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Pericoronitis

Overview

What is pericoronitis?

Pericoronitis is swelling of the gum tissue around your wisdom teeth. Sometimes called third molars, your wisdom teeth are the last set of adult teeth to erupt (grow in) — usually in your late teens or early 20s.

Pericoronitis may develop around one or more wisdom teeth. It typically happens when a tooth is still partially impacted (trapped) under the gum tissue. The condition is also more likely to develop around lower wisdom teeth, though it can affect upper ones, too.

How does pericoronitis affect my oral health?

If you have an impacted wisdom tooth, a gum flap can form over the top of it. This flap — called an operculum — usually covers part of your tooth crown. Food, bacteria and debris can get trapped underneath the operculum and cause infection.

How common is it and who does it affect?

A common dental condition, pericoronitis can affect anyone with wisdom teeth. But the condition is most common in people aged 20 to 29. It affects all sexes equally.

Symptoms and Causes

What are the symptoms of pericoronitis?

Pericoronitis may be acute (short-term) or chronic (long-term).

Acute pericoronitis symptoms may include:

  • Fever.
  • Severe pain around your back teeth.
  • Redness and swelling of your gum tissue.
  • Pus or drainage.
  • Discomfort when swallowing.
  • Lockjaw (trismus).
  • Facial swelling.
  • Swollen lymph nodes in your neck.

Chronic pericoronitis symptoms may include:

  • Mild, temporary achiness near your back teeth.
  • Bad breath (halitosis).
  • A bad taste.

What causes pericoronitis?

Partial tooth impaction is the main pericoronitis cause. When a tooth is partially trapped in your gums, bacteria can build up and lead to swelling and inflammation.

What factors could increase my risk of developing it?

You’re more likely to develop pericoronitis if you:

  • Are in your 20s.
  • Have wisdom teeth that haven’t fully erupted.
  • Are under a lot of stress.
  • Have excess gum tissue.
  • Are pregnant.
  • Have poor oral hygiene.

Is pericoronitis contagious?

Pericoronitis itself isn’t contagious. But the bacteria that cause it can spread to others through saliva. Therefore, someone with pericoronitis could transmit infection by kissing or sharing cups and eating utensils.

Diagnosis and Tests

How is pericoronitis diagnosed?

Your dentist will ask about your symptoms, examine your wisdom teeth and check for excess gum tissue in the area. They’ll probably take dental X-rays to check the health of your teeth roots and rule out other causes of pain, such as cavities.

Management and Treatment

How do you treat pericoronitis?

Pericoronitis treatment varies for each person. Depending on the severity of inflammation, your dentist may recommend cleaning the area, antibiotics, pericoronitis mouthwash, pericoronitis removal or wisdom teeth removal.

Dental cleaning

Your dentist irrigates the affected area to flush out any food particles, bacteria or other debris. They may also prescribe medications, such as antibiotics or an antibacterial mouthwash.

Antibiotics

Oral antibiotics can help clear up a pericoronitis infection. Be sure to take any medications exactly as directed by your healthcare provider.

Pericoronitis mouthwash

Your dentist may recommend using a prescription mouthwash that contains chlorhexidine, a topical antiseptic. It helps destroy harmful bacteria in your mouth.

People who use chlorhexidine rinses may develop temporary side effects, such as a change in taste or dental staining. These side effects are typically short-lived. Be sure to follow the instructions provided by your dentist.

Pericoronitis removal surgery

In many cases, your dentist may recommend removing the gum flap (operculum). This requires a short oral surgery procedure. Sedation is available, but often unnecessary. Typically, your provider can complete this procedure with local anesthesia in less than one hour.

Wisdom tooth removal surgery

If your wisdom tooth continues to cause pericoronitis and other problems, wisdom tooth removal may be necessary. An oral surgeon or periodontist can perform this procedure with or without sedation.

How can I soothe my symptoms with pericoronitis treatment at home?

To ease your pericoronitis symptoms at home, you can:

  • Rinse your mouth with warm saltwater three to four times a day.
  • Swish with an alcohol-free, antibacterial mouthwash twice a day.
  • Take over-the-counter pain relievers, such as acetaminophen or ibuprofen, to manage discomfort.
  • Practice good oral hygiene. Brush at least twice a day and floss between your teeth once daily.

How long does pericoronitis last?

It depends on the situation and the severity of your condition. For instance, mild cases of pericoronitis may last a few days, while severe cases can last several weeks.

With treatment, pericoronitis usually goes away in a week or two. Left untreated, however, your symptoms will likely return.

Prevention

How can I prevent pericoronitis?

You can’t prevent pericoronitis altogether. Sometimes, it can occur even if you have excellent oral hygiene. But there are ways to reduce your risk:

  • Brush your teeth two to three times a day.
  • Floss between your teeth once a day.
  • Use an antibacterial mouthwash twice daily.
  • Visit your dentist regularly for exams and cleanings.
  • Follow your dentist’s treatment recommendations.

Outlook / Prognosis

What can I expect if I have pericoronitis?

If you have pericoronitis, your dentist will talk with you about your treatment options. They may monitor your condition if your symptoms are mild. Or they may clean the area and prescribe antibiotics.

Severe cases usually require surgery. If your wisdom teeth are otherwise healthy, they may recommend surgery to remove the gum flap (operculum) so bacteria is less likely to accumulate there.

If your wisdom teeth are problematic, you may need to have them removed. This common oral surgery procedure usually takes about an hour to complete, and recovery typically lasts a week or two.

Will pericoronitis go away on its own?

Sometimes, pericoronitis occurs temporarily as a wisdom tooth is erupting. In these cases, your dentist might monitor your condition to see if it goes away on its own.

If your wisdom teeth continue to cause problems, though, your dentist will talk with you about your treatment options.

Is pericoronitis serious?

Left untreated, pericoronitis can develop into an abscess. When this happens, infection can spread to other parts of your body. In severe cases, it can even be life-threatening.

With treatment, people usually recover from pericoronitis in a week or two. It’s important to seek care early on, before things worsen.

Living With

Do I need to see a dentist for pericoronitis?

Yes. If you develop pericoronitis symptoms — such as pain, fever or bleeding gums — schedule an appointment with a dentist right away. They can prescribe antibiotics to clear up any infection and determine if further treatment is necessary.

 
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