What is Pericoronitis

Pericoronitis is inflammation of the gum that surrounds a tooth that has not come all the way through the gum (partially erupted or impacted). It often occurs when food particles are trapped in the area between the gum and the tooth and bacteria cause an infection.

Pericoronitis usually affects the bottom wisdom teeth. Wisdom teeth are also called third molars. These are the last teeth to erupt, usually when people are 17–21 years old. Pericoronitis is most common in people in their 20s.

Pericoronitis may start suddenly (acute) and can cause pain and swelling. The infection can also spread to the soft tissues around the tooth and lower jaw.

What are the causes?

This condition is usually caused by the bacteria that normally live in your mouth (anaerobic bacteria).

What increases the risk?

The main risk factor for pericoronitis is a wisdom tooth that is coming in slowly or sideways. Other risk factors include:

• Poor dental care (oral hygiene).
• An upper molar that irritates the lower molar when chewing (occlusal trauma).
• Gum disease (gingivitis).
• Lowered resistance to infection. Illness and pregnancy are among possible causes of this.

What are the signs or symptoms?

Symptoms of this condition may include:

• Pain.
• Redness and swelling of the gum.
• Swelling of the cheek or jaw.
• Bad breath.
• Bad taste in the mouth.
• Fever.
• Stiff and painful jaw movement (trismus).

How is this diagnosed?

This condition may be diagnosed based on your symptoms. You will also have a dental exam, which may include X-rays.

How is this treated?

Treatment of acute pericoronitis may include:

• Injecting numbing medicine and germ-killing solution into the infected area. The gum area over the tooth is then opened to flush out pus, bacteria, and trapped food particles (debris).
• Grinding down an upper tooth that is causing occlusal trauma.
• Giving oral antibiotic medicine.

If you have pericoronitis that keeps coming back, you may need to have the affected wisdom tooth removed (extracted).

Follow these instructions at home:

• Take over-the-counter and prescription medicines only as told by your health care provider.
• If you were prescribed an antibiotic medicine, take or apply it as told by your health care provider. Do not stop taking the antibiotic even if you start to feel better.
• Do not use any products that contain nicotine or tobacco, such as cigarettes and e-cigarettes. If you need help quitting, ask your health care provider.
• Eat soft foods until pain and swelling have gone away.
• Gargle with a salt-water mixture 3–4 times a day or as needed. To make a salt-water mixture, completely dissolve ½–1 tsp of salt in 1 cup of warm water. You may also use a mouthwash that is recommended by your health care provider.
• Practice good oral hygiene by flossing and brushing daily.
• Keep all follow-up visits as told by your health care provider. This is important.

Contact a health care provider if you have:

• Pain or swelling in your gum or jaw.
• A fever.
• A constant bad taste in your mouth or bad breath.

Get help right away if you have:

• Swelling in your mouth or jaw that makes it hard to swallow or breathe.

Summary

• Pericoronitis is inflammation of the gum that surrounds a tooth that has not come all the way through the gum.
• Pericoronitis occurs when food particles and bacteria cause an infection in the area between the gum and the tooth.
• Treatment depends on the cause, but it may include using medicines, grinding down an upper tooth that is irritating a lower tooth, or removing the tooth.
• Follow your health care provider’s instructions for caring for your tooth. These may include taking medicines, eating soft foods, brushing gently, and knowing when to contact your health care provider.