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Pericoronitis (or operculitis) is a type of gum infection. It most often affects people with wisdom teeth (third molars) that haven’t come in properly.
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.1
Pericoronitis can affect any erupting tooth, but most cases are due to impacted wisdom teeth. It’s most common in people in their late teens or early 20s because this is when the wisdom teeth generally erupt into the mouth.
See a dentist immediately if you have pain or other symptoms of pericoronitis. Leaving pericoronitis untreated can lead to serious complications, such as the infection spreading to your jawbone.
The main symptom of pericoronitis is pain. The pain is often throbbing and can radiate to the ear, jaw, or neck on the same side as the affected tooth.
At first, the symptoms of pericoronitis may be mild or moderate. They include:2
If the infection is left untreated, it can lead to more severe symptoms, such as:
See a dentist or doctor immediately if you have moderate or severe pericoronitis symptoms.
The primary cause of pericoronitis is poor oral hygiene. If you don't remove plaque and bacteria around newly erupting teeth properly, an infection can develop.
Unfortunately, the area can be difficult to keep clean if there isn’t enough space for those teeth to emerge completely.
Pericoronitis most often occurs in people in their 20s; around 81% of those affected are between the ages of 20 and 29.3
Risk factors that increase the chance of developing pericoronitis include:4
Once a dentist diagnoses pericoronitis, they'll recommend a treatment plan according to your specific needs.
It may be possible to wait until the wisdom tooth fully erupts. But in most cases, the dentist or an oral surgeon will need to remove the gum flap, the tooth, or both.
Dentists diagnose pericoronitis by visually examining your teeth. They’ll check for signs of inflammation or infection, such as redness, swelling, or pus. They’ll also ask you about any other symptoms you may be having.
The dentist will also take X-rays to view your impacted tooth better. They'll want to be able to rule out other causes for your symptoms, like tooth decay or periodontal disease.
If your symptoms are limited to the tissue surrounding the tooth, a dentist may:
To reduce the pain, your dentist may recommend taking over-the-counter pain relievers like ibuprofen, naproxen, or acetaminophen (Tylenol). 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.
An oral surgeon may need to perform minor oral surgery if the pericoronitis is severe. They may recommend:
A dentist may use a sterile solution to flush out debris around the tooth. They may then remove damaged and infected tissue with special instruments like curettes. This reduces the chance of the infection returning.
This means completely removing the gum flap covering the tooth. This will make the area much easier to keep clean since there will no longer be a pocket where food and bacteria can get trapped.
However, dentists may only recommend this procedure if your tooth is well-positioned to erupt properly. Extracting the tooth may be a better option if the tooth is impacted (can’t fully erupt). Otherwise, the excess gum tissue may grow back even after it’s fully removed once.
If your pericoronitis involves an impacted wisdom tooth, the most likely next step is to extract the tooth. If left in place, the tooth is unlikely to erupt properly.
In some cases, both the wisdom teeth on the affected side need to be removed. This prevents the upper molars from biting and damaging the inflamed lower gum tissue, which could worsen your symptoms.2
You can reduce your risk of pericoronitis by:
Pericoronitis often resolves once the offending tooth either erupts completely or is removed. Removing impacted wisdom teeth may also improve the health of the adjacent teeth.
Following minor surgery, your symptoms (including pain) should subside within 1 to 2 weeks.
If pericoronitis isn't treated promptly, it can lead to serious complications. These include:
Sometimes pericoronitis complications can be life-threatening, although this is rare:
Pericoronitis is inflammation of the gum tissue around a partially erupted tooth, usually a wisdom tooth. The tooth may be covered with a flap of gum tissue that can easily trap bacteria and food particles and become infected.
If pericoronitis is not treated promptly, it can lead to serious complications, such as jawbone damage or difficulty breathing.
You can reduce the risk of developing pericoronitis by maintaining good oral hygiene and regularly seeing a dentist.
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