Pericoronitis Causes, Symptoms & Treatment

Evidence Based
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What is Pericoronitis?

Pericoronitis, also known as operculitis, is the inflammation of the soft tissue associated with a partially erupted tooth crown. Pericoronitis is most often swelling and infection of the gum tissue around the wisdom teeth, the third and final set of molars that erupt when people are in their late teens or 20’s. 

wisdom teeth crowding

It is seen most frequently in relation to the mandibular third molar and happens when the molar becomes partially impacted due to bacteria accumulation. Typically, the tooth is only partially exposed (partial eruption), and there is excess gum tissue overlapping the tooth.

Pericoronitis is a type of gingivitis that occurs around teeth as they are erupting into the mouth.

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Pericoronitis happens when the wisdom teeth do not have enough room to erupt through the gingival (gums). As a result, they may only partially come through the gums, which can lead to inflammation and infection of the soft tissue surrounding the wisdom tooth. Pericoronitis most commonly occurs around the lower wisdom teeth.

What Causes Pericoronitis?

Pericoronitis is caused by a tooth that has failed to come in or has only partially erupted. This partially-erupted wisdom tooth often leaves a flap of gum tissue collecting food particles and other debris, making an ideal breeding ground for bacteria to flourish. Here are some common causes of pericoronitis:

  • Practicing poor oral hygiene and not brushing and flossing or seeing the dentist regularly for checkups
  • Stress
  • Pregnancy 
  • Upper respiratory tract infections 

Symptoms of Pericoronitis

The symptoms associated with pericoronitis vary based on the severity of the infection.

Milder pericoronitis cases are referred to as acute pericoronitis, symptoms include:

  • Painful, swollen gum tissue near the erupted tooth 
  • Difficulty biting down in the area without hitting the swollen tissue
  • A bad taste in your mouth 
  • Bad breath or halitosis 
  • Loss of appetite 

The symptoms associated with more severe cases of pericoronitis: 

  • Swelling of the face
  • Swollen lymph nodes 
  • Jaw spasms 
  • Trismus, more commonly referred to as “lockjaw”
  • Numbness or tingling of the face 

Complications & Risk Factors of Pericoronitis

The more severe symptoms of pericoronitis that we overviewed in the section above are associated with an infection spreading into the throat and neck. In severe cases, this can affect a person’s breathing and swallowing functions and can even be life-threatening. An acute pericoronal abscess may develop that can stay localized or spread. 

In rare cases, complications of pericoronitis can be so severe they are life-threatening. Untreated pericoronitis can cause Ludwig’s angina, an infection that spreads under the tongue and jaw. This condition is also associated with other deep infections in the neck, throat and head.

There is also the risk that pericoronitis can spread into the bloodstream, this life-threatening condition is known as sepsis.

This is why if you start to notice any symptoms arise, you must contact your dentist as soon as possible.

How Long Does Pericoronitis Last?

Symptoms associated with chronic pericoronitis commonly may only last for a day or two but they keep coming back month after month. For acute conditions, the symptoms last three to four days.

How is Pericoronitis Treated?

The treatment options available for pericoronitis include professional and home remedies. If your case requires professional attention, your dentist will begin by flushing away accumulated food particles and debris from the affected area. Next, they will prescribe a course of oral antibiotics, usually penicillin, to help clear up the infection. 

Your dentist may also recommend an antibacterial mouth rinse that contains chlorhexidine to help fight and clear the infection. You can also dilute some hydrogen peroxide or use warm salt water as an oral rinse. Another home remedy is to use irrigators to make sure you are properly and thoroughly cleaning your hard-to-reach wisdom teeth. Irrigators clear out particles and bacteria beneath the operculum to speed up healing and prevent pericoronitis.

You can take over-the-counter pain medication like acetaminophen, ibuprofen, or pain relievers that your dentist prescribes. 

The next step in treatment depends on your wisdom tooth’s status because pericoronitis often develops near a tooth still in the process of eruption. If that’s the case, your dentist will monitor the area to make sure it stays clean and infection-free, until your wisdom tooth has fully grown in. In the case of severe symptoms, you may need to see a maxillofacial surgeon for a minor oral surgery to remove the operculum, or flap of gum tissue.

If it looks like your wisdom tooth won’t come in normally, your dentist will likely recommend extracting the tooth.

Can Pericoronitis Go Away On Its Own?

It is not likely that pericoronitis will go away on its own. In order to treat the condition immediately and properly before any chronic symptoms and conditions appear, contact your dentist as soon as you start noticing any symptoms of pericoronitis. 

Since the course of treatment can vary so much between cases, from rinsing with mouthwash to tooth extraction, it’s essential that you schedule an appointment for your dentist to examine you.

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Resources

Pericoronitis. (2017, May 17). https://www.dental.columbia.edu/patient-care/dental-library/pericoronitis

Dhonge, R. P., Zade, R., Gopinath, V., & Amirisetty, R. (n.d.). An Insight into Pericoronitis. http://www.ijohmr.com/upload/An%20Insight%20Into%20Pericoronitis.pdf

Updated on: October 20, 2020
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