i have 1 wisdom tooth that has been very painfull for 4 days.
and it is red and swollen around the gums.
does this mean it has to come out because
this is the 3rd time it has been swollen and painfull
I'm sorry your tooth is bothering you... does it need to come out? Possibly, but I think a dentist appointment should be your first order of business.
It could be that the wisdom tooth is impacted and causing you pain, or it could be that you have an abcess or infection in the gum around/under the tooth. If the gums are loose enough, there's also a possibility that maybe something (food or debris) has gotten lodged down there and it's causing it to swell and be painful. A dentist will be able to tell you, for sure, and hopefully give you something for pain (or remove the object for you/prescribe something for the infection, too, if that's what it is).
In the meantime, you can try topical ointments like Oralgel to help relieve some of the pain (dabbing it on with a Q-tip works the best for me, personally) and also over-the-counter meds like Ibuprofen, which will help with swelling (and hopefully also help relieve some of the pain); luckily, you can use both at the same time if you want!
impacted wisdom tooth are the number one cause of pericoronitis many times pericoronitis heals by itself but then appears again and again and the best treatment for healing is tooth extraction , you should go to your dentist but the best temporary treatment is keep the area clean, (it hurts but you have to keep brushing it) ,analgesics like panadol tylenol aleve(if you are not allergic to aspirin) you can use a hydrogen peroxide mouthwash or warm salt water ,if your tooth, jaw and cheek are swollen and painful, see your dentist right away. He or she can treat the infection with antibiotics