Wisdom tooth erupting - is pain normal?

Discussion in 'Patient Forum' started by sam91, May 16, 2019.

  1. sam91

    sam91

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    I currently have a wisdom tooth which is coming through the gum.

    It was previously infected but I visited the dentist and it seems to have cleared up. It's no longer red, swollen or has any pus coming out. The tooth appears to be straight and there's room for it to come through. It's partially covered by the gum, about 50% visible.

    I wasn't experiencing any pain after the infection cleared up but it's suddenly come back about a week later. It's no where near as severe as when it was infected but still not very nice. I have no other symptoms and otherwise feel fit and healthy.

    Is this pain normal and should I just take painkillers and make sure I keep it clean or is it a sign I need to get back to the dentists as soon as possible? Is a bit of pain just part of wisdom teeth coming through?
     
    sam91, May 16, 2019
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  2. sam91

    Busybee

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    I had a lot of pain when my wisdom teeth were coming through and it was there for a while as they were coming through the gums and it took a long time for them to fully erupt. I didn't even know what was happening at the time. I was 21 and was having terrible headaches. I didn't have an infection and they were fine in the end (not impacted) If your dentist has not suggested removing them then they cannot be impacted so probably nothing to worry about. If you get a fever or start to feel nausea or feel faint then go back to your dentist. These days they suggest removing them.
     
    Busybee, May 16, 2019
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  3. sam91

    MattKW Verified Dentist

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    It's very rare that wisdom teeth erupt into a functional and cleansable position. You don't say what the dentist said at the time. It's unwise to wait for pain, as with any health condition. You need it assessed and the pros and cons explained.
    What's your age, and do you have an Xray to show us? (An OPG Xray is best).
     
    MattKW, May 17, 2019
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  4. sam91

    sam91

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    The dentist said there was a localised infection and cleaned it up and basically just told me to keep it clean and hopefully it will clear up. They said they don't remove wisdom teeth likely and didn't prescribe antibiotics. Didn't take any X-rays. I'm 27.

    The pain has now totally vanished but I can still taste some fluid which is obviously draining. The inside of my cheek appears slightly swollen. If there's no pain I'm not sure it's considered for an emergency appointment so not sure what to do!?
     
    sam91, May 17, 2019
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  5. sam91

    Busybee

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    Make a routine appointment to check all is ok and then do as your dentist advises.
     
    Busybee, May 17, 2019
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  6. sam91

    Busybee

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    I am not sure where you are based, but in the UK the National Institute of Clinical Excellence has the following guidance which advises leaving wisdom teeth in place if they are not diseased or causing a problem to the dental health of the patient. I am not aware that this guidance has changed since 2000 :

    "The practice of prophylactic removal of pathology-free impacted third molars should be discontinued in the NHS.

    1.2 The standard routine programme of dental care by dental practitioners and/or paraprofessional staff, need be no different, in general, for pathology free impacted third molars (those requiring no additional investigations or procedures).

    1.3 Surgical removal of impacted third molars should be limited to patients with evidence of pathology. Such pathology includes unrestorable caries, nontreatable pulpal and/or periapical pathology, cellulitis, abscess and osteomyelitis, internal/external resorption of the tooth or adjacent teeth, fracture of tooth, disease of follicle including cyst/tumour, tooth/teeth impeding surgery or reconstructive jaw surgery, and when a tooth is involved in or within the field of tumour resection."

    https://www.nice.org.uk/guidance/ta...he-extraction-of-wisdom-teeth-pdf-63732983749

    It is considered that where there is no evidence of disease, the risk of undergoing anaesthesia in the routine removal of wisdom teeth outweighs any benefit to the patient. It is also considered a waste of money to routinely extract wisdom teeth and that there is no health benefit from doing so. This is the UK guidance. Other countries have different approaches and it's a controversial topic.
     
    Busybee, May 17, 2019
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  7. sam91

    MattKW Verified Dentist

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    There is strong opposition to the NICE Guidelines from the dental fraternity, and some of the relevant parts of the detailed concerns by the RCS (2014) are:
    1. " [NICE] has only delayed necessary surgery with the average age of patient at surgery rising from 23 years to-32 years;
    2. It has not reduced the prevalence of M3M surgery (only delayed it) ;
    3. It has resulted in significant damage to second molars due to caries (and resultant patient harm);
    4. The charges associated with nonoperative management of asymptomatic, disease-free M3s will exceed the charges of operative management;
    5. This evidence is sufficient for international Guidelines (Scandinavian, German and US) to have been amended in the last 12 months."
    6. Personally, I see the NICE Guidelines as a stupid retrograde step in public health that should never have been implemented, and appears to have been embraced by bureaucracies more concerned with supposed cost efficiencies than health.
    7. Do you have an Xray to show us?
     
    MattKW, May 18, 2019
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