Treatment of Lower Left Wisdom Tooth Pain
For acute wisdom tooth pain on the lower left side, initiate immediate pain management with NSAIDs or acetaminophen, followed by urgent dental referral within 24-48 hours for definitive evaluation and treatment, as the primary goal is to address the underlying dental pathology causing the pain rather than simply masking symptoms. 1, 2
Immediate Pain Management
Analgesic therapy should be started immediately and dosed at fixed intervals rather than as-needed to maintain adequate pain relief. 3
- Acetaminophen (paracetamol) up to 1000 mg provides statistically significant pain relief at 4 and 6 hours post-administration, with higher doses (up to 1000 mg) providing greater benefit than lower doses. 2
- NSAIDs (such as ibuprofen) are effective for acute dental pain and can be used alone or in fixed combination with opioids (oxycodone or hydrocodone) for moderate to severe pain. 3
- Administer analgesics at fixed intervals when frequent dosing is required, as pain is easier to prevent than treat. 3
- Opioids may be necessary for severe pain but should be prescribed judiciously with appropriate follow-up within 48 hours to ensure the underlying condition is responding to definitive treatment. 3
Urgent Dental Referral
All patients with symptomatic wisdom teeth require urgent dental evaluation within 24-48 hours to determine the underlying cause and definitive treatment. 1, 4
Common Causes Requiring Dental Assessment:
- Pericoronitis (inflammation of gum tissue around partially erupted wisdom tooth) 1, 4
- Dental caries affecting the wisdom tooth or adjacent second molar 5
- Periodontal disease associated with the impacted tooth 5
- Dental abscess or pulp involvement 3
Antibiotic Considerations
Antibiotics may be necessary if infection is present, though this decision should be made by the treating dentist after clinical examination. 1
- Studies show patients with symptomatic wisdom teeth consume an average of 1.6 to 2.5 courses of antibiotics while awaiting treatment, indicating the infectious nature of many symptomatic cases. 1
- Systemic antibiotics are indicated for dental abscesses, severe pericoronitis, or when extraction is planned in the presence of infection. 3
Definitive Treatment Options (Determined by Dentist)
Extraction Indications:
- Pain is the main indication for wisdom tooth removal in 73.7% of referred patients. 1
- Symptomatic impacted wisdom teeth causing recurrent pain, infection, or damage to adjacent structures should be removed. 1, 4, 5
- Extraction performed in younger patients (adolescents and young adults) carries lower risk of postoperative complications compared to older patients. 6, 5
Conservative Management (Retention):
- Asymptomatic, disease-free impacted wisdom teeth may be monitored with watchful waiting, though this does not apply to your symptomatic case. 6, 5
- Very low-certainty evidence suggests retained asymptomatic impacted wisdom teeth may increase long-term periodontitis risk affecting adjacent second molars. 5
Critical Pitfalls to Avoid
Do not use topical anesthetic drops (benzocaine) as primary treatment, as they may mask progression of underlying disease while suppressing pain without addressing the pathology. 3
Do not delay dental referral beyond 48 hours, as prolonged waiting increases antibiotic consumption, lost work days, and patient discomfort. 1
Do not assume pain will resolve spontaneously—symptomatic wisdom teeth typically require definitive intervention (extraction or treatment of associated pathology). 1, 4
Management Algorithm
- Initiate immediate pain control with acetaminophen 1000 mg or NSAIDs at fixed intervals 3, 2
- Arrange urgent dental evaluation within 24-48 hours 1
- Dentist evaluates for pericoronitis, caries, abscess, or periodontal disease 1, 4, 5
- Definitive treatment determined by dentist (typically extraction for symptomatic cases) 1, 4
- If extraction delayed, consider antibiotics for infection and continue scheduled analgesics 1