Pericoronitis is a dental condition that involves the inflammation of the gum tissues surrounding the crown of a tooth, and it usually occurs in a partially erupted or impacted tooth. The tooth usually affected is the mandibular 3rd molar or wisdom tooth that erupts in most people in their late teens or early twenties. People between the ages of 17 to 24 years are commonly affected by pericoronitis. Most infections near the wisdom tooth might possibly be pericoronitis.
The partially erupted or impacted mandibular 3rd molar is the most common site of pericoronitis. The space between the crown of the tooth and the overlying gingival flap is an ideal area for the accumulation of food debris and bacterial growth. Even in patients with non-clinical signs or symptoms, the gingival flap is often chronically inflamed and infected, and has varying degrees of ulceration along its inner surface. Acute inflammatory involvement is a constant possibility.
What Are the Types of Pericoronitis?
Pericoronitis may be acute, sub-acute, or chronic.
Acute pericoronitis is when there are associated symptoms such as fever, swelling and severe pain which may indicate a spreading infection.
Chronic pericoronitis is a mild persistent inflammation of the area. It can also be recurrent in cases where there have been 2 or more acute episodes within a 2-year period.
Pericoronitis is normally caused by a mixture of bacterial species present in the mouth, and these can be brought on by:
- Food debris getting trapped beneath the gum over the partially unerupted tooth e.g wisdom tooth, and then causing an infection by the actions of these bacteria on the food debris.
- Trauma from the opposing tooth biting down on top of the affected tooth.
- Bad oral hygiene.
What Are the Signs and Symptoms of Pericoronitis?
Some of the signs and symptoms of pericoronitis are as follows:
- Oral and dental infections
- Swelling in the gum tissue (caused by an accumulation of fluid)
- A bad taste in the mouth (caused by pus leaking from the gums)
- Halitosis or bad breath
- Dysphagia (difficulty in swallowing)
More severe symptoms include:
- Swollen lymph nodes under the chin (the sub-mandibular nodes)
- Difficulty opening the mouth
- Swelling on the affected side of the face
How is Pericoronitis Diagnosed?
Pericoronitis is diagnosed normally through a clinical oral examination. There might be inflamed gum tissue in the area of the affected tooth which is partially or totally unerupted. The gums may be red, swollen or draining fluid/pus.
How Can Pericoronitis Be Prevention?
It can be prevented by practising good oral hygiene on any erupting wisdom tooth to make sure that food particles and bacteria do not accumulate under the gums. It can also be achieved by removing impacted 3rd molars before they erupt into the mouth.
What is the Treatment for Pericoronitis?
The particular treatment procedures applied to pericoronitis usually depend on the severity of the condition. Some of the treatment options are:
- Management of pain and resolving of the infection, usually by taking painkillers such as Acetaminophen, Ibuprofen, etc.
- Draining of the area if pus is present.
- Cleaning/washing the affected area with Chlorhexidine to remove trapped food particles.
- Taking antibiotics to reduce the infection/fever e.g penicillin, erythromycin, etc.
- Minor surgery to remove the overlapping gum tissues (operculectomy). This will allow better access to properly clean the area and prevent accumulation of bacteria and food debris.
- Removal of the tooth is a common treatment method.
Some alternative home treatments that may be effective include:
- Thorough and gentle brushing of the area to break up plaque or trapped food.
- Rinsing with warm salt water can help soothe the area.