dissolving half a teaspoon of table salt or sea salt in a cup of warm water. Swish for 30 seconds and spit out. Repeat 3-5 times a day or as needed.
• Diluted vinegar, fresh lemon juice, hydrogen peroxide, or a few drops of iodine mixed with water can also serve as effective mouthwashes to prevent mouth infections.
• Wormwood tea is also very helpful in reducing gum inflammation.

• Keep in mind that wisdom teeth do not aid in chewing. The molars and premolars are sufficient to break down food.
• The emergence of wisdom teeth may cause you to bite your cheek or tongue more frequently as they create crowding in your mouth.
• Be aware that persistent headaches might be related to wisdom teeth growth, as they can misalign the bite, causing jaw and skull pain.
• If your wisdom teeth are causing symptoms, you should see a dentist for an X-ray. The X-ray will reveal if the teeth are too tightly positioned, pressing on nerves, or impacting other teeth.

• You may need to have your wisdom teeth removed if you experience: increasing pain, recurring infections, gum disease, tooth decay, damage to other teeth, or misalignment of the teeth, as well as the development of benign tumors.