Wisdom tooth infection: Signs, causes, treatment and removal

 Key takeaways:

• Wisdom teeth are the last set of teeth to grow in an adult. They are prone to infection due to impaction and overcrowding.
• Wisdom tooth infection can cause pain, swelling, and difficulty in moving the jaw.
• When left untreated or poorly managed, wisdom tooth infection can lead to some complications that may be detrimental to a person's health.

The human teeth consist of four sets of teeth, and they include the incisors, canines, premolars, and molars. The wisdom tooth is one of the molars and is often referred to as the third molar. As with other molars, it is used for chewing or grinding food.

The wisdom teeth are the last set of adult teeth to emerge and are located at the very back of the mouth, behind the second molars. They are usually four in number (one on each side of the upper section and one on each side of the lower section) and generally erupt between the late teens and early 20s. A 2013 study found that 53% of people aged 25 and older have at least one wisdom tooth. However, some people may have fewer wisdom teeth, more, or none at all.

In most cases, wisdom teeth grow normally, but sometimes they erupt at an awkward angle, pushing into neighboring teeth or getting stuck in the gum, leading to inflammation and pain, which may result in an infection of the tooth. Also, because wisdom teeth may be difficult to brush, food particles can get trapped in between the teeth or between a wisdom tooth and the flap of gum covering the tooth. Accumulation of the food particles can lead to a buildup of bacteria, resulting in wisdom tooth infection. 

Wisdom tooth infection, sometimes called pericoronitis, is the inflammation and infection of the wisdom tooth and/or the gum surrounding it. There are limited studies on the prevalence of wisdom tooth infection. Nonetheless, an estimated 81% of people between the ages of 20-29 have been recorded to have had a wisdom tooth infection. Wisdom tooth infection can be mild or severe infection and may need removal or other treatments depending on its severity.

 Signs and symptoms of wisdom tooth infection

Some common symptoms of wisdom tooth infection may include:

• Pain in or around the affected tooth
• Pain in the jaw
• Swollen gums or jaw
• Painful jaw movement (e.g., when chewing, or speaking)
• Fever and chills
• Foul-smelling breath
• Facial swelling
• Enlarged painful lymph nodes, which may feel like a lump around the upper part of the neck
• Pus in the affected tooth

The symptoms of wisdom tooth infection vary depending on the severity of your tooth infection.

 What causes wisdom tooth infection?

Several factors contribute to the infection of a wisdom tooth. They may include:

 Tooth impaction

Tooth impaction occurs when a tooth does not erupt well; it either gets stuck in the gum or pushes into a neighboring tooth. It often occurs when there's not enough room in the jaw to accommodate the wisdom teeth. This causes pain and inflammation in the affected tooth and may result in the infection of that tooth if not properly treated.

 Tooth decay

Decay in a tooth can cause a buildup of microorganisms that may result in the infection of that tooth or the surrounding gum.

 Cavity

In some cases of tooth decay, tiny openings begin to form in the affected tooth. This is referred to as a cavity. Cavities may lead to the infection of the wisdom teeth and may result in the removal of the affected tooth.

 Gum disease

Diseases of the gum, such as gingivitis, can spread to affect the wisdom teeth, thereby causing an infection.

 Wisdom tooth extraction

Studies have shown that there's a possibility of infection following wisdom tooth extraction. This may be attributed to poor oral hygiene and poor follow-up management after the surgery.

Although wisdom tooth infection causes pain, which may be mild or severe, it is not the only cause of wisdom teeth pain.

 Other causes

Other causes of wisdom teeth infection may include:

• Gum diseases
• Tooth cavities
• Worn dental fillings
• Gum recession
• Sinus pain
• Overcrowding of teeth
• Cracked tooth
• Worn teeth enamel
• Impacted tooth
• An outgrowth of new teeth

 Complications of wisdom tooth infection

Wisdom tooth infection, when left untreated or poorly treated, can lead to some complications that may be severely detrimental to a person's health. These complications may include:

 Cysts

This is a fluid-filled sac that forms at the root of the affected tooth. Cysts often result from a tooth impaction or infection. If an infection persists, it can stimulate the formation of a cyst in the jawbone near the affected tooth. This cyst can grow and cause further damage to the surrounding bone, teeth, and tissues if not addressed.

 Dry socket

When a tooth is extracted, it is expected that there will be a formation of blood clots in the area of extraction. In a dry socket, the blood clot that forms becomes dislodged or dissolves before the wound heals completely. This exposes the underlying nerves and bone, causing severe pain, a foul taste, and bad breath. It also leads to bleeding from the site and can lead to infection of the affected site.

 Severe or recurrent infection

A poorly treated wisdom teeth infection can cause recurrent infections. This increases the risk of systemic infection, where the infection spreads to other parts of the body through the bloodstream, causing systemic symptoms like fever, malaise, or, in rare cases, more serious complications. Also, recurrent infections can result in the formation of abscesses around the wisdom tooth, leading to increased pain.

 Can wisdom teeth get infected after extraction?

Extraction of wisdom teeth is generally safe and effective. However, infections can occur during the healing process if not properly cared for. Research shows that infection of the wisdom tooth usually occurs between 1-4 weeks after the extraction.

This may be attributed to: 

• Poor oral hygiene: It is important you take your oral hygiene seriously after extraction. This should be commenced after 24 hours of extraction. However, vigorous brushing with a hard bristle brush or aggressive flossing or rinsing should be avoided. Oral cleaning should be done gently to avoid disrupting the healing of the extraction site.
• Bacterial contamination: Some bacteria normally stay in the oral cavity (called oral flora). These bacteria cause no harm and help in breaking down food before swallowing. Nonetheless, when there's a breakdown in the gum or inner lining of the cavity, infection might set in. To prevent this, your doctor may prescribe some antibiotics for you after extraction. 

 Can wisdom teeth infection kill you?

With the advancement of medicine and technologies, death and life-threatening conditions resulting from wisdom tooth infections are very rare. So, wisdom teeth infection rarely kills. However, untreated wisdom tooth infection can spread to other parts of the body through the blood, leading to potentially life-threatening complications such as:

• Sepsis (a life-threatening reaction to an infection)
• Infection of the inner lining of the heart
• Necrotizing fasciitis (Bacterial infection of the soft tissues, e.g., the skin and muscles)
• Collection of pus in the brain
• Ludwig's angina (a rare case of cellular infection that usually affects the neck and floor of the mouth)
• The formation of blood clots in the hollow spaces located underneath the brain and behind the eye sockets called cavernous sinuses.

These conditions, if not managed, may lead to death.

 Treatment for wisdom teeth infection

Treatment for wisdom tooth infection depends on the cause and severity of the infection. The treatment options include:

• Use of medications: Your dentist may prescribe some antibiotics to combat the infection and over-the-counter pain relievers like ibuprofen or acetaminophen to help manage pain and reduce inflammation. Also, in some instances, antibiotics are prescribed before tooth extraction to reduce the infection and avoid complications after tooth extraction. 
• Repair: Teeth repair can encompass various procedures depending on the damage. Some procedures used to repair minor tooth damage may include: dental fillings (used to seal off a hole or cavity in a tooth), crowning (use of a tooth-shaped cap to restore a broken, worn-out, or decayed tooth), and root canals (involves removal of an inflamed or infected inner layer of a tooth which is then cleaned and filled). These procedures are used in treating minor tooth fractures or decay, thus preventing further tooth damage or loss. The appropriate repair method depends on the extent of the damage and overall oral health. 
• Extraction: This is the surgical removal of the affected tooth. If the tooth infection is severe or recurrent, or if the tooth is impacted and causing issues, extraction might be the best solution to prevent further complications.

 Home remedies for the treatment of wisdom tooth infection

There are some home remedies to alleviate the symptoms of wisdom tooth infections or treat minor tooth infections. However, these remedies should not replace the professional treatment gotten from your dentist or healthcare provider.

Some of these home remedies may include:

• Salt and water rinse (saline rinse): This involves adding about one teaspoon of salt to a glass of warm water and using it to rinse your mouth. It's important you hold the water in your mouth for a few minutes before spitting it out.
• Cold compress: Ice therapy is one of the RICE methods that has been shown to reduce inflammation. So, using a cold compress can reduce inflammation in wisdom tooth infections, particularly in cases where there's a swollen jaw. 
• Over-the-counter pain relievers: pain relievers like ibuprofen can be used to alleviate the pain of wisdom tooth infection.

 Can I get antibiotics for tooth infection online?

Telemedicine has made medical consultations by doctors easier. So, it's possible to get a doctor online to prescribe some medications for you. However, it's important you visit a hospital or see a dentist for an initial review of your teeth before the online consultations.

 Infected wisdom tooth removal: When to consider it

Infected wisdom tooth removal is usually considered when there are recurrent infections, impacted teeth, overcrowding, damage to the surrounding tooth, and the presence of cysts. Nevertheless, some dentists or oral surgeons prefer to remove the affected tooth at an early stage of the infection or, in extreme cases of impaction, before the infection occurs. This is done to prevent the development of severe infections. 

A wisdom tooth infection can be very discomforting for people with the condition. It can affect how a person speaks or even eats. If you're experiencing any of the above symptoms, it's best to consult a dentist or oral surgeon to evaluate the situation. They can assess the state of the wisdom tooth and suggest the best course of action for you.