Pericoronitis Causes, Symptoms & Treatment

Pericoronitis (operculitis) is a type of gum infection that often affects people with wisdom teeth that haven’t fully erupted yet or are partially erupted. 

Although it might not seem like a problem because the tooth isn’t out yet, an impacted wisdom tooth that can’t erupt can cause a lot of problems. In this article, we’ll discuss what causes pericoronitis, its symptoms, and treatment options.

What Causes Pericoronitis?

Pericoronitis is primarily caused by poor oral hygiene, which leads to plaque buildup. If you don’t remove plaque and bacteria, an infection can develop in your mouth.

Pericoronitis most often occurs in people in their 20s. Around 81% of those affected are between 20 and 29.

Risk factors that increase the chance of developing pericoronitis include:

• Being pregnant
• Smoking
• Being stressed or fatigued
• Having a respiratory tract infection or other infection
• Taking immunosuppressive drugs, such as steroids

Why Does Pericoronitis Happen?

Sometimes, a wisdom tooth breaks through the gums just a little (partial eruption), creating an ideal space for food and plaque to accumulate.

In other cases, an impacted wisdom tooth grows at an odd angle, pressing on neighboring teeth or irritating gums. Food can get trapped under the gum flaps, leading to inflammation.

What Are the Symptoms of Pericoronitis?

The most common symptom of pericoronitis is a throbbing pain that radiates around the ear, jaw, or neck on the same side as the affected tooth.

At first, the symptoms can be mild or moderate, such as:

• Red, swollen gum tissue near the affected tooth
• Pus around the affected tooth
• Difficulty biting or chewing
• Bad breath or a bad taste in the mouth

What Are the Severe Symptoms of Pericoronitis?

When a wisdom tooth is impacted and can’t erupt fully, a flap of gum tissue sits over it. This flap can become a trap for bacteria and food particles, eventually becoming infected.

Additionally, if an infection is left untreated, it can lead to more severe symptoms, such as:

• Severe pain
• Difficulty opening the mouth
• Swelling of the affected side of the face
• Swollen lymph nodes
• Fever
• Breathing difficulties 
• Difficulty swallowing

See a dentist immediately if you have pain or other symptoms of pericoronitis. Left untreated, pericoronitis can lead to serious complications.

Risks and Complications of Pericoronitis

If pericoronitis isn't treated promptly, it can lead to serious complications, such as:

• Infection of the surrounding bone (osteomyelitis)
• Infections in other areas of the head and neck
• Abscess formation
• Bone loss
• Airway obstruction
• Mandibular nerve injuries
• Trismus (difficulty opening the mouth)

Although it’s rare, pericoronitis can lead to life-threatening complications. One of these conditions includes Ludwig’s angina, an infection that spreads under the jaw and tongue and causes difficulty breathing.

The infection may also spread into the bloodstream and cause a serious condition known as sepsis.

Treatment Options 

If your symptoms are limited to the tissue surrounding the tooth, a dentist may thoroughly clean the area, remove any food debris, and drain pus.

Dentists will prescribe antibiotics to prevent the infection from spreading. They may also recommend taking over-the-counter pain relievers like ibuprofen, naproxen, or acetaminophen (Tylenol) to reduce the pain.

Home remedies like warm salt water rinses can also help remove plaque and food debris. Once the infection resolves, the next steps will depend on your specific situation.

Sometimes, there may be room for your tooth to erupt fully, and the dentist may suggest a “watch and wait” approach.

Minor Surgery

If the pericoronitis is severe, an oral surgeon may need to perform minor oral surgery. They’ll begin by cleaning the infected tissue with a sterile solution to flush out debris around the tooth.

They may remove damaged and infected tissues with special instruments, such as curettes, to reduce the chance of the infection returning. Other surgeries include:

• Operculectomy — A procedure that involves removing the gum flap covering the tooth to make the area easier to clean. However, dentists may only recommend this procedure if the tooth is well-positioned to erupt correctly.
• Tooth extraction — If your wisdom tooth is impacted, it’ll most likely be removed. In some cases, both the wisdom teeth on the affected side must be removed to prevent molars from damaging the inflamed lower gum tissues.

At-Home Remedies for Pericoronitis

At-home remedies won’t be enough for severe pericoronitis, but these remedies can help manage symptoms. These remedies include:

• Salt water rinses
• Cold compress
• Over-the-counter pain relief

Can Pericoronitis be Prevented?

Yes, you can reduce your risk of pericoronitis by regularly brushing and flossing, especially around newly erupting teeth. This helps remove plaque and bacteria.

You can also take preemptive action by regularly visiting your dentist and getting a routine teeth cleaning. You can even make lifestyle changes to reduce your chances of pericoronitis.

These lifestyle changes include:

• Avoiding smoking
• Reducing or avoiding alcohol
• Managing your stress levels
• Maintaining a healthy diet