Wisdom Tooth Pain? Here’s When You Might Need Antibiotics

Pain in the back of your mouth, especially near a partially erupted wisdom tooth, is a common problem particularly among adults in their late teens to thirties.

One of the most frequent causes is a condition called pericoronitis which is an inflammation of the gum tissue surrounding a partially erupted tooth.

In this article, a dentist explains what pericoronitis is, what symptoms to watch for, and when antibiotic treatment might be necessary.

What Is Pericoronitis?

Pericoronitis occurs when the gum tissue around a partially erupted wisdom tooth becomes inflamed or infected. It often happens in the lower jaw where food, bacteria, and plaque can collect beneath the gum flap that partially covers the tooth.

There are two forms:

  • Mild pericoronitis: Localised inflammation, redness, and discomfort

  • Severe pericoronitis: Swelling, difficulty opening the mouth (trismus), pus, and systemic symptoms like fever

Why Wisdom Teeth Are Prone to Infection

Wisdom teeth are the last to erupt and often lack enough space to fully emerge. This can lead to:

  • Partial eruption, creating pockets for bacteria to accumulate

  • Difficulty brushing and cleaning the area

  • Repeated trauma from the opposing tooth biting the swollen gum

  • Chronic irritation that leads to infection

If left untreated, pericoronitis can develop into a more serious infection that spreads beyond the gum.

When Is Antibiotic Treatment Considered?

Antibiotics are not always required for pericoronitis. In fact, mild cases can often be managed with local measures, including improved cleaning and saltwater rinses.

However, a dentist may consider antibiotics if you are experiencing:

  • Facial swelling or spreading infection

  • Pus discharge around the gum or tooth

  • Severe pain with restricted mouth opening

  • Fever or swollen lymph nodes

  • Recurring infections in the same area

Even if antibiotics are used, the source of infection must still be addressed often by cleaning, gum trimming, or eventual removal of the wisdom tooth.

When You May Not Need Antibiotics

Many patients experience mild, localised pericoronitis that can be managed conservatively with:

  • Careful brushing and flossing

  • Warm saltwater rinses

  • Anti-inflammatory pain relief (paracetamol, ibuprofen)

  • Temporary dietary changes to avoid food trapping

A dentist can help assess whether these measures are sufficient or whether escalation is required.

Signs It’s Becoming an Emergency

Seek urgent dental advice if you notice:

  • Rapidly worsening swelling or pain

  • Jaw stiffness or limited mouth opening

  • Difficulty swallowing or speaking

  • Foul taste or pus from the area

  • Signs of infection spreading beyond the gum

These symptoms may indicate a deeper infection that requires immediate attention.

Summary

Pericoronitis is a common cause of wisdom tooth pain and while it’s not always serious, it can become an emergency if left untreated. Antibiotics may be necessary in some cases, but the underlying issue must also be managed.

If you're unsure whether your symptoms suggest mild inflammation or a more significant infection, our dentists can provide assessment, advice and a dental prescription for antibiotics if appropriate.

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