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Pericoronitis: Types, Causes, Signs and Symptoms, Diagnosis, Treatments and Prevention

Pericoronitis: Types, Causes, Signs and Symptoms, Diagnosis, Treatments and Prevention
Pericoronitis with pus (Wikimedia Commons)

Around 17 to 25 years old, our third and final set of teeth erupts called wisdom teeth.

Unlike our primary and permanent teeth, this last set of molars do not form in the womb.

Wisdom teeth develop in one of these five ways:

  1. Vertical or correct
  2. Mesioangular or crooked toward the front of the mouth
  3. Distoangular or crooked towards the back of the mouth
  4. Horizontal or at 90-degree angle laying on its side
  5. Failure to completely break through the gums

When the wisdom tooth fails to erupt entirely, it can lead to pericoronitis.


Contents:


What is pericoronitis?

Pericoronitis is an oral-related problem that often affects the third set of molars or wisdom teeth.

Also, colloquially referred as the “wisdom tooth infection,” pericoronitis is the inflammation of the soft tissues around the crown area of a partially erupted tooth where the gingival tissue overlays the chewing surface of the tooth.

The dental problem can either be persistent or severe.


What are the different types of pericoronitis?

  • Chronic pericoronitis is a mild inflammation of the infected area with minor symptoms or no symptoms at all.
  • On the one hand, acute pericoronitis is characterized by intensified, wide-range symptoms like fever, swelling, and pain, which indicate the spread of the infection.

What leads to pericoronitis?

Although differentiated with periodontitis such that it occurs around a partially erupted tooth that has not emerged from the overlying gum, the cause of pericoronitis is the same to the development of a gum abscess in gum disease which is the ensnarement of food particles beneath the gum tissue.

The partial eruption of the wisdom tooth allows an opening for bacteria to enter around the tooth and for food particles to get stuck. Because of the entrapment of debris in the space between the tooth and the overlapping gum flap called an operculum, bacteria build up and lead to the formation of an abscess under the operculum or operculitis.

If not treated, the infection can expand to other soft tissues, irritate the gums, and eventually lead to pericoronitis.

When pericoronitis becomes severe, the inflammation can reach the jaw, cheeks, and the neck.


What increases the likelihood of pericoronitis?

Because the condition usually affects the wisdom teeth, people in their mid-20s who are likely to develop their wisdom tooth are more susceptible to get pericoronitis.

Also, the presence of excess gingival tissue overlapping the wisdom tooth heightens the risk of pericoronitis.

Wisdom teeth, which are located at the back of the mouth, are also difficult to reach, making proper cleaning challenging. Because of this predicament, the area can be more vulnerable to bacteria that can infect the partially erupted tooth and the overlying gum.


What are the signs and symptoms of pericoronitis?

Signs and symptoms of pericoronitis vary in severity and include:

  • Pain that can radiate to other parts of the oral cavity like the ear, throat, floor of the mouth, the temporomandibular joint or TMJ, and the posterior submandibular region. As the condition worsens, the pain can become severe and disturb sleep and bite.
  • Gum swelling due to fluid accumulation, as well as, redness and tenderness.
  • A bad taste in the mouth due to the leaking of pus from the gums
  • Lymph nodes in the neck are swelling
  • Opening the mouth and jaw, and swallowing become difficult
  • Bad breath or halitosis
  • Fever
  • Loss of appetite

How is pericoronitis diagnosed?

The dental condition can be diagnosed through the occurrence of symptoms and clinical evaluation.

A dental X-ray is used to determine the position of the wisdom tooth and access the condition of your mouth, along with your symptoms. Other causes of pain and inflammation must be ruled out before making a pericoronitis diagnosis.

Any licensed dentist is qualified to treat pericoronitis, but when the condition requires surgery, an oral surgeon may be tapped. For severe and complicated cases, a gum specialist called a periodontist is more qualified to provide treatment.


How is pericoronitis treated?

Treatment of pericoronitis includes pain and inflammation management, surgery, and wisdom tooth extraction.

When symptoms of pericoronitis are noticed, visit your dentist immediately for proper diagnosis. Your dentist can prescribe antibiotics, as well as, pain relievers like aspirin or ibuprofen.

But, if the pain and inflammation become intense and challenging to manage, undergoing an oral surgery may be your best option to remove the gum flap. Removing the gum flap allows you to access the area and properly clean it to prevent bacteria build-up and food particles from lingering. However, the gum tissue may grow back and lead to the same condition.

Another option and the most common is wisdom tooth extraction. Because wisdom tooth is often poorly positioned or do not erupt entirely, many individuals opt to get them remove. It is also recommended to extract an impacted wisdom tooth to prevent pericoronitis.

Severe symptoms of pericoronitis can call for dental emergency especially when the pericoronal abscess is rapidly spreading, and the lymph nodes are swelling.

We at Hawaii Family Dental welcome patients for dental emergencies. Our emergency dentist will relieve you from pain and save you from worsening conditions that may call for more extensive and expensive dental procedures.


What home remedies can you do for pericoronitis?

Proper oral hygiene remains to be the best home remedy you can do for mild indications of pericoronitis. Thoroughly and gently brush your teeth to remove plaque and food. You can use oral water irrigators to clear out particles and bacteria beneath the operculum.

To soothe the inflamed area, you can rinse with warm salt water or with diluted hydrogen peroxide to lessen the bacteria.

However, when symptoms are severe, seek proper care from the right healthcare professionals.


What is the prognosis for pericoronitis?

With proper care and treatment, pericoronitis can be managed or treated. Depending on the severity, the dental condition can last for days or weeks but can be resolved in around a week or two with treatment.

It is recommended to address symptoms as early as possible to avoid complications from occurring like Ludwig’s angina and sepsis which are life-threatening.


How can pericoronitis be prevented?

Like most dental problems, pericoronitis can also be prevented. We recommend conscientious oral hygiene like brushing, flossing, and rinsing with mouthwash to prevent the accumulation of bacteria and the lingering of food particles that can lead to infection.

We also suggest visiting the dentist at least twice a year to help identify dental problems early before they worsen. Your dentist can check the development of your wisdom teeth and determine the need for extraction.


Disclaimer: The oral health information published on this web page is solely intended for educational purposes. Hawaii Family Dental strongly recommends to always consult licensed dentists or other qualified health care professionals for any questions concerning your oral health.

References:

  • https://www.webmd.com/oral-health/guide/pericoronitis
  • https://www.medicinenet.com/pericoronitis/article.htm
  • https://www.sciencedirect.com/topics/medicine-and-dentistry/pericoronitis

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