Pericoronitis: Symptoms, Causes, Surgery, Home Treatment: Antibiotics Removal Mouthwash and Pictures

Pericoronitis is a common dental medicine condition affecting the soft tissue surrounding partially erupted teeth, particularly the lower wisdom teeth. Characterized by acute symptoms and potential complications, pericoronitis requires careful management by dental professionals, including an oral and maxillofacial surgeon if necessary.

Key Facts

• Pericoronitis is a dental condition where the gum tissue surrounding the crown of a tooth, typically a wisdom tooth, becomes swollen and infected
• It’s mainly caused by the partial eruption of a tooth, creating a flap of gum tissue where food particles and bacteria can accumulate
• Common symptoms include pain, redness, and swelling in the gum tissue behind the molars, difficulty in opening the mouth, and bad breath
• Treatment options range from oral hygiene instruction and medication to surgical intervention in severe cases
• Pericoronitis usually affects young adults in their late teens or early twenties, as this is the age when the wisdom teeth typically start to emerge

It’s most common in the lower wisdom teeth, which are the third and final set of molars that typically emerge in the late teens or early 20s.

What is Pericoronitis?

Pericoronitis is an oral health condition characterized by the inflammation and infection of the gum tissue surrounding the crown of a tooth. This condition most commonly affects the wisdom teeth, also known as third molars, which are the last to erupt, usually in late adolescence or early adulthood.
When a wisdom tooth does not have enough space to fully emerge, it may only partially break through the gum. This creates a small flap of gum tissue next to the tooth, known as an operculum, where food particles and bacteria can become trapped. The accumulation of debris under this flap is what often leads to the infection and inflammation characteristic of pericoronitis.
There are two types of pericoronitis: acute and chronic. Acute pericoronitis refers to the sudden onset of inflammation often accompanied by severe pain, while chronic pericoronitis can involve mild persistent inflammation and discomfort over a long period.

How Does Pericoronitis Affect My Oral Health?

Pericoronitis can have several effects on oral health:

• Pain and Discomfort: The inflammation of the gum tissue can cause significant pain and discomfort, making it difficult to eat (chewing or swallowing) and sometimes to open the mouth (when the condition is severe). Chronic pericoronitis can lead to persistent discomfort and may affect your overall oral health if left untreated.
• Infection Spread: If not treated, the infection can spread to other areas of the mouth and even to the neck and cheeks.
• Tooth Decay: The accumulation of food particles and bacteria can also lead to tooth decay in the affected tooth or adjacent teeth.
• Bad Breath (Halitosis) and Taste Alteration: The accumulation of bacteria and pus can cause bad breath and a foul taste in the mouth.

If the infection spreads, it could potentially lead to more serious complications such as cellulitis or abscess formation, and in very rare cases, a severe infection called Ludwig’s angina, which is a medical emergency.

How Common Is It and Who Does It Affect?

Pericoronitis primarily affects young adults, usually in their late teens or early twenties, as this is the age range in which the wisdom teeth typically emerge. It can occasionally affect older individuals if the wisdom teeth emerge later in life. The condition is relatively common among people whose wisdom teeth are coming in, especially if there is not enough space in the jaw for the teeth to emerge fully.
While everyone who has an emerging wisdom tooth is at risk, certain factors can increase the likelihood of developing pericoronitis:

• Poor Oral Hygiene: Inadequate brushing and flossing can contribute to the accumulation of bacteria around the emerging tooth.
• Crowded Teeth: Individuals with crowded teeth are more likely to experience impaction or partial eruption of the wisdom teeth.
• High-Carbohydrate Diet: Diets high in carbohydrates and sugars can provide a favorable environment for the bacteria that contribute to pericoronitis.

What Causes Pericoronitis?

Pericoronitis is caused by the infection and inflammation of the gum tissue surrounding a partially erupted tooth, usually a wisdom tooth.
The main causes include:

• Partial Eruption: When a tooth, commonly a wisdom tooth, doesn’t fully emerge, it creates a flap of gum tissue where food and bacteria can accumulate.
• Bacterial Infection: The accumulation of food particles and bacteria under the gum flap provides a breeding ground for bacteria, leading to infection.
• Mechanical Irritation: Sometimes, the upper wisdom tooth can bite down on the gum flap of the lower wisdom tooth during chewing, causing mechanical irritation that contributes to inflammation.

Pericoronitis Risk Factors – What Factors Could Increase My Risk of Developing It?

Several factors can increase your risk of developing pericoronitis:

• Age: Young adults in their late teens or early twenties are more at risk as this is when wisdom teeth usually emerge.
• Poor Oral Hygiene: Not brushing or flossing properly increases the risk as it allows for the accumulation of bacteria.
• Crowded or Misaligned Teeth: If the teeth are crowded or misaligned, it may hinder the proper eruption of the wisdom teeth.
• High Sugar Diet: Consuming a diet high in sugar and carbohydrates can encourage bacterial growth in the mouth.
• Tobacco Use: Smoking or using tobacco products can contribute to gum inflammation and infection.

What Are the Symptoms of Pericoronitis?

The symptoms of pericoronitis can vary depending on the severity of the infection and inflammation.
Some common symptoms include:

• Pain and Tenderness: One of the first symptoms usually noticed is pain and tenderness around the affected tooth and surrounding gum tissue. This pain can be throbbing and may worsen when biting or chewing.
• Swelling and Redness: The gum tissue around the impacted tooth may become swollen and red. In severe cases, this swelling can extend to the cheek and neck.
• Difficulty Opening the Mouth: The swelling and pain can make it difficult to open the mouth wide, a condition known as trismus.
• Bad Breath and Foul Taste: The accumulation of food particles and bacteria under the gum flap can cause a foul smell and taste in the mouth.
• Fever and Malaise: In more severe cases, the infection can lead to a fever and a general feeling of being unwell.
• Pus Discharge: Sometimes, there may be a discharge of pus from the affected gum tissue.
• Swollen Lymph Nodes: The lymph nodes in the neck may become swollen and tender due to the infection.

How is Pericoronitis Diagnosed?

The diagnosis of pericoronitis is primarily based on a clinical examination by a dentist. The dentist will assess the symptoms and perform a thorough examination of the oral cavity.
The diagnosis process includes:

• Medical History: The dentist will ask questions regarding the onset of symptoms, pain, and any history of similar episodes.
• Oral Examination: The dentist will examine the affected area for signs such as redness, swelling, pus discharge, and the presence of a gum flap around a partially erupted tooth.
• X-rays: In some cases, the dentist may take X-rays to evaluate the position of the wisdom teeth and to determine the extent of the infection.

Based on the clinical examination and X-ray findings, the dentist will diagnose pericoronitis and recommend an appropriate course of treatment.

Treatment: How Do You Treat Pericoronitis?

The treatment of pericoronitis depends on the severity of the condition. The main goals of treatment are to eliminate the infection, reduce inflammation, and prevent recurrence. Initial pericoronitis treatment involves meticulous oral hygiene to remove food debris and bacteria. Warm salt water rinses are often recommended to reduce inflammation and discomfort.
Treatment options include:

• Dental Cleaning: The dentist may clean the area under the gum flap to remove any trapped food particles and bacteria. This is sometimes done using a syringe with saline or an antiseptic solution.
• Antibiotics: If there is a severe infection, especially if it has spread beyond the immediate area of the tooth, antibiotics may be prescribed to control the infection.
• Pericoronitis Mouthwash: The dentist may recommend a medicated mouthwash that contains an antiseptic to reduce bacteria and inflammation in the mouth.
• Pain Relief: Pain relief medications such as ibuprofen or acetaminophen may be recommended to alleviate pain and discomfort.
• Pericoronitis Removal Surgery: In some cases, a minor surgical procedure to remove the gum flap (operculectomy) may be performed. This is usually done under local anesthesia and can be effective in preventing recurrent infections.
• Wisdom Tooth Removal Surgery: If pericoronitis recurs or if the wisdom tooth is impacted, the best solution may be to have the tooth extracted. This procedure is usually performed under local anesthesia, but sedation or general anesthesia may be used in some cases.

In addition to professional treatment, good oral hygiene practices including regular brushing, flossing, and the use of an antiseptic mouthwash can be helpful in managing and preventing pericoronitis.

How Can I Soothe My Symptoms with Pericoronitis Treatment at Home?

While professional treatment is essential in managing pericoronitis, there are several measures that you can take at home to soothe the symptoms:

• Saltwater Rinses: Mix half a teaspoon of salt in a glass of warm water and use it as a mouthwash. Gently swish the solution around the affected area and spit it out. This can help reduce inflammation and bacteria in the mouth.
• Cold Compress: Apply a cold compress or ice pack to the outside of your cheek for 15-20 minutes. This can help reduce swelling and provide relief from pain. Avoid applying ice directly to the skin; instead, wrap it in a cloth or towel.
• Pain Relievers: Over-the-counter pain relievers like ibuprofen or acetaminophen can help alleviate the pain. Be sure to follow the dosage instructions on the label.
• Maintain Oral Hygiene: Continue to brush and floss regularly, but be gentle around the affected area to avoid further irritation.
• Avoid Irritants: Avoid consuming hot, spicy, or crunchy foods, as they may irritate the affected area. Opt for soft and bland foods to reduce irritation.

How Can I Prevent Pericoronitis?

To prevent pericoronitis, it is important to focus on maintaining good oral hygiene and taking steps to address the factors that contribute to the condition:

• Regular Dental Check-ups: Regular visits to the dentist can help in early detection of problems with the wisdom teeth and gum health.
• Oral Hygiene: Brushing twice a day, flossing daily, and using an antiseptic mouthwash can help keep the mouth clean and reduce the risk of infections.
• Address Impacted Teeth: If you have impacted wisdom teeth or other dental issues that increase the risk of pericoronitis, discuss with your dentist whether extraction or other treatments are appropriate.
• Avoid Tobacco Products: Tobacco use can contribute to gum infections and should be avoided.

By following these preventive measures and seeking timely dental care, you can significantly reduce the risk of developing pericoronitis.

How Long Does Pericoronitis Last?

The duration of pericoronitis can vary depending on several factors, including the severity of the infection, the effectiveness of the treatment, and individual healing capabilities. With appropriate treatment, mild cases of pericoronitis may resolve within a few days. However, more severe cases or those with complications might take longer to heal, possibly up to two weeks or more. If the underlying cause, such as an impacted wisdom tooth, is not addressed, pericoronitis may recur.

What Can I Expect If I Have Pericoronitis?

If you have pericoronitis, here’s what you can typically expect:

• Initial Symptoms: The initial symptoms usually include pain and discomfort around the affected tooth, usually a wisdom tooth. This can be accompanied by swelling, redness, and difficulty in opening the mouth.
• Professional Care: Seeking care from a dentist is important. Your dentist will likely recommend treatments such as cleaning the area under the gum flap, prescribing antibiotics if there’s an infection, and suggesting pain relievers for comfort.
• Follow-up and Monitoring: Depending on the severity, your dentist may schedule follow-up appointments to monitor the healing process. If pericoronitis is recurrent or the tooth is impacted, discussions regarding the removal of the gum flap or tooth extraction may take place.
• Home Care: You’ll need to follow good oral hygiene and may need to use saltwater rinses and take pain relievers. Your dentist may also prescribe a medicated mouthwash.
• Dietary Adjustments: During the healing process, you may need to modify your diet by consuming soft and bland foods and avoiding irritants such as spicy or crunchy foods.

Will Pericoronitis Go Away on Its Own?

Pericoronitis does not typically go away on its own, especially if it is caused by an impacted tooth or poor oral hygiene. While some of the symptoms such as pain and swelling may temporarily subside, the condition can reoccur if the underlying cause is not addressed. It’s important to seek dental care to properly manage and treat pericoronitis. In cases where the infection is due to an impacted tooth, surgical intervention might be necessary to prevent recurrent episodes.

Is Pericoronitis Serious?

The seriousness of pericoronitis varies depending on the severity and how it’s managed. In mild cases, where it’s treated promptly, pericoronitis can be resolved without serious complications. However, if left untreated, it can become serious. The infection can spread, leading to severe pain, swelling, and in rare cases, the infection can spread to other parts of the neck and head. This can be a serious health risk and requires immediate medical attention. It is crucial to take pericoronitis seriously and seek dental care at the onset of symptoms.

What are the complications of pericoronitis?

If left untreated, pericoronitis can lead to serious complications. The infection can spread to the cheeks and neck causing cellulitis, or form a more localized abscess. In rare cases, it can lead to a serious, life-threatening infection called Ludwig’s angina, which can cause difficulties in breathing.

Do I Need to See a Dentist for Pericoronitis?

Yes, it is essential to see a dentist if you suspect that you have pericoronitis. Since pericoronitis involves infection and inflammation around a partially erupted or impacted tooth, professional dental care is necessary to properly diagnose and treat the condition. A dentist can provide the appropriate treatment, which may include cleaning the affected area, prescribing antibiotics, and advising on pain management. In recurrent or severe cases, a dentist can also discuss surgical options such as removal of the gum flap (operculectomy) or extraction of the impacted tooth.

Is Pericoronitis Contagious?

Pericoronitis itself is not contagious, as it is an inflammation and infection of the gum tissue surrounding a partially erupted tooth. However, the bacteria causing the infection can be transmitted through saliva. It’s important to note that even if the bacteria are transmitted, the other person will not necessarily develop pericoronitis. The development of pericoronitis is mainly dependent on oral health factors, such as the eruption of wisdom teeth and oral hygiene practices.

What Is The ICD-10 Code For Pericoronitis?

ICD-10 Code For Pericoronitis is: K05.3 Chronic periodontitis. This code is applicable to these conditions:

• Chronic pericoronitis
• Complex periodontitis
• Periodontitis NOS
• Simplex periodontitis

Bottom Line

Pericoronitis is a dental condition that involves the inflammation and infection of the gum tissue surrounding a partially erupted or impacted tooth, usually a wisdom tooth. It is characterized by pain, swelling, and sometimes difficulty in opening the mouth. While there are measures you can take at home to alleviate the symptoms, seeing a dentist for professional diagnosis and treatment is crucial. Without proper treatment, pericoronitis can recur and may lead to complications. Maintaining good oral hygiene, having regular dental check-ups, and seeking prompt dental care at the onset of symptoms are key in managing and preventing pericoronitis effectively.

This article is complete and was published on June 4, 2023, and last updated on December 20, 2023.