What is actually happening
A wisdom tooth that has come through only partway leaves a flap of gum over part of the crown. Food and bacteria collect underneath it, in a space no toothbrush reaches, and the gum around it becomes infected. That is pericoronitis, and it is the reason most wisdom teeth start hurting.
It has a characteristic pattern: it builds over a couple of days, it is worse when you are run down or short of sleep, the muscles around the jaw tighten so opening becomes difficult, and the taste is unmistakable. It often flares, settles for a few weeks, then flares again slightly worse.
What to do tonight
Warm salt water, repeatedly
A teaspoon of salt in a glass of warm water, held over the area and released, several times. This is genuinely the most useful thing available at home for this specific problem.
Keep the area as clean as you can manage
Brush the area gently even though it is sore. Most of the pain is coming from what is trapped under the gum flap.
Your usual painkiller, at the packet dose
It will take the edge off. It will not clear what is trapped underneath, which is why this comes back.
Soft food, nothing that lodges
Avoid rice, seeds, crisps and anything that will find its way under the flap.
Call if you cannot open, or the face is swelling
Difficulty opening the mouth and swelling that is spreading move this from uncomfortable to urgent. See the abscess page.
Why the extraction is not done at three in the morning
A wisdom tooth extraction is a planned procedure. It needs a proper X-ray assessment of where the roots sit relative to the nerve in the lower jaw, an unhurried appointment, and a patient who has eaten, is not exhausted, and has someone to go home to. None of that describes three in the morning.
So the emergency visit does the part that is urgent: the area is cleaned and irrigated under the flap, the infection is treated, and the pain is settled. The extraction, if it is needed at all, is then planned properly for a normal appointment. Anyone offering to take a wisdom tooth out on the spot at three in the morning is doing you no favours.
Not every painful wisdom tooth needs removing. Some settle permanently once cleaned, particularly if the tooth is upright and has room to come through fully. The X-ray answers that question.
What the visit involves
Prices are published in advance: consultation AED 500, X-ray AED 175 to 550, emergency appointment AED 1,500 to 2,500 all in.