Pericoronitis is a common problem in young adults with partial tooth impactions. It usually occurs within 17 to 24 years of age as it is when the third molars start erupting. It occurs when the tissue around the wisdom tooth has become inflamed because bacteria have invaded the area. Poor oral hygiene and mechanical trauma on nearby tissue can cause this inflammation. However, it can be impossible to effectively brush the necessary area and prevent this from occurring due to a partially erupted tooth. Food impaction and caries (tooth cavity) are also problems associated with third molar pain. The pain caused can be extreme.
What Causes Pericoronitis?
Pericoronitis can develop when wisdom teeth only partially erupt (break through the gum). This allows an opening for bacteria to enter around the tooth and cause an infection. In cases of pericoronitis, food or plaque (a bacterial film that remains on teeth after eating) may get caught underneath a flap of gum around the tooth. If it remains there, it can irritate the gum and lead to pericoronitis. If the pericoronitis is severe, the swelling and infection may extend beyond the jaw to the cheeks and neck.
Treatment for minor symptoms of pericoronitis (spontaneous pain, localized swelling, purulence/drainage, foul taste) is irrigation. Major symptoms of pericoronitis (difficulty swallowing, enlarged lymph nodes, fever, limited mouth opening, facial cellulitis/infection) are usually treated with antibiotics. In most instances the symptoms will recur and the only definitive treatment is extraction. If left untreated, however, recurring infections are likely, and the infection can eventually spread to other areas of the mouth. The most severe cases are treated in a hospital and may require intravenous antibiotics and surgery.
The removal of the wisdom tooth (extraction) should occur at a time when the acute phase or "infection" is not present, as extracting this tooth during the time of the acute/painful infection can cause the infection to spread to dangerous area around the throat. Therefore, a dentist will usually clean the area and/or prescribe antibiotics and wait for it to calm down until scheduling the extraction of it.
Pericoronitis can be managed with local debridement and warm salt water rinses. It should go away in about one week. However, if the tooth does not completely enter the mouth and food and bacteria keep building up under the gum, pericoronitis will more than likely return.
Pericoronitis does not cause any long-term effects. If the affected tooth is removed or erupts fully into the mouth, the condition cannot return.
How Is Pericoronitis Diagnosed?
Your dentist will examine your wisdom teeth and how they are coming in, and see if any are partially erupted. He or she may take an dental x ray periodically to determine the alignment of the wisdom teeth. Your dentist will also take note of any symptoms such as swelling or infection, and will check for the presence of a gum flap around a wisdom tooth.