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Wisdom tooth pain relief: why akal daad hurts and when removal is needed

Why wisdom teeth hurt, what you can safely do tonight, and how to know if yours needs to come out.

By Dr. Apoorva Sharma, BDS Published 9 min read

Akal daad (wisdom tooth) pain usually means the tooth does not have enough room to come through. The gum over it gets trapped food and bacteria and becomes sore and swollen. Warm salt water rinses, a cold compress and a suitable painkiller can ease it for now. See a dentist if the pain lasts more than 2 days, or if you have swelling, fever or trouble opening your mouth.

I am Dr. Apoorva Sharma, a dentist (BDS). Akal daad is one of the most common reasons people message me late at night. Usually the pain started as a dull ache at the back of the jaw and grew worse over a day or two. This guide covers what is happening, what you can safely do, and what to expect if the tooth needs to come out.

What is akal daad?

Akal daad is the Hindi name for the wisdom tooth, the last molar at the very back of each jaw. Most people have four, one in each corner. Some have fewer, or none.

They are called wisdom teeth because they come in later than the others. The American Dental Association says they usually appear between ages 17 and 21 (ADA MouthHealthy). The NHS says the teens or early 20s, though they can cause problems at any age (NHS).

When the jaw has enough space, a wisdom tooth can come in straight and cause no trouble at all. When it does not, problems start.

Why does akal daad hurt?

Most wisdom tooth pain comes from a tooth that is stuck or only partly through the gum. The NHS lists the usual problems (NHS):

  • Impaction. The tooth is blocked by the tooth in front of it, or stays under the gum or bone.
  • Gum infection (pericoronitis). A flap of gum partly covers the tooth. Food and bacteria collect under it. The gum swells and hurts.
  • Food getting stuck between the wisdom tooth and the molar in front.
  • Tooth decay in the wisdom tooth, or in the molar next to it. Both are hard to clean.
  • Gum disease around the back teeth.
  • A cyst, a fluid-filled sac around the tooth.
  • A dental abscess, a pocket of pus from infection.

The American Dental Association adds that a partly erupted wisdom tooth "can give bacteria a place to enter the gums." This can lead to "pain, swelling and stiffness in your jaw" (ADA MouthHealthy).

Signs your akal daad is the problem

  • A dull or throbbing ache at the very back of the jaw
  • A swollen, red gum flap behind your last molar
  • Pain when you bite down on that side
  • A bad taste or bad breath that comes back after brushing
  • A stiff jaw, or trouble opening your mouth wide
  • Pain when you swallow

Wisdom tooth pain relief: safe things you can do at home

Home care eases the pain while you arrange a dental visit. It does not fix a tooth that has no room. The Indian Dental Association and the NHS both list the steps below (IDA; NHS).

1. Rinse with warm salt water

Dissolve half a teaspoon of salt in a glass of warm water. Swish gently around the back of the mouth, then spit it out. Repeat after meals and before bed (NHS). This loosens food under the gum flap. Children should not do salt water rinses in case they swallow it (NHS).

2. Hold a cold compress on your cheek

Wrap ice or a cold pack in a thin cloth. Hold it on the outside of your cheek for 15 minutes at a time. The IDA advises a cold compress to reduce swelling (IDA).

3. Keep the area clean

Brush the back teeth gently with a soft brush. Food under the gum flap feeds the infection. The ADA advises cleaning carefully around wisdom teeth (ADA MouthHealthy).

4. Eat soft food and chew on the other side

Curd rice, khichdi, dal and upma are easier than roti or crunchy snacks. Avoid foods that are very sweet, very hot or very cold (NHS).

5. Ask about pain relief

For adults, the American Dental Association recommends ibuprofen-type medicines, alone or with paracetamol, as the first choice for dental pain (ADA News, 2024). These do not suit everyone. Ask a pharmacist or dentist before taking any medicine. A pharmacist can also advise on a numbing gel for the mouth (NHS).

6. Clove oil, with care

Laung (clove) has been used for toothache in Indian homes for generations. The IDA notes that some doctors recommend it (IDA). Clove contains eugenol. In one small trial, a clove gel numbed the gum about as well as a standard numbing gel (Alqareer et al., 2006).

Eugenol can also irritate and damage soft tissue (Sarrami et al., 2002). So if you use it:

  • Use a tiny amount on a cotton bud.
  • Touch it to the tooth. Keep it off the gum as much as you can.
  • Do not leave soaked cotton in your mouth.
  • Stop if it stings or burns.
  • Do not use it for young children.

What not to do

  • Do not put an aspirin tablet on the gum. Aspirin is acidic and can cause a chemical burn on the inside of the mouth (Saudi Endodontic Journal case report, 2020).
  • Do not start leftover antibiotics. A dentist decides if you need them. For many toothaches, antibiotics do not ease the pain. A Cochrane review found too little evidence that they help tooth nerve pain (Agnihotry et al., Cochrane, 2019).
  • Do not poke the gum with a pin, toothpick or safety pin to "let out" pus.
  • Do not use tobacco, gutkha or paan near the sore area. It can make dental problems worse (NHS).
  • Do not ignore pain that keeps coming back. Repeated flares are a sign the tooth needs a proper plan.

Does akal daad always need to be removed?

No. A wisdom tooth that causes no problems is usually left in place and checked at routine visits (NHS). A Cochrane review found too little evidence to say that healthy, symptom-free impacted wisdom teeth should be taken out (Ghaeminia et al., Cochrane, 2020).

Removal is more likely when the tooth causes (NHS; ADA MouthHealthy):

  • Repeated gum infections (pericoronitis)
  • Decay in the wisdom tooth or the molar next to it
  • Gum disease around the back teeth
  • A cyst or abscess
  • Food trapping that cannot be cleaned

Your dentist will usually take an X-ray first. It shows the angle of the tooth, how deep it sits and how close it is to the nerve (ADA MouthHealthy). The decision is made together with you.

What happens during wisdom tooth removal

Most wisdom teeth are removed in the dental chair under local anaesthetic. The area is numbed with an injection. Sedation or general anaesthesia is an option for harder cases or anxious patients (NHS). If the dentist's chair worries you, read conquering dental anxiety.

The NHS describes the main steps (NHS):

  1. A small cut in the gum, if gum covers the tooth.
  2. Widening the socket.
  3. Taking the tooth out whole, or in 2 or 3 pieces.
  4. Dissolvable stitches, if needed.

It often takes a few minutes and should take no more than 40 minutes (NHS).

Recovery: pain and swelling are common for up to 2 weeks, and start to improve after 1 or 2 days (NHS). Possible problems include dry socket, infection, and numbness of the lip, chin or tongue. The numbness usually gets better but can last weeks or months (NHS). For the day-by-day plan, see tooth extraction aftercare and the printable post extraction instructions.

Surgical removal is part of implant and surgical dentistry.

For typical wisdom tooth removal costs, see our tooth extraction cost guide and the dental treatment cost guide for India.

See a dentist in person if...

  • Pain lasts more than 2 days, or painkillers do not help (NHS).
  • Your cheek or jaw is swollen, or you have a fever, red gums or a bad taste (NHS).
  • You cannot open your mouth fully, or it hurts to swallow.
  • The same wisdom tooth flares up again after settling.

Go to a hospital emergency or call 112 if swelling spreads to your eye or neck, or makes it hard to breathe, swallow or speak (NHS). Do not drive yourself.

Frequently asked questions

How do I stop akal daad pain fast at home?

Rinse with warm salt water, hold a cold compress on your cheek, and keep the area clean. Ask a pharmacist about a suitable painkiller. These steps ease the pain for a while. They do not fix a tooth with no room. See a dentist if pain lasts more than 2 days.

How long does akal daad pain last?

A flare of gum pain around a wisdom tooth often settles over a few days with cleaning and rinses. It tends to come back if the tooth stays partly covered by gum. Pain that lasts more than 2 days, or keeps returning, needs a dentist (NHS).

Can wisdom tooth pain go away on its own?

Sometimes the soreness settles once the tooth finishes coming through. If the tooth is stuck, the pain usually returns. A dentist can check with an X-ray and tell you whether the tooth is likely to come in properly (ADA MouthHealthy).

Should all wisdom teeth be removed?

No. Healthy wisdom teeth that cause no trouble are usually left and checked at routine visits (NHS). Removal is advised when they cause infection, decay, gum disease or a cyst.

Is akal daad removal painful?

The area is numbed with a local anaesthetic, so you feel pressure during removal (NHS). Some pain and swelling afterwards are common. They usually start to improve after 1 or 2 days (NHS).

What is the cost of akal daad removal in India?

Prices vary by city, clinic and how hard the tooth is to remove. A surgical removal of an impacted tooth usually costs more than a simple removal. See our tooth extraction cost guide for typical ranges. Ask for a written estimate that includes X-rays and follow-up.

Not sure if your akal daad needs to come out? I offer a ₹200 video consultation. Send me your X-ray if you have one, or show me the area on camera. I will explain what I see and whether you need an in-person visit. Book a video consultation.

This guide is general information. It does not replace an examination by a dentist.

References

  1. NHS. Wisdom tooth removal (reviewed June 2024). https://www.nhs.uk/tests-and-treatments/wisdom-tooth-removal/
  2. NHS. Toothache (reviewed July 2024). https://www.nhs.uk/symptoms/toothache/
  3. American Dental Association, MouthHealthy. Wisdom teeth. https://www.mouthhealthy.org/all-topics-a-z/wisdom-teeth/
  4. Indian Dental Association. Dental emergencies. https://ida.org.in/Public/Details/Dental-Emergencies
  5. American Dental Association. New ADA guideline recommends NSAIDs to manage dental pain in adults, adolescents. ADA News, February 2024. https://adanews.ada.org/ada-news/2024/february/new-ada-guideline-recommends-nsaids-to-manage-dental-pain-in-adults-adolescents/
  6. Ghaeminia H, Nienhuijs ME, Toedtling V, et al. Surgical removal versus retention for the management of asymptomatic disease-free impacted wisdom teeth. Cochrane Database of Systematic Reviews. 2020;5:CD003879. https://pubmed.ncbi.nlm.nih.gov/32368796/
  7. Agnihotry A, Thompson W, Fedorowicz Z, et al. Antibiotic use for irreversible pulpitis. Cochrane Database of Systematic Reviews. 2019;5:CD004969. https://pubmed.ncbi.nlm.nih.gov/31145805/
  8. Alqareer A, Alyahya A, Andersson L. The effect of clove and benzocaine versus placebo as topical anesthetics. Journal of Dentistry. 2006;34(10):747 to 750. https://pubmed.ncbi.nlm.nih.gov/16530911/
  9. Sarrami N, Pemberton MN, Thornhill MH, Theaker ED. Adverse reactions associated with the use of eugenol in dentistry. British Dental Journal. 2002;193(5):257 to 259. https://pubmed.ncbi.nlm.nih.gov/12353045/
  10. Chemical burn from direct application of aspirin onto a painful tooth. Saudi Endodontic Journal. 2020;10(1). https://doi.org/10.4103/sej.sej_24_19