Pain in the very back of the mouth, behind the last molars, is one of the most common reasons people search for answers about wisdom teeth. Sometimes the discomfort is mild and passes as a tooth moves into place. Other times it is a sign of infection, decay or a tooth that does not have enough room.
Here is what can cause wisdom tooth pain, what you can safely do at home and when it is time to have the area examined.
When do wisdom teeth come in?
Wisdom teeth are the third molars, the last teeth to develop. According to the American Dental Association (ADA), they usually appear between the ages of 17 and 21. Some people have all four, some have fewer and some have none. Wisdom teeth that do not have room to come in fully may stay trapped in the jaw or under the gums. Dentists call these teeth impacted.
Why does my wisdom tooth hurt?
Some discomfort can be normal while a wisdom tooth is emerging. The ADA notes, however, that if you have pain you should see your dentist. Common causes include:
- A partially erupted tooth. When a wisdom tooth breaks only partway through the gum, it can create a place for infection to start. The ADA notes this can lead to pain, swelling and stiffness in the jaw.
- Inflamed gum tissue around the tooth. Inflammation of the soft tissue around the crown of a wisdom tooth is called pericoronitis. A published research review describes it as most common in people roughly 18 to 25 years old and more common in the lower jaw.
- Decay. The ADA lists decay that cannot practically be restored as one reason a wisdom tooth may need to come out.
- Gum disease around the back teeth.
- A cyst. An impacted wisdom tooth can form a cyst on or near the tooth.
- Pressure on the neighboring molar. The ADA notes that some believe wisdom teeth without room to come through can crowd or damage nearby teeth.
Pain in the back of the mouth is not always caused by the wisdom tooth itself. That is one reason an exam and X-ray matter before deciding what is wrong.
What does pericoronitis feel like?
In early stages, pericoronitis may cause only slight pain and discomfort near the back tooth. As it progresses, the review describes pain that increases with chewing, swallowing and opening the mouth, pain that may spread toward the side of the head and face, and difficulty opening the mouth fully.
Treatment depends on how severe the inflammation is. A dentist may clean and rinse the area under the gum, and in some cases recommend treating or removing the tooth so the problem does not keep coming back.
What can I do at home for wisdom tooth pain?
Home care can make you more comfortable while you arrange a visit, but it does not treat an infection or an impacted tooth. The ADA's guidance for a toothache is to:
- Rinse your mouth with warm water to clean the area.
- Gently floss to remove any food caught between your teeth.
- Avoid putting aspirin directly on the tooth or gums, since it can burn the gum tissue. You can read more in our article on why aspirin does not belong on a sore tooth.
- Contact your dentist if the pain continues.
For short-term dental pain in adults and teens 12 and older, a 2024 ADA guideline for dentists recommends nonsteroidal anti-inflammatory drugs (NSAIDs), with or without acetaminophen, as a first choice. Over-the-counter pain relievers are not right for everyone, so check with your dentist, physician or pharmacist about what is safe for you, and follow the label.
When is wisdom tooth pain urgent?
A spreading infection needs prompt attention. MedlinePlus, from the National Library of Medicine, lists these among the signs of a tooth abscess:
- A severe or throbbing toothache that does not go away
- Fever
- Swollen glands in the neck
- A swollen area of the upper or lower jaw, which it describes as a very serious symptom
- A bitter taste in the mouth or bad breath
Facial or jaw swelling, fever, or trouble opening your mouth or swallowing are reasons to call a dentist the same day. If you have difficulty breathing, seek emergency medical care right away. Our article on toothache with a fever explains more about these warning signs.
Do wisdom teeth always need to be removed?
No. Not every wisdom tooth causes problems. The ADA explains that removal may be recommended when there are changes in the mouth such as pain, infection, cysts, tumors, damage to neighboring teeth, gum disease or decay that cannot be restored. Removal may also be part of planning for braces or other dental care.
Wisdom teeth that stay in place should continue to be monitored. Before recommending anything, your dentist will examine your mouth and take an X-ray to see how the tooth is positioned and whether it is affecting nearby teeth or bone. If extraction is the right choice, you can learn what to expect on our wisdom tooth extraction page.
How can I keep wisdom teeth healthy?
- Brush carefully all the way to the back of your mouth.
- Floss around your wisdom teeth, as the ADA recommends.
- Keep regular dental visits so changes are caught early.
- Do not ignore pain, swelling or a bad taste near the back teeth, even if it comes and goes.
Wisdom tooth evaluation in Palo Alto
If you have pain, swelling or pressure in the back of your mouth, Palo Alto Oral Health can examine the area, take any needed X-rays and talk through your options, including whether monitoring or treatment makes sense for you. Call (650) 321-9693 or request an appointment.
Sources
American Dental Association, MouthHealthy: Wisdom Teeth
American Dental Association, MouthHealthy: Dental Emergencies
ADA News: New ADA Guideline Recommends NSAIDs to Manage Dental Pain in Adults, Adolescents (2024)
MedlinePlus, National Library of Medicine: Tooth Abscess
This article provides general education and does not replace an individual dental examination or diagnosis.
