How to Manage an Infected Wisdom Tooth

Identify the Symptoms. Pericoronitis occurs when the tissue around the wisdom tooth becomes inflamed and infected. This condition arises when only part of the wisdom tooth has emerged through the gum, or when the crowding of nearby teeth prevents proper cleaning or flossing. To determine whether your wisdom tooth is infected, look for these signs and symptoms:

• Red or inflamed gums, often with white spots. The area around the tooth may also be swollen.
• Moderate to severe pain in the jaw that makes eating difficult. You might even notice a small swelling on your cheek, which feels warm to the touch.
• A metallic taste in your mouth due to blood and pus accumulation at the infection site. This can also cause bad breath.
• Difficulty swallowing or opening your mouth, indicating that the infection has spread from the gums to surrounding muscles.
• Fever. A body temperature over 37.8°C suggests you have a fever, meaning your body is fighting the infection. In severe cases, muscle weakness may also occur. If you experience these symptoms, it is essential to visit a dentist or doctor immediately.
• In some cases, the infection can affect the tooth's root, which may require the dentist to extract the tooth.

Rinse with salt water. Salt is a natural disinfectant, and rinsing with salt water can help eliminate bacteria in your mouth. Mix ½ to 1 teaspoon of salt in about 250 ml of warm water and stir until fully dissolved before using.

• Take a generous sip and swish the salt water around in your mouth for about 30 seconds, focusing on the infected area to kill bacteria.
• After 30 seconds, spit out the salt water—do not swallow it. Repeat this process 3 to 4 times a day.
• In addition to taking antibiotics prescribed by your dentist, you should combine this mouthwash technique for better results.

Use dental gel to reduce pain and swelling. You can find dental gel at your local pharmacy. If they don’t carry it, try larger pharmacies. This gel helps control the infection while reducing pain and swelling.

• Before applying the dental gel, rinse your mouth thoroughly. Then, place one or two drops directly on the infected area and apply gently with a cotton swab.
• Avoid using your fingers to apply the gel, as this can introduce more bacteria into your mouth.
• Apply the dental gel 3 to 4 times a day for optimal results.

Relieve pain. If the wisdom tooth infection causes severe pain, you should take pain relievers, which also help reduce inflammation. You can easily purchase nonsteroidal anti-inflammatory drugs (NSAIDs) at the pharmacy without a prescription.

• Common NSAIDs include ibuprofen (Mofen-400, Ibuprofen), naproxen (Ameproxen), and aspirin. Do not give aspirin to children under 18 years old, as it is linked to the development of Reye's syndrome, which causes brain and liver damage.
• Acetaminophen (paracetamol) is not an NSAID and does not have anti-inflammatory effects but can help relieve pain.
• Follow the dosage instructions on the packaging or as prescribed by your doctor, and do not exceed the maximum allowed dosage.
• Remember that each medication has some side effects, so you must carefully read the label before taking any medication. Consult your pharmacist or doctor if needed.

Apply a cold compress. If you prefer not to take medication or cannot, try applying cold to the infected area. Cold compresses can reduce pain and swelling while you wait to see a doctor. However, if the infection site is significantly swollen, seek medical treatment immediately.

• Place ice cubes in a plastic bag and wrap it in a cloth. Apply the cold pack to the painful area for at least 10 minutes.
• You can also use a frozen vegetable bag, such as peas or corn (do not consume the vegetables after they have thawed and refrozen multiple times).

Visit the dentist. The most important step is to see your dentist as soon as possible. Without appropriate medical intervention, the infection may spread to other areas of your mouth and body.

• Infection around the tooth can lead to complications such as gum disease, tooth decay, and the formation of an abscess. More serious complications include swollen lymph nodes, sepsis, systemic infection, and even death.
• If the dental clinic is too crowded and you cannot see a dentist immediately, go to the emergency room or a hospital. Many places have emergency dental care available.

Discuss treatment options with your dentist. They will examine the infected area and take an X-ray to assess the severity and determine the best treatment plan.

• The dentist will also check the wisdom tooth to see if it has fully erupted or if it's only partially visible, as well as examine the surrounding gums.
• If the wisdom tooth hasn't erupted, an X-ray will help determine its position. These factors will guide the decision on whether the tooth needs to be extracted.
• Inform the dentist about any medications you are allergic to so they can avoid prescribing those drugs.

Ask about the costs, risks, and benefits of the treatment. It's important to know the cost of the treatment, as well as the potential risks and benefits, and if there are any alternative treatment options.

• Don't hesitate to ask questions. You have the right to fully understand the procedure you're about to undergo.

Allow the dentist to clean the infected area. If the wisdom tooth is about to erupt without causing major issues and the infection is mild, the dentist may clean the infected area using an antiseptic solution.

• They will remove any infected gum tissue, pus, and plaque. If there's an abscess, the dentist may need to make a small incision to drain the pus.
• Once the area is cleaned, the dentist will provide instructions for home care in the following days. They may prescribe a gel to reduce inflammation, antibiotics to treat the infection, and painkillers if necessary. Common antibiotics prescribed include amoxicillin, clindamycin, and penicillin.

Prepare for minor surgery. The main cause of wisdom tooth infection occurs when the gum tissue covering the tooth (known as the operculum) becomes infected due to plaque and food particles trapped beneath. If the tooth is still beneath the gum but in a proper position, removing the infected gum tissue is easier than extracting the tooth entirely.

• To remove the gum tissue over the wisdom tooth, the dentist will perform a minor procedure called 'gingival flap surgery.'
• Once the tissue is removed, it will be easier to clean away plaque and bacteria, significantly reducing the risk of a wisdom tooth infection.
• Before the surgery, the dentist will inject a local anesthetic into the affected gum. Then, they will remove the infected tissue using a scalpel, laser, or electrosurgical device.

Consider tooth extraction. If the infection spreads and the wisdom tooth shows no signs of erupting, extraction may be necessary. Tooth removal is also required in cases of severe infection.

• Depending on the tooth's position, the extraction may be performed by either the dentist or a surgeon.
• A local anesthetic will be administered before the extraction procedure.
• After the extraction, antibiotics and painkillers may be prescribed to prevent post-surgical infections. Be sure to follow the dentist’s instructions for oral hygiene.
• Don't forget to schedule a follow-up appointment so the dentist can monitor the healing process and ensure no issues arise. Additionally, the dentist will check the opposite wisdom tooth to determine if it needs extraction as well.

Brush your teeth twice daily. To prevent infection, it’s essential to maintain proper oral hygiene. The first step is to brush your teeth twice a day with a soft-bristled toothbrush, avoiding hard-bristled brushes that can wear down tooth enamel.

• Hold the toothbrush at a 45-degree angle to your gum line.
• Brush in a circular motion, avoiding back-and-forth strokes, as this can damage the enamel.
• Each brushing session should last at least two minutes. Don’t forget to brush along the gum line and reach the back teeth.

Use dental floss daily. Flossing is just as important as brushing because it removes plaque and bacteria between your teeth that a toothbrush can’t reach. Failure to floss can lead to cavities, infections, and gum disease. Make sure to floss at least once a day.

• Hold the floss securely with both hands and gently slide it between your teeth, following the natural curve of each tooth. Avoid snapping the floss into the gums to prevent irritation or bleeding.
• Shape the floss into a 'C' and gently slide it between the tooth and gum.
• Move the floss up and down gently along the sides of the teeth.
• Be sure to floss all gaps, including those between the back molars. Always rinse your mouth after flossing to remove any bacteria or plaque dislodged by the flossing process.

Use a mouthwash with antiseptic properties. Antiseptic mouthwash helps control the bacteria in your mouth while keeping your breath fresh and clean. If you live in the U.S., look for a mouthwash with the ADA (American Dental Association) seal of approval to ensure it’s effective for oral hygiene.

• You can use mouthwash before or after brushing your teeth. Pour the recommended amount into the cap and rinse thoroughly between your teeth for about 30 seconds before spitting it out.
• You can use a commercially available antiseptic mouthwash or a simple, undiluted chlorhexidine solution, which can be found in most pharmacies.
• If the mouthwash feels too harsh and causes a burning sensation, opt for a non-alcoholic alternative.

Schedule regular dental check-ups. Regular dental check-ups are the best preventive measure to avoid wisdom tooth infections and other dental issues.

• It is recommended to visit the dentist every six months, especially if your wisdom teeth have not erupted. Your dentist may advise more frequent visits if you have specific health concerns.

Avoid smoking. Refraining from smoking or using tobacco products is crucial when dealing with an infected wisdom tooth, as it can irritate the gums and worsen the infection.

• Smoking is harmful to your overall health and, of course, your oral health. Consult your doctor for advice on how to quit smoking as quickly as possible.
• Smoking stains your teeth and tongue, slows down your body's recovery ability, and increases the risk of gum disease and oral cancer.