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, this happens 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 more likely to develop around lower wisdom teeth, though it can affect upper ones, too.

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
• Facial swelling
• Swollen lymph nodes in your neck

Chronic pericoronitis symptoms may include:

• Mild, temporary achiness near your back teeth
• Bad breath
• A bad taste in your mouth

Pericoronitis causes

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

Risk factors

You’re more likely to develop pericoronitis if you:

• Are in your 20s
• Have wisdom teeth that haven’t fully erupted
• Have excess gum tissue
• Have poor oral hygiene
• Have a short-term condition that weakens your immune system (like pregnancy or stress)
• Have a long-term condition that weakens your immune system (like diabetes or an immunodeficiency disorder)

Complications of this condition

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.

It’s important to seek care early on, before things worsen.

How doctors diagnose this condition

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 the roots of your teeth and rule out other causes of pain, like cavities.

How is it treated?

Pericoronitis treatments depend on the severity of inflammation. They include:

• Dental cleaning: Your dentist irrigates the affected area to flush out any food particles, bacteria or other debris. They’ll scrape away plaque and tartar.
• 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: You may use a prescription mouthwash that contains chlorhexidine, a topical antiseptic. It destroys harmful bacteria in your mouth. It can cause side effects, like dental staining and a change in taste. But these changes are usually temporary.
• Pericoronitis removal surgery: Your dentist may remove the gum flap (operculum). This requires a short oral surgery procedure. 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 issues, wisdom tooth removal may be necessary. An oral surgeon or periodontist can perform this procedure with or without sedation.

Recovery time

Your recovery depends on 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 within a week or two.

When should I see my healthcare provider?

If you have pericoronitis symptoms — like pain, fever or bleeding gums — schedule an appointment with a dentist right away. They can do a thorough dental cleaning of the area and decide if you need further treatment.

What can I expect if I have this condition?

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 are less likely to build up there. If your wisdom teeth are causing issues, you may need to have them removed.

Will pericoronitis go away on its own?

It may. 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.

But remember, untreated pericoronitis can become serious if the infection spreads. This is why it’s important to see a dentist instead of hoping it will improve on its own.

Is there anything I can do to feel better?

To ease 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, like acetaminophen or ibuprofen, to manage discomfort.
• Practice good oral hygiene. Brush at least twice a day and floss between your teeth once daily. Use an antibacterial mouthwash twice daily.

Can this be prevented?

You can’t prevent pericoronitis altogether. Sometimes, it can occur even if you have excellent oral hygiene. But you can reduce your risk by practicing good oral hygiene. In addition to being attentive to your daily routine, see your dentist regularly for exams and cleanings.