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What are treatment options for a swollen, painful gum at my wisdom tooth area?

Dental Wisdom Teeth

I’m an 18 year old who has been growing out my wisdom tooth since last year. These past few days however the gums at my widom tooth have been swollen and it hurts to even close my mouth. There’s also a stench from the area which I believe is food trapped under the gum flap. I’ve also got pain in my lymph nodes at my jaw near the wisdom tooth area. Please advise.

DOCTOR’S ANSWER (2)

From the symptoms you described (painful & swollen gums), it seems like you have a case of acute pericoronal tissue infection (meaning inflammation of the tissue around the crown of the wisdom tooth).

This is commonly observed when there is a food (bacteria) trap caused by the partially erupting wisdom tooth. If left unattended, the infection may spread and cause your lymph nodes or face to swell too.

Removal of the infected wisdom tooth is the most common treatment method and it will help to prevent any future infection. During the process of removal, your oral surgeon/dentist will also help to clean the area thoroughly. Antibiotics will also be given after the wisdom tooth surgery to control the infection.

If you are already experiencing pain and swelling, you are recommended to visit an oral surgeon/dentist for treatment as soon as possible to prevent the condition from worsening.

Best regards,

Dr Ho Kok Sen

897 views 29 Jun 2018

Sorry to hear that you are experiencing such discomfort at the moment! As you are 18 years old, this a prime age for wisdom teeth to be growing out ie erupting and they usually cause discomfort as they are the last ones to erupt so there is usually no space for them to come out straight. 

As a result, bacteria accumulates with the 'awkardly' angled (impacted) wisdom teeth and it sometimes causes something called pericoronitis. This is gum inflammation around the wisdom tooth. The infection can cause a bad smell and spread to the lymph nodes on the same side if not treated fast enough which sounds like what you are going through.

Your options for this include 

1. Consultation and Antibiotics (As soon as possible) 

Visit a dentist you are comfortable with, get a recommendation on whether this wisdom tooth should be removed or not. An Xray will most likely be needed to check the angulation and to see if there is any underlying infection or cavities within the jaw bone and tooth. 

2. Wisdom tooth extraction 

Generally not recommended when there is an active infection but sometimes it can be done. This is a case by case basis. For surgical extractions, you are able to use personal or next of kin's medisave ie your parents medisave if needed provided you are PR / Singaporean.

3. Deep cleaning around the gum 

Sometimes it could due to an accumulation of bacteria and food within the area so a deep cleaning can help but is usually not the long term solution. 

My best advise to you is to first go for a consultation with a dentist and get the medication needed first. Don't wait any longer as the infection needs to be treated as soon as possible before it gets worse. 

All the best and I hope you feel better really soon! 

Warm Regards, 

Dr Beth 

929 views 25 Jun 2018
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Disclaimer: Any answers provided are for general informational purposes only and is not a substitute for professional medical advice. If you think you may have a medical emergency, call your doctor immediately. Always seek the advice of your doctor before starting or changing treatment.

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